Legislation builds on efforts to expand authority of nurse practitioners

There are now two pieces of legislation in the mix that aim to change Pennsylvania law for nurse practitioners.

A new bill emerged in the state House last week that, if passed, would allow nurse practitioners to practice without being affiliated with a physician.

The bill, H.B. 100, was introduced by Rep. Jesse Topper (R-Bedford) as the companion bill to a state Senate bill introduced in February.  

Both bills are similar legislation that moved through the state House and Senate last year but never became law.

Efforts to give nurse practitioners full practice authority in Pennsylvania have been ongoing, driven by arguments that nurse practitioners have enough education to practice independently, and that they could be the answer to the shortage of providers in rural communities.

However, many physicians oppose the efforts. They fear that full practice authority for nurse practitioners would break up the traditional team practice of physicians and nurses working together.

Under existing Pennsylvania law, nurse practitioners need to have collaborative agreements with two physicians to be practicing.

The House and Senate bills would allow nurse practitioners to see patients without an agreement, once they’ve completed three years and 3,600 hours of collaboration with a physician.

The legislation would still leave Pennsylvania with one of the longest transition periods for nurse practitioners in the nation, according to the Pennsylvania Coalition of Nurse Practitioners.

Nurse practitioners currently have full practice authority in 22 states and the District of Columbia, the coalition said.

In January, the U.S. Department of Veterans Affairs granted nurse practitioners full practice authority in all VA hospitals in an effort to cut wait times.

Full practice authority in the VA, which is the largest employer of nurse practitioners in the country, gave hope to those in Pennsylvania that the state would soon follow suit.

Now with two bills on the table again, change is closer to reality. Many health care trade groups in Harrisburg, such as the Hospital and Healthsystem Association of Pennsylvania and the Pennsylvania Rural Health Association, support the legislation.

“Nurse practitioners are well positioned to alleviate the primary care shortage in rural communities,” said Shelba Scheffner, president of the rural health association. “They are twice as likely to practice in rural areas compared to physicians, and nurse practitioners in states with full practice authority are more likely to practice in rural areas than nurse practitioners in states like Pennsylvania without full practice authority.”

Lenay Ruhl

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