Current through Register Vol. 50, No. 9, September 20, 2024
A. Consultation and Collaboration.
Consultation and collaboration shall include discussion of any item the
physician considers relevant to the coordination of the patient's medical care
or evaluation of the psychopharmacologic management planned by the MP. The
physician's consultation shall be documented in the patient's medical record
and include, at a minimum:
1. Patient
Authorization. A physician shall not consult and collaborate without the
patient's written authorization to provide and/or receive from the MP any
documents or records the physician may deem necessary throughout the course of
psychopharmacologic management. A physician shall either obtain such
authorization directly or document the MP's verification that the MP has done
so and request and obtain a copy for his medical record on the
patient;
2. Patient Identity, Date
and Parties. The patient's name, current addresses and telephone number; the
date of the consult; and the MP's name and telephone number shall be clearly
identified. If the physician is unfamiliar with the MP, the physician shall
also verify that the MP holds a current certificate of prescriptive
authority;
3. Purpose. The purpose
for the consult (e.g., new medication; change in medication; discontinuance of
medication; adverse treatment effects; treatment failure; change in mental
status; etc.);
4. Psychological
Evaluation and Diagnosis. If known, the MP's psychological evaluation of the
patient, including any relevant psychological history, laboratory or diagnostic
studies; the MP's psychological diagnosis; and any other information the
physician may deem necessary for the coordination of medical care of the
patient;
5. Medication. The
specific drug(s) the MP plans to utilize, including the starting dosage and
titration plan, if any; frequency of use; the number of refills and anticipated
duration of therapy; relevant indications and contraindications; any previously
utilized psychopharmacologic therapy; and any alternatives;
6. Treatment Plan. The MPs treatment and/or
management plan for the patient;
7.
Results of Consultation. The results of the consultation (e.g., concurrence,
deferring or denying medication recommended by the MP);
8. Responsibilities. Any specific
responsibilities of the physician and MP respecting the patient's
care;
9. Reporting. Any reporting
and documentation requirements the physician may request of the MP and/or a
schedule by which such are to take place; and
10. Immediate Consultation. A plan to
accommodate immediate consultation between the physician, MP and/or the
patient.
B. Denying or
Deferring Concurrence. If, following discussion, the physician does not concur
or believes that there is a need for further medical evaluation or information
before concurring in the psychopharmacologic management planned by the MP
(e.g., that the patient may be suffering from a condition that may be primarily
physiological; physician assessment or additional laboratory or diagnostic
testing is indicated; information has been requested from the MP or the patient
for prior review; etc.), the physician shall deny concurrence of the
psychopharmacologic management planned by the MP or shall defer concurrence
until and unless the physician determines that such is appropriate for the
patient.
C. Concurrence in
Psychopharmacologic Management. Upon completion and satisfaction of the
conditions prescribed in Subsection 7209.
A of this Section, and upon a physician's
judgment that the psychopharmacologic management planned by an MP is medically
appropriate, the physician may concur. Thereafter, continued coordination of
the patient's medical care shall include consultation and collaboration and
other activities as the physician may deem appropriate including, but not
limited to, the following:
1. Assessment of
Treatment Efficacy. A physician shall see any patient subject to consultation
or collaboration with an MP at least once every 12 months to assess the medical
efficacy of the treatment and assure such treatment remains medically
indicated. In the event the psychopharmacologic management includes a Schedule
II or III controlled substance, the physician shall see the patient at least
once every 6 months.
2. Treatment
records. A physician shall document and maintain in the medical record of a
patient subject to consultation and collaboration:
a. accurate and complete records of all
consultations with the MP including, but not limited to each of the items
specified in 7209.A;
b. copies of
all consultations and documentation received from the MP; and
c. history, physical and other examinations
and evaluations, consultations, laboratory and diagnostic reports, diagnoses,
treatment plans and objectives, psychopharmacologic and other medication
therapy, informed consents, and the results of periodic assessments and
reviews.
D.
Responsibility for Treatment. A physician shall retain professional
responsibility to his or her patients for consultation and collaboration with
an MP.
E. Consultation or
collaboration with an MP is personal to the physician. A physician shall not
authorize a non-physician to consult with an MP on his or her behalf.
F. Consultation and Collaboration. All
adjustments or changes in the patient's medication subsequent to initial
concurrence of psychopharmacologic management, including dosage adjustments or
adding or discontinuing a medication, shall be preceded by consultation and
collaboration with the MP that includes, but is not limited to, updating the
information required by Subsection 7209.
A of this Section.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
37:1270(A)(1), 1270(B)(6)
and 37:2371-2378.
