California Association for Nurse Practitioners

RESOURCES

Frequently Asked Questions

Membership FAQs

Why should I become a member?

When you join CANP, you enter a close-knit community where information and ideas are freely exchanged, helping members stay at the top of their profession and play a powerful role in health care today.

How do I renew my membership?

You can renew your membership by any of the following methods:

  • Under the My Account section, click "Renew" and complete the renewal form
  • Click the renew link under the membership tab
  • Download an application and mail to CANP 1415 L Street, Suite 1000 Sacramento, CA 95814
     
Once I’m a member, how do I become involved?

First and foremost, contact your local chapter. Most members are involved at the local level, where chapters typically conduct monthly meetings that provide valuable networking opportunities. You’ll definitely want to attend the Annual Educational Conference, CANP’s premier annual event. Are you looking to help influence the direction of the association? There are many opportunities for you to get involved at the leadership level. You could participate on a committee, become a representative at the House of Delegates, even become a member of the board of directors. While all members are encouraged to get involved, your level of engagement is entirely up to you. 

There’s a lot of emphasis on “advocacy.” What does that mean for me?

CANP has a long history of being actively engaged in the legislative process, educating legislators and policy makers about the role NPs play in California's health care delivery system and protecting and expanding NP practice. Through its advocacy efforts, CANP helps thousands of nurse practitioners speak as one, providing a collective voice in the State Capitol.

How does CANP help me earn continuing education credits?

Our Annual Educational Conference is the state’s only event focused exclusively on continuing education for advanced practice nursing. Each year, CANP leaders work with members to design a program of courses featuring some of the most influential figures in the industry. That’s in addition to other educational opportunities that CANP membership delivers.

What other benefits do I get as a CANP member?

The benefits of CANP membership include discounts on products, services and resources vital to you and your practice. These include items that make routine tasks easier, tools for managing your practice, and information channels that expand your knowledge base - as well as your career opportunities.

When I renew my membership, when will I receive a new membership card?

When renewing online, a new membership card is generated and emailed to members immediately. When renewing by mail you will receive a new membership card within 3 business days by email. You can also access your membership card via the "My Membership" link in the "My Account" section.

As a CANP member, do I automatically become an AANP (American Association of Nurse Practitioners) member?

You do receive a discounted rate for AANP membership because you're a CANP member, but you do not automatically become a member of AANP.

What methods are acceptable for payment for membership?

CANP accepts personal and business checks, Visa, MasterCard, American Express and Discover. We also offer members the ability to pay in four equal quarterly payments.  You can even arrange automatic renewal payments – for the full year or on a quarterly basis – by selecting the Auto Pay option when choosing your member type.

How long does my membership last?

Membership expires one year from the join date. (Example: September 1, 2012 to September 1, 2013)

How do you become a CANP member?

Click the Become a Member link in the left sidebar and fill out the membership application form, or download an application and follow the instructions for submitting it.

Controlled Substance II FAQs

How do I apply for CS II authority if I already have a DEA number?

Complete a BRN-Approved CS II Authority Continuing Education Course. Submit the CE certificate, a written request for CS II Authority and a copy of the course outline to the following address:

Board of Registered Nursing
Advanced Practice Unit
PO Box 944210 Sacramento, CA 94244-2100

I am a student nurse practitioner. Do I need to attend a CS II Authority Course prior to obtaining my furnishing license?

If you are currently enrolled in a NP program, inquire with your educational institution regarding their plan to include this content if you have already completed your pharmacology course. Most, if not all, NP programs are including a separate lecture with the BRN-required content if the students have already finished their pharmacology course.

If current law requires the patient’s provider to write the prescription for CS II medication, how do we handle refills when I am covering for other doctors and nurse practitioners if I do not have an established relationship with the patient?

California’s Health and Safety Code Section 11154 (a) states, “Except in the regular practice of his or her profession, no person shall knowingly prescribe, administer, dispense, or furnish a controlled substance to or for any person or animal which is not under his or her treatment for a pathology or condition…” You may want to speak to an attorney for your specific situation if you are covering for other health care providers whose patients may require CS II medications in their absence. CANP offers members five free Legal Consultations with an attorney who is also a licensed NP.

How will the pharmacist know that the patient is terminally ill if I send in a CS II prescription on a regular prescription blank?

California law does not require a health care provider to utilize anti-fraud prescription blanks for CS medications if the patient is certified as “terminally-ill” as defined in Health and Safety Code Section 11159.2 (d). The prescription must indicate that the prescriber has certified that the patient is terminally ill by printing the words "11159.2 exemption" on the prescription blank. Certification can only be made by a physician.

Does the physician’s name and DEA number need to appear on the Anti-Fraud Prescription Blank?

No, California law was changed and no longer requires the name and DEA number on a prescription pad of an NP. The Board of Nursing and Board of Pharmacy concur with this answer.

Common Practice Questions

The manager of my county family clinic wants me to do 100 hours with a pediatrician before seeing pediatric patients. Is this within my scope of practice?

Following is a link to the BRN website FAQ document. That question is addressed (somewhat vaguely) on the bottom of the first page. It states that in addition to clinical hours, you should take a theory course.

The Standardized Procedure guidelines requirements show that a disease format can be used. This seems difficult to develop for a Primary Care outpatient setting. Does CANP have advice on templates?

