Re "Nurse practitioner bill advances" (Capitol & California, Aug. 14): As a surgeon, I value the important contributions of nurse practitioners in the delivery of health care.
I do have the following question regarding reimbursement for the patient care they might provide when unsupervised, if SB 491 is signed into law.
Medicare requires NPs to be appropriately supervised by doctors for a patient encounter to be billed, while Medicaid allows NPs to function independently and bill for the service.
How can busy clinics and hospitals be structured to ensure that NPs don't inadvertently provide an expanded scope of services to Medicare patients without the proper oversight?
-- John Maa, San Francisco