AMA looks to stop APRN practice expansion

As we approach the end of the year, the AMA reports that it has worked to stop proposed scope of practice expansions for advanced practice registered nurses (APRN) in eight states. The AMA says it collaborated with state medical and osteopathic associations and national specialty societies to prevent legislation from being passed that would give APRNs more independence in delivering patient care.

“Advanced practice registered nurses are valued members of the health care team, but their medical education and training does not come close to matching that which is required of physicians,” writes Andis Robeznieks, a senior writer for AMA. "Patients deserve care led by physicians—the most highly educated, trained and skilled health care professionals."

The states with the failed legislative efforts include:

• Florida: Proposed legislation would have allowed all nurse practitioners (NP) to practice independently; expanding a law enacted last year that allows NP practicing in primary care to practice independently
• Kansas: Proposed legislation would have allowed all APRNs the ability to provide medical care without any physician involvement and allow them to prescribe controlled substances
• Kentucky: Proposed legislation would have eliminated physician oversight for prescribing and would have allowed all APRNs to provide medical care without any physician involvement
• Louisiana: Proposed legislation would have allowed all APRNs to provide medical care without any physician involvement
• Maine: Proposed legislation would have removed the transition-to-practice requirement, thereby allowing all APRNs to practice without any physician involvement, including newly graduated APRNs
• Mississippi: Proposed legislation would have allowed all APRNs the ability to provide medical care without any physician involvement and would have also allowed NPs to provide oversight of other APRNs, including certified registered nurse anesthetists, nurse midwives, and clinical nurse specialists, without any education or training in these specialized areas of care
• Tennessee: Proposed legislation would have removed physician oversight
• Texas: Proposed legislation would have expanded the scope of practice of APRNs, including allowing them to prescribe without any physician involvement

Two states that recently passed legislation expanding scope of practice are Delaware and Utah. In August, Delaware granted full practice authority to NPs. In March, Utah relaxed prescribing laws for NPs to allow them to prescribe controlled substances.

"States with FPA demonstrate a proven track record for increasing accessibility and patient satisfaction, while maintaining excellent care quality and outcomes," said AANP President April N. Kapu, DNP, APRN, ACNP- BC, FAANP, FCCM, FAAN, when the Delaware legislation was passed. "We are encouraged to see other states looking to modernize their laws, eliminate healthcare disparities, and increase healthcare access and choice for patients by fully engaging the NP workforce."