Question

Other than prescriptive authority, what are the key legislative issues that your state NP organization is currently working on?

Answer 1

According to 30th Annual APRN(advanced practice registered nurse ) Legislative Update,each state responses to statutory/regulatory authority. And the key legislative issues that NP organization is currently working on are:

Reimbursement

Amendments to statutes or regulations pertaining to APRN reimbursement historically have been lacking. In 2017, only one state reported the passage of legislation impacting APRN reimbursement. On June 7, 2017, Vermont enacted Act 64 relating to insurance coverage for telemedicine services delivered in or outside a healthcare facility. Specifically, Act 64 requires commercial health plans and Medicaid to cover telemedicine services regardless of where the patient receives those services.

Practice authority

Signature authority- Global signature authority is generally defined as authorization for recognized APRNs to sign, certify, or endorse all documents related to healthcare within their scope of practice (SOP) provided for their patients. Some states limit these documents (partial) to a statutorily authorized list, while others are broader in their approach.

Consensus Model adoption- According to the National Council of State Boards of Nursing, 15 states have implemented 100% of the Consensus Model recommendations for APRN licensure, accreditation of APRN programs, certification in respective APRN roles and educational program requirements. Although many states have achieved FPA(Full Pratice Authority)as defined by the AANP(American Association Of Nurse Practitioners), many states continue to work on legislative and regulatory amendments to move toward uniformity in these areas.

Ordering home health services- This year(2017), survey respondents were asked to respond to a question regarding state statutory authority to order home health services. If the home health agency is Medicare- and/ or Medicaid-certified, 42 Code of Federal Regulation 484.18 requires a physician signature to order home health services. However, some states authorize home health agencies to accept orders from APRNs when patients are private-paying or non-Medicare/ non-Medicaid recipients under state law. While many states did not respond to the question, there is initial information on statutory authority.

Advances in protocol/collaborative agreement requirements and SOP- The supervisory nature of practice in Florida was not changed during this legislative session.