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Can a NP provide services to a No - Fault patient?
Can a NP provide services to a No –Fault patient

Question:

Can a Nurse Practitioner provide services to a No-fault patient?

 

Answer from WCH experts:

As according to NEW YORK STATE DEPT OF FINANCIAL SERVICES REGULATIONS IMPLEMENTING THE COMPREHENSIVE MOTOR VEHICLE INSURANCE REPARATIONS ACT REGULATION NO. 68-A (11 NYCRR 65-1)
65-1.1 Requirements for minimum benefit insurance policies for personal injuries, Mandatory personal injury protection endorsement, Section I, Medical Expense

Medical expense shall consist of necessary expenses for:

(a) medical, hospital (including services rendered in compliance with Article 41 of the Public Health Law, whether or not such services are rendered directly by a hospital), surgical, nursing, dental, ambulance, X-ray, prescription drug and prosthetic services;

Under the same ACT, Section 65-3.16 Measurement of no-fault benefits, (4)

The term 'nursing,' as used in section 5102(a)(1)(i) of the Insurance Law, shall include but not be limited to all necessary services rendered to the eligible injured person by a licensed practical nurse.

To view a full document of REGULATION NO. 68 please visit New York State Department of Financial Services

As according to the 11 NYCRR 68, PART 68 – CHARGES FOR PROFESSIONAL HEALTH SERVICES (Regulation 83) Appendix 17C, Part B

Private nursing services fee schedule is being determined as following:

  • Registered professional nurses. The maximum permissible charge for private nursing services is the local prevailing charge for such services.
  • Licensed practical nurses. The maximum permissible charge for private nursing services is the local prevailing charge for such services.

To view a full document please visit New York State Department of Financial Services

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Insights
March 2018