Prescriber Capacity Survey

Partners is seeking information on prescriber capacity and information to inform the credentialing committee around gaps and needs.  Based on Communication Bulletin #J232 Clinical Coverage Policy 8C: Nurse Practitioner Credentialing and informs LME-MCOs and providers about the amendment to Nurse Practitioner (NP) credentialing requirements located in Clinical Coverage Policy 8C, Section 6.1.
Effective July 1, 2017, Clinical Coverage Policy 8C will be amended to reflect the following requirements applicable to NPs not certified as Psychiatric Mental Health Nurse Practitioners (PMHNP):

·    Nurse Practitioners not certified as PMHNP may be eligible to provide psychiatric services to Medicaid beneficiaries if they meet all the requirements listed below, as demonstrated to the credentialing body of the Prepaid Inpatient Health Plan (PIHP):

a.   Documentation that they have three (3) full-time years of psychiatric care and prescribing experience under licensed psychiatric supervision including psychiatric assessments and psychotropic medication prescribing; and
b.   A signed supervision agreement with a North Carolina Licensed Psychiatrist that covers prescribing activities; and
c.   Continuing education requirements, going forward, which include
20 hours each year focused on psychiatric physiology, diagnosis, and psychopharmacology. (21 NCAC 36.0807)


·    The PIHP credentialing body and the Medical Director are responsible for assessing the qualifications of Nurse Practitioners not yet certified as Psychiatric Mental Health Nurse Practitioners and for monitoring the supervision and continuing education requirements.

·    Waiver of the requirement for three years of supervised psychiatric experience for a NP not yet certified as a PMHNP must be based on access needs of the PIHP, documented in the records of the credentialing body, approved by the PIHP Medical Director, and reassessed on an annual basis.  Other details in items b. and c. above apply.

The goal in developing this policy was to assure that qualified NPs are working within the behavioral health system and to recognize the need for flexibility so that access to services would not be impacted.  As you implement this policy, we are asking you to:

·    Avoid any action that would eliminate the ability to practice for a NP not certified as a Psychiatric Mental Health Nurse Practitioner, who has less than three years of experience and is currently practicing in your network, unless there is a quality of care issue.

·    Consult with your providers about ongoing needs to employ or contract with NPs not certified as a Psychiatric Mental Health Nurse Practitioner with less than three years of experience.

Partners is wanting immediate feedback on prescriber capacity and needs in the Partners area to ensure that our consumers have access to needed prescribers.