Legislation within the last 5 YEARS, Description, Accomplishment
Texas Nurse Practitioners (TNP) has made important milestone to improve access to care for patients and the practice environment for advanced practice nurse. TNP helped advance the SB 654 that expands access to patients in rural and underserved rural areas and allow nurses to see Medicaid patients by eliminating the insurance requirement (Eastin, 2017). Filed on 01/30/2017, the SB Bill 654 sailed various bill stages and passed into law on 5/29/2017. The Insurance Recognition increases access to care in medically underserved and rural areas in Texas (Eastin, 2017). Texas is in dire need of more healthcare practitioners for Medicaid patients in underserved rural areas. The legislation allows advanced practice nurses to serve more patients in these areas. This is because it helps remove restrictions that prevent advanced practice nurses (APNs) from Medicaid patients without the delegated authority of physicians (Eastin, 2017). In Texas, APNs are required to have a delegating physician so as to see patients and practice, even though the physician never treat or see any of the patients that APNs see. This forces APNs to sign contract with and pay thousands of dollars to physicians before they perform the job they are licensed and trained to do (Helbig, 2018). This needless physician cost drives APNs to more friendly states. Additionally, APNs practicing in Texas can only accept Medicaid insurance plan that is acceptable to their delegating physicians. This means that APNs cannot accept a Medicaid plan that their physicians decide not to participate in, which poses a huge challenge for APNs in underserved areas and patients.
Insurance Legislation removes this arbitrary insurance requirement by allowing APNs to freely decide to serve patients in all or any of the sixteen Medicaid plans. The legislation expands network capabilities in regions of Texas with shortages of healthcare providers by removing the requirement that APNs must be in similar insurance network as their delegating physicians (Eastin, 2017). Furthermore, the legislation removes outdated delegation barriers for APNs results in direct cost savings for consumers and the state, more quality care and improved access to care (Helbig, 2018).
What additional steps need to be taken to continue advocacy for this issue?
More legislative efforts are needed to expand access to care by removing delegation requirement barrier and allowing APNs to practice to the full extent of their training and education. Nursing profession should continue to support legislative efforts to improve access, quality and eliminate delegation requirement. Under current state law and regulations, delegation requirement remains a barrier to improved access to care (National Academies of Sciences Engineering Medicine, 2011). APNs are not allowed to practice to the full extent of their education and training (ANA, n.d). They are forced to enter into delegation contract with physicians in order to practice to their full potential. Yet the shortage of healthcare providers and pressing healthcare needs means that patients in Texas are not getting any value or clear protection they need. There is need to advocate for more access and more options for patients. This can be achieved by building a strong coalition and lobbying to gain support from powerful committee chair (Helbig, 2018). Strong coalitions make it possible to lobby legislators to support pieces of bills that support the potential of APNs to practice to extent of their training and licensure and to eliminate delegation barriers (ANA, n.d). Congresswoman Eddie Bernice Johnson can use her professional nursing experience to be the voice for nursing. She can support bills that better support nurse. The American Nurses Association should continue advancing the nursing profession by advocating on behalf of APNs at top level of government to be allowed to practice to the full scope of their education and training without delegation requirement.
References
ANA. (nd). Nurses Serving in Congress. American Nurses Association. Retrieved on July 5, 2021 from https://www.nursingworld.org/practice-policy/advocacy/federal/nurses-serving-in-congress/
Eastin, E. (2017). Rep. Smithee and Sen. Seliger Champion Legislation to Improve Access to Health Care. Retrieved on July 5, 2021 from https://www.texasnp.org/news/328476/Rep.-Smithee-and-Sen.-Seliger-Champion-Legislation-to-Improve-Access-to-Health-Care-.htm
Helbig, B. (2018). Influencing Health Care Through Advocacy. Trends in Health Care: A Nursing Perspective. Retrieved on July 5, 2021 from https://lc.gcumedia.com/nrs440vn/trends-in-health-care-a-nursing-perspective/v1.1/#/chapter/4
National Academies of Sciences Engineering Medicine (2011). The Future of Nursing: Leading Change, Advancing Health. Retrieved on July 5, 2021 from https://www.nap.edu/read/12956/chapter/2
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