What must be in a Pennsylvania NP collaborative practice agreement?

A Pennsylvania NP collaborative practice agreement must include specific collaboration terms with a physician. Required elements are a predetermined emergency services plan; the physician’s immediate availability via direct communication or telecommunication; regular review of patient charts and records; and information on physician availability for referrals, review of standards of medical practice (including consultation, chart review, and drug/medical protocols within the practice setting), periodic updates in medical diagnosis and therapeutics, and cosigning records when necessary¹².

For NPs with prescriptive authority, a separate prescriptive authority collaborative agreement is required. It must identify the collaborating physician(s) and at least one substitute physician (with license numbers), the CRNP’s specialty, the categories of drugs the CRNP may prescribe or dispense, how often and under what circumstances the physician will personally see patients, and the amount of professional liability insurance covering the CRNP³. This prescriptive authority agreement is distinct from the general collaborative agreement².

Prescriptive authority agreements must be reviewed and updated at least every two years or whenever changed⁴, be available for inspection upon request, and any updates or termination must be reported to the Board with amended agreements filed when appropriate⁵.