AGO Opinion Topics: PROFESSIONAL REGULATION

An Advanced Registered Nurse Practitioner may, when consistent with his or her professional license, lawfully furnish or prescribe a drug to a woman for the purpose of inducing an abortion where the drug may lawfully be prescribed and the woman seeks to terminate her pregnancy before the fetus is viable or for the purpose of preserving the woman’s life or health

1.An agreement between an optometrist and an ophthalmologist whereby the optometrist refers a patient to the ophthalmologist for surgery with the understanding that the referring optometrist will provide post-operative care does not violate the anti-rebate provisions of chapter 19.68 RCW or RCW 18.130.180(21), so long as each party performs services he or she is licensed to perform and bills only for those services.2.The Medical Disciplinary Board lacks authority to prohibit ophthalmologists from delegating post-operative management of eye surgery patients to optometrists, if the prohibition amounts to an effort to regulate the practice of optometry or to prevent optometrists from performing functions they are licensed to perform; however, the Medical Disciplinary Board does have authority to define the scope of post-operative care and define the extent of a medical doctor's responsibility for such post-operative care.

1.  RCW 19.68.010 prohibits a person licensed to practice medicine in Washington from receiving a rebate, commission, or other consideration in connection with the referral of a patient.  RCW 19.68.040 provides that a licensed physician is not prohibited from collecting compensation for services provided by an employee.2.  RCW 19.68.010 prohibits a physician from referring a patient to an infusion therapy company in which the physician is a shareholder.  However, under RCW 19.68.040 this prohibition would not apply if the persons performing the services for the infusion therapy company are under the control of the physician such that they are employees of the physician.3.  RCW 19.68.010 does not prohibit a physician from receiving a set fee from an infusion therapy company for providing various services to the company's customers.  However, the fees must actually provide the services, and the fee paid must reflect the market value of the services provided.