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2019: Big Changes Coming To NP And PA Scope Of Care

One of the most common issues our clients struggle with is the scope of practice (SOP) limitations set by states on Nurse Practitioners (NPs) and Physician Assistants (PAs). With the physician shortage only increasing, many clients - especially those serving rural patients - are relying on other providers as the primary care solution in their area. And it seems like the Department of Health and Human Services is starting to take notice.

In December 2018, a report entitled Reforming America's Healthcare System Through Choice and Competition, prepared by the Department of Health and Human Services (HHS) and the Departments of Treasury and Labor and the Federal Trade Commission, describes the extent to which state and federal laws, regulations, guidance, and policies discourage choice and competition in healthcare markets.

The report includes several recommendations to improve Nurse Practitioner and Physician Assistant practice and remove barriers to licensure. Some of the recommendations to broaden scope of practice include:

  • States should consider changes to their SOP statutes to allow all healthcare providers to practice to the top of their license, utilizing their full skill set.

  • The federal government and states should consider accompanying legislative and administrative proposals to allow non-physician providers to be paid directly for their services where evidence supports that the provider can safely and effectively provide that care.

  • States should consider eliminating requirements for rigid collaborative practice and supervision agreements between physicians and their care extenders (most specifically physician assistants) that are not justified by legitimate health and safety concerns.

  • States should evaluate emerging healthcare occupations and consider ways in which their licensure and scope of practice can increase access and drive down consumer costs while still ensuring safe, effective care.

Furthermore, the report states that, “... in underserved areas and for underserved populations, the benefits of expanding supply are clear: Consumers will have access to services that were otherwise unavailable. Even in well-served areas, the supply expansion will tend to lower prices for any given level of demand, thus lowering healthcare costs.”

It seems that a broader scope of practice for NPs and PAs is inevitable and has now been officially backed by the current administration. We’re excited to see how states respond and we will be keeping you updated as licensure and SOP changes occur.