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Supervising or Working as Nurse Practitioners

Nurse practitioners (NPs) are one of the five eligible provider types for the TennCare Medicaid EHR Incentive Program. As eligible professionals (EPs) they attest to meaningful use and earn incentive payments as individuals, but demonstrating their individual achievement of meaningful use can be complicated by the ways in which NPs interact with their supervisors. FAQ 10665 discusses  the determination of who counts the encounter when a patient is seen by staff or a NP. This FAQ is helpful for EPs who are not NPs deciding whether or not to include their NP’s patients as patients "seen by the EP" and included in the denominators of the measures.

This FAQ is less helpful for NPs achieving MU. As EPs attest individually, the NP should not in turn include all patients seen by her supervisor without the NP. A supervising EP’s patient population can include all the patients he treated with the option of adding the patients he supervised the NP treating, but an NP’s patient population can only include the patients seen by the NP. To achieve MU, each EP has to have the ability to tie his/her actions to his/her patients in the EHR. An NP’s meaningful use data would not be identical to her supervising physician’s data unless they saw each patient during the reporting period together.