Wisconsin Governor Tony Evers last week vetoed Senate Bill (SB) 394, a bill that would have greatly expanded the scope of practice for advanced practice nurse practitioners (APRNs).
In his veto message, Gov. Evers said he “objects to altering current licensure standards for APRNs, allowing practices functionally equivalent to those of physicians or potentially omitting physicians from a patient’s care altogether, notwithstanding significant differences in required education, training and experience.”
The Wisconsin Radiological Society (WRS), which received funding from the American College of Radiology Association® (ACRA®) Scope of Practice Fund, was a leader in advocating against SB 394. Prior to the veto, WRS sent the governor a letter detailing its objections to the bill. The American College of Radiology® (ACR®) Radiology Advocacy Network (RAN) and WRS both sent multiple action alerts to Wisconsin radiologists urging them to contact Governor Evers to request he veto the legislation.
“Governor Evers' veto of the APRN independent practice bill is a victory for patient safety,” said Gregg Bogost, MD, FACR, WRS government relations chair. “It also shows the power of many voices and diverse specialties working together to stand up for the physician-led team care model. We are grateful to ACRA for its Scope of Practice Fund grant, which made it possible for us to devote significant time and effort to this fight.”
Kansas Governor Laura Kelly signed legislation (House Bill 2279) that grants nurse practitioners independent authority to prescribe durable medical equipment and medication. Most nurse practitioners will be required to maintain malpractice insurance coverage and comply with U.S. Drug Enforcement Administration requirements related to controlled substances.
“The Kansas Radiological Society was aligned with the Kansas Medical Society and other medical societies in opposition to the recently passed APRN bill, which allows APRNs to prescribe durable medical equipment and drugs without a collaborative practice agreement with a physician,” said Mary M. Mitchell, MD, president of the Kansas Radiological Society. “This bill, which did not have a public hearing this session nor follow the standard legislative process of floor debate and review…is an example of the attempts being made to increase the scope of practice of medicine by non-physician practitioners, without appropriate, specified oversight by the Board of Healing Arts.”
New York Governor Kathy Hochul recently approved the state’s 2022-2023 budget, which included a provision to allow a nurse practitioner with more than 3,600 hours of experience to practice without a written practice agreement with a physician.
“While the New York State Radiological Society is pleased with the focus on healthcare that this year's state budget has provided, we are concerned with the elimination of the requirement for collaborative practice agreements between nurse practitioners and physicians,” said Keith Hentel, MD, FACR, president of the New York State Radiological Society. “By moving away from team-based healthcare, this change has the potential to result in many patients no longer benefiting from the training and expertise physicians provide, leading to lower quality of care. Although less apparent, decreased supervision may also increase the cost of care. For example, in imaging, non-physician providers may utilize more imaging than their physician counterparts, leading to the increased cost to patients and our healthcare system.”
There has been an increase in governors using their executive powers to expand scope of practice. While initially used due to the COVID-19 pandemic, executive powers now are being used as a tactic to carve out more permanent scope of practice. When decisions are made via executive action, they tend to be more challenging to address as there typically are no comment periods or public hearings.
The ACR has a number of resources to help state chapters fight non-physician scope of practice expansion legislation, including the ACRA State Scope of Practice Fund. ACR members can also keep up to date with bills being introduced through the ACR policy map, in Advocacy in Action e-newsletter and through FiscalNote, a legislation and regulation tracking service.
If members are interested in opting in for FiscalNote reports or would like more information about any state issues, please contact Eugenia Brandt, ACR Government Affairs Director or Dillon Harp, ACR Senior State Government Relations Specialist.