20 states let NPs prescribe independently

Nurse practitioners, or advanced practice registered nurses, have varying degrees of practice independence, depending on where they practice medicine. Some states allow NPs to practice without physician oversight, for example, while others require a practice agreement between NPs and physicians.

Many states have passed or considered legislation allowing NPs greater practice independence, especially in light of the nation's developing physician shortage — providers like NPs can help meet the growing demand for healthcare and fill in the gaps left by the shrinking supply of physicians.

Additionally, the Federal Trade Commission, in a staff paper, has stated limiting the practice of APRNs can reduce competition and that state legislators should carefully consider proposals limiting their scope of practice.

However, opponents say patient safety is at risk when NPs are allowed too much practice independence.

Regardless, in the following states, NPs have the authority to prescribe medications without physician or Board of Medicine involvement, according to Barton Associates.

1.    Alaska
2.    Arizona
3.    Connecticut
4.    Hawaii
5.    Idaho
6.    Iowa
7.    Maryland
8.    Minnesota
9.    Montana
10.    Nevada
11.    New Hampshire
12.    New Mexico
13.    North Dakota
14.    Oregon
15.    Rhode Island
16.    Utah
17.    Vermont
18.    Washington
19.    Washington, D.C.
20.    Wyoming

In Colorado and Maine, NPs can prescribe independently from the Board of Medicine and physicians after completing certain state requirements.

Notably, no states in the southeast U.S. allow NPs to prescribe medications independently.

This information was taken from Barton Associates' Interactive NP Scope of Practice Law Guide, found here.

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