The regulatory landscape for nurse practitioners (NPs) varies widely by state and can be challenging to navigate. Zivian was created to handle the challenges of collaboration compliance so that you can focus on providing care. If you are an NP trying to find a collaborating physician in Mississippi, we’ve got you covered.
The state of Mississippi requires nurse practitioners to collaborate with a physician. Mississippi’s regulatory structure is Reduced Practice Authority.
In this post, we break down state regulations and key considerations for Mississippi NPs to establish a compliant collaboration with a physician.
Note: State regulations and requirements are subject to change. Always check with your state medical or nursing board to confirm the most up-to-date information.
Collaboration with a physician is required.
Yes, a collaboration agreement is required.
Contact our team to learn more about the required components of a Mississippi collaboration agreement.
View a sample of a Mississippi collaboration agreement here .
Each collaborative relationship must include and implement a formal quality assurance / quality improvement program which shall be maintained on site and shall be available for inspection by representatives of the board. This quality assurance / quality improvement program must be sufficient to provide a valid evaluation of the practice and be a valid basis for change, if any.
The quality assurance / quality improvement program must be maintained on site and must be available for inspection by representatives of the Board of Nursing.
Physicians who wish to collaborate must add the NP to their file via the Medical Enforcement and Licensure System (MELS) Online Licensure Gateway, or its successor, prior to the commencement of patient care under the agreed protocol, and must submit all required information regarding the collaboration to the board.
The NP must submit the collaboration agreement to the Board of Nursing prior to beginning to practice. Additionally, the collaboration agreement must be submitted upon renewal or reinstatement of an NP’s license.
Revisions to the collaborative agreement must be submitted to the Board of Nursing prior to implementation.
Changes or additions regarding practice sites shall be submitted to the Board of Nursing by the NP on forms supplied by the Board of Nursing. The NP may not practice at a site prior to approval by the Board.
The NP must notify the Board of Nursing immediately regarding changes in the collaborative relationship, including death, disability or relocation which would result in the NP not having a collaborative physician.
NP, physician, and backup physician.
There is no requirement.
"Physician" means any person licensed to practice medicine or osteopathic medicine in the state of Mississippi who holds an unrestricted license, whose practice or prescriptive authority is not limited as a result of voluntary surrender or legal/regulatory order, and who practices within the state of Mississippi for a minimum of twenty (20) hours per week or eighty (80) hours per month (does not include telemedicine or chart review).
Exceptions to the in-state practice requirement may be granted by the board, by and through the Executive Committee, in cases demonstrating good cause. Additionally, temporary permission may be granted by the Executive Director until the request can be heard before the Executive Committee.
The collaborating physician must designate an alternate collaborating physician for when the primary collaborative physician is unavailable. Physicians with collaborative relationships with an NP must ensure backup physician coverage when the primary collaborative physician is unavailable, which includes being outside the approved distance for Extended Mileage. The backup physician must be a signatory to the protocol. In the event securing backup coverage is not possible, the primary collaborator and the APRN may agree, via terms written in the protocol, that no patients will be seen when the primary collaborator is unavailable.
There is no requirement.
The collaborating physician must review the lesser of 10% or twenty (20) randomly selected charts of the NP every month representing the variety of patient types seen by the nurse practitioner.
The NP must maintain a log of charts reviewed that includes the identifier for the patient's charts, reviewers’ names, and dates of review.
A collaborative physician must meet face to face, either in person or via video conferencing, with each collaborative NP once per quarter for the purpose of quality assurance, and this meeting shall be documented in the same manner as chart review. The physician denoted as the primary collaborator within MELS, or, in the absence of a noted primary, the physician performing most of the chart review, is ultimately responsible for all QI requirements.
Physicians who wish to collaborate with a NP who plans or anticipates practicing in a practice setting that is more than seventy-five (75) miles away from the primary office of the collaborative physician must submit an Application to the Board of Medical Licensure and appear personally (or by telephone interview) in front of the board to obtain approval for the collaborative relationship. The facts and matters to be considered by the Board regarding any collaborative relationship shall include, but are not limited to, how the collaborating physician and NP plan to implement the protocol, compatibility of practice (e.g., specialty compatibility or day-to-day practice differences), the method and manner of collaboration, the availability of backup coverage, consultation, and referral.
This mileage restriction does not apply for primary care practices where:
The practice site must be located in Mississippi and reported to the Board of Nursing.
According to regulations, a practice site is defined as “the designated physical location in Mississippi which is the usual practice location as reported to the Board where the Board can conduct a site visit to evaluate the delivery of care by a licensee and compliance with laws and regulations regarding delivery of care by a licensee, and does not include the patient's home.”
Remote supervision is permitted, but the NP must be able to communicate reliably with the collaborating physician while practicing.
See the additional filing requirements above.
An NP cannot prescribe any medication without a good faith agreement subsequent to examination and medical indication thereof. According to regulations:
In addition, an NP who prescribes any device or medication, including controlled substances, must maintain a complete record of the patient's examination, evaluation, and treatment plan.
The Board has the authority to conduct random audits of patient records at APRN practice sites. These records shall be made available for inspection by representatives of the Board.
There are additional requirements for use of “diet medication.”
According to state regulations, “authorized APRNs may prescribe Schedules II, III, IV, or V. Application for this privilege requires an additional fee. Additionally, an application must be submitted to the Drug Enforcement Administration (DEA).”
Zivian handles all the challenges of compliance so that you can stay focused on providing great patient care.
If you are in need of a collaborating physician in Mississippi, contact us today !
Miss. Code Ann. § 73-15-20
30 Miss. Admin. Code Pt. 2630
30 Miss. Admin. Code Pt. 2840
