Full Practice Authority of Advanced Practice Registered Nurses in New York State:
Vision for 2020.
TAMARA MCFARLANE
DANIEL OWUSU-ANSAH
Lehman College NUR 723
Strategies for Advanced Nursing Practice December, 2016
Instructor: DR. BRIGITTE S. CYPRESS
Executive Summary
Introduction
There are many barriers that prevent APRNs from functioning to their fullest potential during practice. One of these barriers is prescriptive authority. According to the article, APRN Prescribing Law: A State by State Summary, prescriptive authority (independent prescribing) “is the ability of Advance Practice Registered Nurses (APRNs) to prescribe, without limitation, legend (prescription) and controlled drugs, devices, adjunct health/medical services, …show more content…
State regulations on APRNs scope of practice contribute to the barriers that affect APRNs. Regulatory barriers include having onsite physician oversight, physician chart review requirements, and lack of prescriptive authority, inability to admit patients to hospitals, order tests and medical supplies. (Institute of Medicine, 2011) According to the article, Restrictive Practice Environment and Nurse Practitioners’ Prescriptive Authority, “eliminating restrictions to allow NPs to practice at their full potential would alleviate many problems of access to primary care services.” (Pan, Straub, & Geller, 1997) Lifting restrictions and allowing APRNs to practice to their full potential including full prescriptive authority, would reduce delay in care, improve patient satisfaction, allow physicians to focus on complex health issues and increase access to primary care. APRN education and abilities have evolved over the years. Outdated insurance policies have not kept up with the change in healthcare to recognize and properly reimburse APRNs for care rendered. Under federal legislation, NPs who bill for direct reimbursement for Medicare part B services are reimbursed at a rate of 80% for the lesser charge or 85% of the fee schedule amount for physicians. (American Association of Nurse Practitioners, 2013) In some states NPs and CNMs are not listed as primary care providers by insurance companies …show more content…
Expand the Medicaid and Medicare managed reimbursement for NP services provided in primary care settings. The provider demographic is changing, and along with it, patients’ expectations for provider choice. It is important for the patients to elect APRNs as their provider and have those services covered by their insurance. The APRNs are required to bill incident to an on-site delegating physician. When an APRN bills incident to a physician, the service gets reimbursed at the physician rate, the facility charges more for the visit. This ultimately increases costs for the insurance companies and the patients. Medicare reimburses APRN services at 85% of the physician fee schedule amount for the same primary care services. We believe that consumers should have the option to select a nurse practitioner as their provider and that third-party payers should be required to reimburse for that care fairly. Such policies would increase competition and incentivize APRNs to practice in New York. We urge policymakers to require third-party insurers to credential APRNs as primary care providers and reimburse them fairly for their
Vision for 2020.
TAMARA MCFARLANE
DANIEL OWUSU-ANSAH
Lehman College NUR 723
Strategies for Advanced Nursing Practice December, 2016
Instructor: DR. BRIGITTE S. CYPRESS
Executive Summary
Introduction
There are many barriers that prevent APRNs from functioning to their fullest potential during practice. One of these barriers is prescriptive authority. According to the article, APRN Prescribing Law: A State by State Summary, prescriptive authority (independent prescribing) “is the ability of Advance Practice Registered Nurses (APRNs) to prescribe, without limitation, legend (prescription) and controlled drugs, devices, adjunct health/medical services, …show more content…
State regulations on APRNs scope of practice contribute to the barriers that affect APRNs. Regulatory barriers include having onsite physician oversight, physician chart review requirements, and lack of prescriptive authority, inability to admit patients to hospitals, order tests and medical supplies. (Institute of Medicine, 2011) According to the article, Restrictive Practice Environment and Nurse Practitioners’ Prescriptive Authority, “eliminating restrictions to allow NPs to practice at their full potential would alleviate many problems of access to primary care services.” (Pan, Straub, & Geller, 1997) Lifting restrictions and allowing APRNs to practice to their full potential including full prescriptive authority, would reduce delay in care, improve patient satisfaction, allow physicians to focus on complex health issues and increase access to primary care. APRN education and abilities have evolved over the years. Outdated insurance policies have not kept up with the change in healthcare to recognize and properly reimburse APRNs for care rendered. Under federal legislation, NPs who bill for direct reimbursement for Medicare part B services are reimbursed at a rate of 80% for the lesser charge or 85% of the fee schedule amount for physicians. (American Association of Nurse Practitioners, 2013) In some states NPs and CNMs are not listed as primary care providers by insurance companies …show more content…
Expand the Medicaid and Medicare managed reimbursement for NP services provided in primary care settings. The provider demographic is changing, and along with it, patients’ expectations for provider choice. It is important for the patients to elect APRNs as their provider and have those services covered by their insurance. The APRNs are required to bill incident to an on-site delegating physician. When an APRN bills incident to a physician, the service gets reimbursed at the physician rate, the facility charges more for the visit. This ultimately increases costs for the insurance companies and the patients. Medicare reimburses APRN services at 85% of the physician fee schedule amount for the same primary care services. We believe that consumers should have the option to select a nurse practitioner as their provider and that third-party payers should be required to reimburse for that care fairly. Such policies would increase competition and incentivize APRNs to practice in New York. We urge policymakers to require third-party insurers to credential APRNs as primary care providers and reimburse them fairly for their