Rules governing nurse practitioners too strict, experts testify [MA]
Posted almost 10 years ago by Nicholas M Perrino
"Costs of care can be higher for such clinics in Massachusetts than in other states of because of the strictness of laws dealing with nurse practitioners, said David Auerbach, the Health Policy Commission's deputy director of research and cost trends. Scope of practice laws set the legal boundaries on what tasks a medical professional can perform and under what restrictions or oversight.
'Here's the bottom line: Massachusetts has among the most restrictive laws in the nation,' Auerbach said, adding that those laws can become barriers that prevent patients from accessing necessary care.
If the limitations on nurse practitioners were lessened or lifted, Auerbach said, the state would likely see an increase in access to care, and an increase in care outcomes and quality would be probable as well. The impact it would have on health care spending is ambiguous, he said.
A total of 22 states allow nurse practitioners full practice authority, eight of which joined that group with updates to their laws in the past four years, Auerbach said.
Massachusetts has made incremental changes to its own scope of practice laws for nurse practitioners in recent years, according to Auerbach. In 2008, the state recognized nurse practitioners as primary care providers who could be chosen by patients. In 2012, they were granted the ability to sign death and disability forms.
Restrictions that remain include requirements that nurse practitioners follow treatment guidelines set by physicians, that they maintain a collaborative agreement with a physician to prescribe drugs and that the Board of Medicine approve the implementation of any new practice authority for nurse practitioners.
CVS MinuteClinic Chief Medical Officer Nancy Gagliano said Massachusetts is 'not the most challenging state for nurse practitioners to operate in,' but that states that don't require formalized agreements for nurse practitioners to prescribe drugs or be supervised by a physician make it easier.
'Where it does get challenging is it is indeed true that we do pay every single consulting physician money to be available to that provider,' she said. 'That can be a burden in some states and plays potentially an unfair advantage and can limit competition.'
Rep. Jeffrey Sanchez, a Boston Democrat who co-chairs the Joint Committee on Health Care Financing, told the commission his committee is considering a bill that would charge the commissioners with reviewing the scope of practice laws."