January 4, 2022 – As emergency changes in response to the COVID-19 pandemic were made permanent, the past year saw significant progress toward increased independent practice authority for advanced practice registered nurses (APRNs), according to the 34th Annual Legislative Update presented exclusively in the January issue of The Nurse Practitioner. The journal is published in the Lippincott portfolio by Wolters Kluwer.
"Relaxation of existing regulations in supervision, collaboration, license renewal, and portability due to the continuing COVID-19 pandemic improved practice authority for APRNs in reduced- and restricted-practice states," writes Susanne J. Phillips, DNP, APRN, FNP-BC, FAANP, FAAN, of the University of California, Irvine, in her introduction to the annual report on legislative developments in APRN practice. The 34th Annual Legislative Update is now freely available on the journal website.
Many pandemic-related APRN practice changes become permanent
The 2020 Legislative Update reported on the adoption of temporary, emergency regulations by many states to expand the role of APRNs in responding to the COVID-19 pandemic. These changes increased practice authority for all types of APRNs, including not only nurse practitioners and certified nurse practitioners, but also certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists.
As the pandemic enters its third year, several states have made these regulations permanent or enacted new laws expanding practice authority for APRNs. Delaware and Massachusetts passed amendments resulting in full practice authority. With its new law, Delaware joins North Dakota as the second state to join the "APRN Compact," which allows APRNs to hold one multistate license with a privilege to practice in other compact states.
Two additional states enacted laws expanding practice authority, including a new pathway for full independent practice authority in Arkansas and a shorter time to practice period (from 5 years to 2 years) authorizing NPs to practice independently. Several other states – including Florida, Illinois, Louisiana, North Carolina, and Oklahoma – have enacted new laws or updated regulations improving practice authority for APRNs.
Several states have adopted laws authorizing APRNs and other providers to provide and be reimbursed for home health care and telehealth services. Other states, including Arkansas, Louisiana, Maine, and Washington, passed other changes improving reimbursement for APRN services.
The Nurse Practitioner's Annual Legislative Update summarizes APRN practice authority and reimbursement status in all 50 states, based on a nationwide survey of state Boards of Nursing and APRN associations. Dr. Phillips notes that at the end of 2021, APRNs have full, autonomous practice and prescriptive authority in 14 states and the District of Columbia, and full practice authority following a transition to practice period in another 10 states.
DOI: 10.1097/01.NPR.0000802996.14636.1c
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The Nurse Practitioner