28 States Considering Expanding Duties of Nurse Practitioners

Twenty-eight states are considering expanding nurse practitioners' duties to help offset the nation’s shortage of primary care physicians, the AP/Baltimore Sun reports. NPs are nurses with advanced degrees.

Currently, laws regulating the scope of responsibilities for NPs vary significantly by state. For example, some states require physicians to manage NPs, while Montana allows NPs to practice without a supervising physician. Most states allow NPs with a doctorate in nursing practice to use the title "doctor."

In Florida, lawmakers are considering a bill that would allow NPs to prescribe controlled substances.

Health Reform Gives Boost to Nurses

The new health reform law would expand NPs' power by:

• Allocating $50 million to nurse-managed health clinics providing primary care to low-income individuals;
• Allotting $50 million annually from 2012 to 2015 for hospitals to train nurses with advanced degrees on how to care for Medicare beneficiaries;
• Boosting nurse midwives' Medicare reimbursement to the physician level; and
• Providing 10% Medicare bonuses to primary care providers, including nurse practitioners, who practice in areas with few physicians.

Support, Opposition

The American Medical Association currently opposes proposals to expand NPs' responsibilities. The AMA and other critics say such action could put patients at risk, while using the title "doctor" could be confusing.

However, NPs contend they are highly trained, spend more time with patients and charge less (Johnson, AP/Baltimore Sun, 4/13).