Knoxville Nurse Practitioner and Physician Assistant License Defense Attorney

Nurse practitioners (NPs) and physician assistants (PAs) play an essential role in providing health care to many patients. These medical professionals may provide treatment at urgent care centers, hospitals, and other medical practices. However, they may face scrutiny related to how they prescribe medications, document the care provided to patients, and work with physicians. A complaint from a patient, an employer, a pharmacy, or another source can lead to an investigation that could put a provider's license and livelihood in jeopardy.

The Baker Law Firm defends nurse practitioners and physician assistants who are facing disciplinary investigations and issues that could affect their licenses. Our attorney understands the rules that govern advanced practice providers in Tennessee, including prescribing laws, collaboration requirements, and documentation standards. He can provide guidance on how to respond during investigations, and he can provide the representation needed during disciplinary hearings to help a person protect their career.

Why NPs and PAs May Face Disciplinary Action

Nurse practitioners hold advanced practice registered nurse (APRN) certificates issued by the Tennessee Board of Nursing. Physician assistants are licensed by the Board of Physician Assistants. These boards may investigate practitioners and take disciplinary action based on issues related to:

Prescribing Opioids and Other Controlled Substances

Prescribing practices are some of the most common reasons for discipline for advanced practice providers in Tennessee. Prescribers are required to follow the Controlled Substance Monitoring Database Program and check the database before prescribing certain medications. Specific documentation may be required when prescribing opioids or other medications.

The Tennessee Department of Health regularly reviews prescribing data, and a board may open an investigation when a provider appears on a list of practitioners that prescribe high volumes of controlled substances. Concerns may also arise when nurse practitioners or physician assistants prescribe stimulants, combine opioids with sedatives, fail to require patients to use pain management agreements, or continue to issue prescriptions for certain patients despite warning signs of addiction or drug misuse.

Diagnosis and Treatment Decisions

A board may take action if it believes that a provider has failed to meet the proper standards of care when treating patients. Examples of concerns that could lead to investigations and discipline include misdiagnosing conditions, ordering inappropriate tests, failing to refer a patient to a physician when needed, or failing to follow up on abnormal results.

Scope of Practice

Tennessee law limits the types of treatment that NPs and PAs may provide based on their education, training, and certifications. A nurse practitioner who is certified in family practice may face discipline if they have treated other types of patients. A physician assistant who has performed procedures that are not covered by their practice agreement may face charges of practicing beyond their authorized scope.

Physician Oversight

Advanced practice providers in Tennessee will typically be required to maintain formal relationships with physicians. NPs may need to operate under a supervising physician while following written protocols. PAs are required to work with collaborating physicians. Problems may arise when physicians do not review records related to treatment, when a physician leaves a practice without a replacement, or when a physician has little actual involvement in a provider's work.

Other Patient Safety Concerns

Investigations may also involve allegations of impairment due to drugs or alcohol, violations of patient boundaries such as allegations of sexual misconduct, claims of billing fraud or falsified records, arrests for offenses such as DUI, or a provider's failure to meet continuing education requirements.

How Disciplinary Proceedings Can Affect NPs and PAs

The consequences of an investigation can have an impact on a person's entire career. Possible effects of investigations and disciplinary proceedings include:

• Practice Restrictions: A board may limit a provider's authority to write prescriptions, require close monitoring of their practice by a physician, or prohibit them from working in certain settings, such as pain clinics.
• Loss of Income: A license suspension or revocation can immediately stop a provider from working.
• Employment Problems: Employers and health systems may terminate or suspend providers who are under investigation. Records related to investigations or disciplinary action may prevent a person from being hired in the future.
• Credentialing and Reimbursement: Insurers, Medicare, and Medicaid may remove providers from their networks because of disciplinary action.
• DEA Registration: Discipline involving controlled substances may lead the Drug Enforcement Administration to review or restrict a provider's controlled substance registration.
• Reputation: Public records related to discipline against a provider may be accessible by patients, employers, and colleagues.

Frequently Asked Questions About License Defense for NPs and PAs