Before You Accept…

The business of being a nurse practitioner is not just about having a business. It’s also important for NPs who are employed. Employed NPs are faced with a myriad of situations which demand they pay attention to the business of healthcare, not only for their own success but for that of the practice,  their patients and of course, the legal issues. The more we understand business, the better patient advocates we become.

I’m honored to have Carolyn Buppert, MSN, JD guest post for NPBusiness. For those of you who don’t know Carolyn, she is the author of the highly acclaimed Nurse Practitioner Business Practice & Legal Guide, now in its 5th edition. You’ll find her contact information below the article.

After you read this article, you’ll also understand why I believe that NPs should always carry their own coverage and not rely on that of their employers.

Check out the history of prospective employers and business partners

I am hearing from nurse practitioners who are being offered contracts to work for companies with suspicious business plans. For example, a nurse practitioner with her own practice was approached by a pharmacy company in another state with a plan for the nurse practitioner to route her patient’s prescriptions through the pharmacy. The nurse practitioner would receive a percentage of the business in return. I advised the nurse practitioner to turn down the offer. The arrangement is a “kickback,” which is illegal. As part of my research into the company, I found that this wasn’t a reputable operation.

I advised the nurse practitioner to turn down the offer. The arrangement is a “kickback,” which is illegal. As part of my research into the company, I found that this wasn’t a reputable operation.

I also hear from nurse practitioners who accepted employment or contracts to work with companies, without researching the company, and now are facing a) demands from payers for a)demands from payers for return of money (which the nurse practitioner never received), b) fraud investigations, and c) loss of license to practice.

The pitch to the nurse practitioner went something like this: “We will pay you X dollars per interaction, we will credential you with the payers, and we will deal with the Board of Nursing.”

The course of things goes like this: The company does pay the nurse practitioner X dollars per interaction and credentials the nurse practitioner with payers, but doesn’t get the paperwork correct with the Board of Nursing and uses the nurse practitioner’s name on all sorts of inappropriate claims, without the nurse practitioner’s consent or knowledge. Then, when payers find out about the scam, the company closes or is otherwise unresponsive, while the nurse practitioner is left without legal support, facing charges of practicing without the proper documents and perpetrating fraud.

Sometimes, it will be a physician who is the initial contact. Then, suddenly, the physician is out of the picture and the nurse practitioner finds him or herself dealing with a company of non-clinician business people.

The skills of a nurse practitioner and the authority to write prescriptions and bill for services is very valuable, both to legitimate practices and to shady business people. So, check out prospective employers and people wanting you to work for them.

  • Have they been in business for less than 3 years?
  • Does an Internet search turn up any prosecutions, fines, questionable postings about the company’s credibility or bad reviews from patients?
  • Does the deal sound too good to be true? If “yes,” protect your future career and pass on the project.

For more information about the legal and business issues affecting nurse practitioners, visit



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  1. Google all NPs, PAs and physicians you will be working with.

    Check them out on Linked-In, national practitioner data bank, etc. Drug abuse? Sexual abuse?

    Get a copy of your malpractice info-even the first page is good. File it away at home.

    Ask “Who has the power to let me go and how would that be decided?

    Much more………

  2. Great ideas Dave! I love the idea of having a copy of your malpractice info, and I’d file it not only at home, but also in a personal cloud account such as Dropbox or Evernote so it’s always available to you regardless of where you are.

    Thanks for stopping by!

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