Author Archives: Stephen

I’m Dr. Stephen Ferrara, a practicing Nurse Practitioner with over 10 years of clinical experience. I’m a senior clinical associate at a large urban hospital system in the Bronx, NY and I’ve owned and operated the largest Nurse Practitioner retail based clinic operation in New York State. I have experience in college, correctional and men’s health.

I have my Bachelor’s degree in Biology and Nursing as well as my Master’s degree, and recently I attained the Doctor of Nursing Practice degree! I’m active within my state’s nurse practitioner association and have lectured at numerous conferences.

In addition to blogging here at, for the past 3 years I’ve authored A Nurse Practitioner’s View. I have a passion for health care technology and integrating evidence-based practice into daily practice.Thanks for stopping by! I hope you find the information on this blog useful for your educational and career endeavors into the field of nursing.

The ABCs of Health Insurance and ObamaCare

On the brink of the Health Exchanges opening for business on October 1st, 2013, I gave a recent lecture to a group of  NP students on some of the health insurance basics. However, much uncertainty exists as legislators consider a governmental shutdown over ideological differences.  Here are some of the highlights and terms from that lecture (most of my references came from
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Real-Time Controlled Prescription Drug Monitoring Coming To Your State Soon?

Just this past week, a new regulation went into effect for every prescriber in New York State who orders controlled substances for their patients. The new regulation is called I-STOP, or Internet System to Stop Over Prescribing, and consists on a centralized database where most prescribers must log in to prior to writing a new prescription for a controlled substance and view if any recent controlled substances were written by other providers.
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Researching Nurse Practitioner Programs? You Must Do This

One of the most frequent questions I receive among NP students is assistance looking for a preceptor for clinical placements. It is so important for NP students to be very familiar with your school’s policy for clinical placements – it actually may be THE most important thing! The vast majority of NP programs rely on a network of providers willing to accept their NP students. This a very different process than medical students’ “Match Day” – where their residencies are largely funded by Medicare dollars.
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Nurse Practitioners: Evidence Beyond the Turf Wars

There is fierce on-going debate regarding how the healthcare system of tomorrow will look and who will provide care. Nurse practitioners are seeking full practice authority – the ability to practice to the full extent of their education and training without arbitrary barriers – while physicians wage a turf war as to who should be captain of the ship.
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Quality vs. Quantity

Across the United States, many states are struggling in preparation of  implementing “Obamacare” as 2014 looms. Some are in process of setting up the Health Insurance Exchanges that will offer consumers and the Small Business Health Options Program (SHOPs) a mechanism to purchase coverage.   It is widely expected that the newly insured will create a demand for health access that cannot be currently met under existing models and limiting regulations. We can look to Massachusetts’ passage of mandated health coverage in 2006 and the backlog of access to primary care that it created to not repeat the same missteps.
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What Is Incident-to Billing & Why You Should Avoid It?

One of the most challenging issues for NPs comes down to billing for services. After having performed a thorough history and physical, prescribing a culturally competent and evidence-based treatment, proper documentation is essential for the success of a practice.  For NPs billing Medicare, they will receive 85% of the physician payment schedule (there is really no rhyme or reason as to how they arrived at this number). Private insurers vary on their reimbursement rates from 100% to something less.
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Prescribing Controlled Substances – What you Need to Know

In a widely circulated national news article, the  FDA recently voted to change hydrocodone along with some other controlled substances to the more restrictive Schedule II classification. There was much confusion among nurse practitioners when some of the news articles erroneously reported that this change would prevent all nurse practitioners and physician assistants from prescribing the medication. While there are a few states that do not allow NPs to prescribe schedule II medications, the majority of states do allow the prescribing of this medication. The American Association of Nurse Practitioners is working at the national level to assist those states where NPs would be affected.
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What Every Hospital Employee Will Need to Do in 2013

If you haven’t had enough of influenza-related news over the last few weeks, for those of you working in the acute care hospital setting, there is more to come.

Beginning the 2012-13 influenza season, the CDCs, National Healthcare Safety Network (NHSN), is requiring all employees, students/volunteers, licensed independent providers, and contractors to answer questions  about their influenza vaccination status. There have been recent news reports of various hospital employees being terminated for refusing influenza vaccine.  While the new NHSN requirement does not mandate the vaccination, it does require hospitals to report their staffs vaccination rates.
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