DID YOU KNOW? PAs can sign FL-2 forms
A PA recently reached out to NCAPA and asked, "Does state law prohibit PAs from signing FL-2 forms?" The PA had been told by a colleague that FL-2 forms, the form a provider must fill out in order for a Medicaid patient to be admitted into an adult care home, must be signed by a physician, not a PA or a NP, although the PA had signed several FL-2 forms in the past without issue. By a quick glance at the form, one would think that a physician must sign the form, as the signature box states: "Physician's Signature." Click here to view the form on the Division of Medical Assistance's website.
After doing some research, we found that in 2010, North Carolina clarified that Medicaid, YES, will accept the signature of a physician, PA, or NP on the FL-2 form:
Attention: Adult Care Home Providers, Nurse Practitioners, and Physicians
Adult Care Home Prior Approval and Admissions
Medicaid will accept the signature of a physician, nurse practitioner or physician assistant on an FL2 for use in an adult care home prior approval and/or admission, in order to comply with G.S. 90-18.3 of the Physician Practice Act, which states:
(a) Whenever a statute or State agency rule requires that a physical examination shall be conducted by a physician, the examination may be conducted and the form signed by a nurse practitioner or a physician assistant, and a physician need not be present. Nothing in this section shall otherwise change the scope of practice of a nurse practitioner or a physician assistant, as defined by G.S. 90-18.1 and G.S. 90-18.2, respectively.