Alabama to allow more collaborative practice agreements

The Alabama Board of Medical Examiners & Medical Licensure Commission will now allow physicians to hold collaborative/supervisory practice agreements with up to nine advanced practice professionals (APP). Previously, physicians were limited to four full time equivalents (FTE) of these practitioners (e.g., certified nurse midwives, certified registered nurse assistants, and physician assistants).

“This is a positive joint effort that recognizes patients’ interests are best served when they are treated by a physician-led team of health professionals. It will help ensure patients in Alabama receive safe, quality care,” said Alabama Board of Medical Examiners Chairman Mark H. LeQuire, MD.

In states where APPs must practice under a physician’s tutelage, a collaborative or su­pervisory agreement may be required to delineate the nature of this relationship. The specific contents and implicated parties of such agree­ments vary by state, discipline, and, in some cases, facility. Despite these variations, a collaborative/supervisory agree­ment typically outlines the reporting structure, accountability, and division of labor between the physician and the APP; states what the APP does and does not have the authority to do; and spells out the physician’s oversight responsibilities and availability for consultation.

Before submitting a new collaborative practice agreement for approval by the state licensing board, physicians will have to disclose all existing collaboration agreements in all states. A physician with more than four FTE APPs will also be required to conduct monthly quality assurance reviews for the first six months of a new collaboration agreement.

Starting January 1, 2024, collaborating physicians will be required every four years to complete the Board of Medical Examiner’s continuing medical education regarding the rules and statutes governing collaborative practice in Alabama.