Texas NPs press legislature for more autonomy

Nurse practitioners (NP) in Texas have long fought against state regulations that link them financially and professionally to supervising physicians, an arrangement they say limits their ability to treat patients in a state with a looming shortage of primary care physicians. Texas lawmakers loosened some supervision requirements during the last legislative session following a compromise with physician groups, who argue that NPs do not have the training or experience to be entirely independent. But NPs are still battling for increased autonomy in the state Medicaid program.

Texas offers health coverage to poor children and people with disabilities through a managed care system in which private insurance companies contract with the state to enroll patients and cover medical services such as physician visits and prescriptions. NPs argue that SB406, a bill passed by state lawmakers in May 2013, should have allowed them to be approved by these state-contracted insurance companies even if their supervising physicians did not treat patients on Medicaid. But state officials and the physician lobby said that interpretation of the bill was never agreed upon. 

Beyond issues with Medicaid, NPs are ultimately pushing for complete independence from physicians as part of a national effort. They have been successful in several states, including Arizona, Colorado, and New Mexico. 

Source: The Texas Tribune