The AMA Says APRNs Need Medical Board Oversight, ANA Refutes Recommendation

4 Min Read Published June 23, 2023
The AMA Says APRNs Need Medical Board Oversight, ANA Refutes Recommendation

The American Nurses Association (ANA) continues to support the Improving Care and Access to Nurses (ICAN) Act (H.R. 2713), which will remove administrative, practice, and other barriers currently faced by advanced practice registered nurses (APRN) and their patients under federal law.

Unfortunately, the American Medical Association’s (AMA) House of Delegates (HOD) recently created a policy amendment that states that APRNs “be licensed and regulated jointly by the state medical and nursing boards.” 

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The American Nurses Association Statement

ANA President Jennifer Mensik-Kennedy, Ph.D., MBA, RN, NEA-BC, FAAN issued a statement on behalf of the ANA during the Membership Assembly in Washington. 

“At the end of the day, the licensing and regulation of APRNs do not and have never required the oversight of state medical boards. U.S. nursing regulatory bodies have the authority and oversight because they understand the practice and principles of nursing to ensure that competent nursing care is provided by licensed nurses.

Joint licensing would place unnecessary administrative burdens on APRNs, and create additional barriers to practice.  The downstream effect of this action only hurts the patients who rely on the safe, quality and evidence-based care provided by APRNs. This is especially true for those in underserved communities and rural areas who are often faced with a shortage of providers and access to timely care.

Our modern and complex healthcare delivery system requires flexibility. This is why ANA continues to stand firmly in our support of the Improving Care and Access to Nurses (ICAN) Act (H.R. 2713), which will remove administrative, practice and other barriers currently faced by APRNs and their patients under federal law.

This week, during ANA’s annual Hill Day, nearly 400 members of ANA members urged Congressional leaders to cosponsor the ICAN Act. This bipartisan legislation continues to receive support and momentum, with more than 235 organizations that have endorsed the bill.

The health of our patients and communities must come first. Antiquated barriers to practice and actions that perpetuate misinformation about APRN care are a dated way of thinking and a disservice to patients.”

The ANA is not the only organization speaking against the policy amendment by the AMA. The NCSBN strongly opposes the amendment stating, “In the interest of public safety and protection, best practice dictates that regulation of APRNs should be within the purview of NRBs.” Maryann Alexander, Ph.D., RN, FAAN, NCSBN Chief Officer of Nursing Regulation added, “Adding the needless oversight of state medical boards does nothing to enhance patient protection but has the potential to add unnecessary bureaucracy that may actually slow down the regulatory process and impede access to care.”

Improving Care and Access to Nurses Act

On April 24th, Congressman Dave Joyce (OH), Congresswoman Suzanne Bonamici (OR), Congresswoman Lauren Underwood (IL), and Congresswoman Jennifer Kiggans (VA) re-introduced the act. 

This unique bipartisan act would, 

  • Increase healthcare access

  • Improve the quality of care

  • Lower costs by removing barriers in the Medicare and Medicaid programs that prevent APRNs from practicing the full scope of their education and clinical training

“Nurses are on the frontlines of the effort to ensure that Americans have access to the healthcare they need, but outdated federal restrictions are limiting patients’ access to care,” said Congressman Joyce, Co-Chair of the Congressional Nursing Caucus. “By removing these unnecessary federal barriers that prevent Advanced Practice Registered Nurses from carrying out their duties, our bipartisan bill will increase access to care and strengthen patient choice. That’s why I am proud to join this effort with my colleagues to expand access to care, lower patient costs, and ensure every Ohioan can receive services from the healthcare provider of their choice.”

“AANA thanks Representatives Joyce, Bonamici and the Congressional Nursing Caucus for introducing the Improving Care and Access to Nurses legislation. As the only anesthesia provider in most rural hospitals, and the predominant provider in underserved communities, Certified Registered Nurse Anesthetists (CRNAs) play an important role in maintaining critical access in communities across the country. Yet unnecessary regulations serve as barriers to expanding care, especially at a time when those same communities face a shortage of providers. This critical legislation is an answer to workforce shortages in healthcare, as it will reduce barriers to help ensure that everyone who needs access to the high-quality care Advanced Practice Registered Nurses such as CRNAs provide, can have it,” said AANA President Angela Mund, DNP, CRNA.

APRNs are at minimum master’s prepared, more often than not doctoral prepared, and have the ability and training to treat patients in both acute and primary care settings. 

Unfortunately, federal statutes and regulations at times require physician oversight and limit the role and abilities of APRNs. These vary by state but the Improving Care and Access to Nurses Act would eliminate these barriers. It’s important to note that the bill does not expand the scope of practice or impede upon state law for APRNs. 

According to the official announcement, “the bill simply ensures that the federal government honors state law, ensuring that Medicare and Medicaid patients living in states where nurses have already been granted full practice authority are permitted to choose to seek care from a nurse practitioner.”

Kathleen Gaines
Kathleen Gaines
News and Education Editor

Kathleen Gaines (nee Colduvell) is a nationally published writer turned Pediatric ICU nurse from Philadelphia with over 13 years of ICU experience. She has an extensive ICU background having formerly worked in the CICU and NICU at several major hospitals in the Philadelphia region. After earning her MSN in Education from Loyola University of New Orleans, she currently also teaches for several prominent Universities making sure the next generation is ready for the bedside. As a certified breastfeeding counselor and trauma certified nurse, she is always ready for the next nursing challenge.

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