As the nation braces for the effects of the primary care physician shortage, several states are taking matters into their own hands and considering expanding the independence of advance practice registered nurses and nurse practitioners.
Allowing NPs and APRNs to practice without physician oversight will increase access to care in areas where physician appointments are difficult to come by, supporters of increased independence say. However, opponents say patient safety is at risk when advanced practitioners are allowed to practice independently.
The Federal Trade Commission released a policy report in March stating that limiting APRNs' range of independent practice can reduce competition. "Even well-intentioned laws and regulations may impose unnecessary, unintended or overbroad restrictions on competition, thereby depriving healthcare consumers of the benefits of vigorous competition," it states. "Expanded APRN scope of practice is good for competition and the American consumers."
The following states either recently passed or considered passing laws increasing APRN and NP independence, beginning with the most recent coverage from Becker's Hospital Review.
1. The Connecticut state Senate passed a bill that would allow APRNs to practice without physician oversight after working in collaboration with a physician for three years.
2. New York passed the Nurse Practitioners Modernization Act as part of its budget in April. The law will remove the nurse-physician written practice agreement requirement when it takes effect Jan. 1, 2015.
3. Kansas Senate Bill 326 would allow APRNs to prescribe drugs without a required collaborative agreement with a physician. However, as of April 1 the bill had not received a hearing in the House or Senate and it will likely be revised and presented during the 2015 legislative session.
4. A bill introduced in the Nebraska Senate, which received first-round approval in the Senate in March, would eliminate the need for NPs to have a practice agreement with a physician.
5. In February, a Florida House committee approved a proposal that would allow APRNs and nurse anesthetists to practice without physician supervision.