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Prescriptive Authority

Lori is a newly certified nurse, and with one physician in the clinic, she is likely to need the ability to give prescriptions. Being a primary care nurse calls for the ability to create a relationship of trust with the patient and make decisions on the care of the patient including medication.

States have different requirements with regards to acquiring prescriptive authority. Montana requires prescribers to be licensed separately under the professional law before giving prescriptions to ensure patients are accorded quality primary care. Lori would be needed to apply for authority under Schedule III-V of controlled substances and Schedule II that handles controlled substances in situations of emergency. She would be required to pay a fee of $100 as the application fee. In addition, she will provide evidence that she has completed a course in advanced pharmacology, making a diagnosis, and management of disease that takes three semesters. Each year she would pay a renewal fee of $75 annually (Buppert, 2014).

Application to the Drug Enforcement Authority (DEA) is the responsibility of the Federal Government. It is granted on approval by the State of the status of prescriptive authority. The requirement is meant to manage the illegal distribution of drugs by filing a form available online and obtaining a unique DEA number. The number provided for Lori would facilitate investigation to prevent illegal use of drugs by health practitioners. The process takes up to 6 days once Lori fills the form entirely, with a signature and a date. A three-year non-refundable fee of $551 would have to be enclosed with the application in cash, personal check or provision of card details. The fee was reviewed from $390 in 2012 (Nagelkerk, 2006).


Article: Coding Trends of Medicare Evaluation and Management Services (Levinson, 2012)

The article introduces a real issue that Medicare payments have been on the rise. Through evaluations, the authors established that there were incorrect payments as the system is open to fraud, especially through inaccurate documentation (Levinson, 2012).

The study was done through analysis of records provided by various beneficiaries for medics charging higher fees for ten years from the year 2001-2010. Quality standards were followed for evaluation to ensure integrity and efficiency. It is evident from the study that there is an increased billing on evaluation and monitoring (E/M) codes. It has been particularly evident during second inpatient visits where the billing was increased. The article recommends training of medics on billing to prevent such occurrences and enforcement of rules and regulations on charging based on services provided. It is fundamental for Medicare to facilitate review through reports showing trends in billing to prevent improper billing (Levinson, 2012).

Medicare provides for all services including E/M, but they have to be necessary and reasonable for the condition that an individual is being treated. It is wrong for physicians to bill Medicare for more expensive codes in situations where lower level codes that are less expensive could have been used. Reimbursement would be prohibited if the information required was missing (Levinson, 2012). It means that nurses working independently or collaboratively have a responsibility to correctly document information as the requirements are not limited to either of the practices.

It is ethically wrong to benefit in the medical field at the expense of other people. The article highlights that names of over 1700 physicians would be taken to advisory committees to take appropriate action against such individuals. It is a key challenge balancing between the cost of investigations and higher fees paid by Medicare (Levinson, 2012).                        

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