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March 4, 2013

Nurses use Medicaid expansion to push for wider scope of practice

Daily Briefing

    The American Association of Nurse Practitioners (AANP) is using the Medicaid expansion in the Affordable Care Act (ACA) as a catalyst in its efforts to expand which services NPs can offer, the Washington Post's "Wonkblog" reports.

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    AANP President Angela Golden argued that NPs are "uniquely positioned" to accommodate the additional beneficiaries, particularly since 68% of NPs work in primary care, one of the areas most affected by the physician shortage. In addition, she said that research showing that NPs have similar outcomes as physicians demonstrates that NPs "have a proven track record of providing this care, and doing it very well."

    However, the American Medical Association (AMA) and other physician groups tend to oppose NPs' efforts to expand their scope of practice because they lack a physician's education. AMA said in 2010, "Nurses are critical to the health care team, but there is no substitute for education and training."

    In 2012, seven states rejected legislation that would expand NPs' scope of practice. However, Golden pinpointed three reasons why NP's push for expanded scope of practice may be more successful in 2013:

    • The Supreme Court decision and President Obama's re-election have confirmed that the ACA will be implemented;
    • 14 states are considering NP scope-of-practice laws, an increase from the seven that considered similar legislation in 2012; and
    • AANP is accruing more endorsements for its position, including the National Governors Association.

    Golden also said that AANP is seeking change on a federal level by pushing for legislation that would allow NPs greater authority to authorize home health care and hospice care for Medicare beneficiaries (Kliff, "Wonkblog," Washington Post, 2/27).

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    1. Current ArticleNurses use Medicaid expansion to push for wider scope of practice

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