Scope of Practice

In some states, despite the urgent need to expand access to primary care and preventive services, a number of barriers prevent the full deployment of nurses, in particular advanced practice registered nurses (APRNs). While laws in 23 states permit APRNs to practice independently, 20 states require them to practice in collaboration with a physician, and seven mandate physician supervision. All states permit APRNs to prescribe medications, but many impose limits on this authority.

Like regulatory barriers, reimbursement policies also contribute to the unwillingness of some insurers to credential APRNs as primary care providers. This means these APRNs cannot be reimbursed for providing the primary care that they are authorized to practice.

What is the Center Doing About It?

The Center to Champion Nursing in America is working with states to examine laws and regulations that limit scope of practice for APRNs. Additionally, we are working to identify and disseminate promising state-based solutions that strengthen scope of practice for APRNs.