Most facilities use the standardized procedure rather than a disease based format because it is nearly impossible to cover every clinical problem that could materialize. The BRN has posted the standardized procedure guidelines. You will also need the furnishing piece of it in which you must list all drugs and devices that you will furnish. We have included the link to the pharmacy regulations.

Are the new federal incentives for meaningful use of EHR for the individual practitioner or for the clinic where employed?

As NPs, we are not eligible providers (EPs) in the EHR incentive program. So if you are in a private practice that has implemented EHRs, the physician would be the EP. If you are at a clinic that has implemented EHR, the clinic will receive the monies, as the clinic has had to make the investment in EHR technology.

I was told I can't be reimbursed for doing Medi-Cal first trimester dating ultrasounds. Is this true? I thought the July legislation eliminated this?

Upon researching the Medi-Cal policies, we do not see anything that precludes the NP from performing and billing for 1st trimester ultrasounds. We have included the link to the Medi-Cal early pregnancy document for you to utilize as necessary. We have also copied the announcement that went out regarding NP's ability to bill Medi-Cal.

“After much discussion with the staff at the Department of Health Care Services (DHCS), they have expedited their state plan amendment processes and are now granting Medi-Cal provider numbers to nurse practitioners, which will allow NPs to bill directly for services provided, rather than under a physician's number. AB 1591, Chan, Chapter 719, Statutes of 2006 requires DHCS to permit a certified nurse practitioner to bill Medi-Cal independently for his or her services. Further, the statute requires that the Department make payment directly to the certified nurse practitioner if he or she bills independently for his or her services. 14132.41 (b) defined ‘certified’ as ‘nationally board certified in a recognized specialty.’ The code does not limit or specify which certifications will be recognized or accepted by Medi-Cal.”

DHCS issued this provider bulletin with more detail implementing this change — see item #17 referenced in this link.

At what age do you recommend patients begin routine mammograms? How often do you want women to have routine mammograms?

We’re more than happy to answer your questions as a personal opinion — not the opinion of CANP: As a clinician, we start routine mammograms at age 40 unless there is a strong family risk or physical finding that would prompt us do a mammogram before age 40. We order mammograms annually, but we think that every two years is fine in a low risk, asymptomatic patient.

Common Legal Questions

Can DNPs be called "Doctor" in clinical settings?

There is no case statute or law that states DNPs cannot be called “doctor” in a clinical setting in California. Some states have enacted legislation to prevent DNPs from being called doctor. These measures have not been found to be unconstitutional.

Can NPs sign death certificates?

No, they cannot. The death certificate must be signed by a physician.

What laws govern billing?

Only Medicare and Medi-Cal name nurse practitioners. Some private and HMO insurance allow NPs on their panels. However, many private and HMO insurances do not allow NPs on their panels. It is the decision of the insurance companies, not a law. Frequently, NPs have to bill under their collaborating physician. It may be necessary to call the insurance companies to ask how they want billing done for NPs.

If an NP is in private practice with their collaborating MD offsite, what is the MD's legal responsibility if the NP is sued for malpractice?

Since NPs practice under their own scope of practice and under protocols, she/he is responsible for his/her own actions. However, if under consultation, the physician instructs the NP to treat the patient incorrectly, the physician can be held accountable for the NP's actions. If the NP makes the decision himself/herself, the NP is liable. This does not mean the physician will not be sued in a lawsuit. The physician can still be named but eventually not be held liable.

How long does a physician have to send me (NP) medical records?

There is no set time period. The patient must sign a release form before another physician can send the NP records. The release form states who the records are being released to. The physician cannot argue that the medical records can only be sent to another physician. The patient can release his/her medical records to whomever they wish. The process should not take more than a couple of weeks. The physician transferring the records can charge a reasonable copying fee. If the physician continues to refuse to transfer medical records, you can report him/her to the Medical Board.

I left my place of employment as an independent contractor due to many issues and the physician is withholding my paycheck because he/she said I abandoned my patients. What recourse do I have?

As an independent contractor you cannot take advantage of the Department of Labor's assistance in getting your paycheck. However, you can sue in small claims court for back wages if it is not more than $7,000. If it is more than $7,000, you will have to file a suit in civil court. As far as abandonment, it is very difficult to prove in a primary care practice where there are other health care providers who can take your patients.

I am leaving my employment due to many issues and the physician is refusing to give me my last paycheck and is threatening to report me for abandoning patients. What do I do?

The physician cannot refuse to pay you for services performed. Go to this page on the California Department of Industrial Relations Web site. It will walk you through the steps, and no attorney fees will be charged. Abandoning a patient indicates you are leaving that patient without anyone to care for him/her. This is a common threat. However, the patient is the physician’s responsibility, not yours, so you are not abandoning the patient.

Is there a set rule as to the incentives the physician receives by a collaborating NP?

You need to be very careful in this area as an NP cannot pay the collaborating physician individual-to-individual, as this is against the corporate practice of medicine. You need to speak to an attorney about your individual situation to determine if you are following the law. If following the law, payments can vary from no fee to $500-$3,000 or more. It depends also on your type of practice.

I have a Medicare number and am being told I cannot use it.

Many physicians prefer to bill "incident to" because they can receive 100% of the physician rate. That may be why you are being told you cannot use your own number. However, when billing incident to, you must be very careful, as a physician must be on the premises. The physician must also be an integral part of the patient’s care. If a physician is not on the premises, you must use your own number and bill at 85% of the physician rate. Review and understand the definition of incident to billing before you become involved in patient care and billing.