34th Annual APRN Legislative Update

Abstract

Relaxation of existing regulations in supervision, collaboration, license renewal, and portability due to the continuing COVID-19 pandemic improved practice authority for advanced practice registered nurses (APRNs) in reduced-and restrictedpractice states. This 34th Annual Legislative Update covers the scope of practice changes, and legislative and regulatory decisions that most impacted APRNs across the US in 2021.

Addressing Barriers to APRN Practice: Policy and Regulatory Implications During COVID-19

“…To add to practice confusion, the requirement for transition to practice varies by state regardless of APRN practice authority status. For example, 10 states with FPA have transition to practice requirements (Colorado, Connecticut, Massachusetts, Maryland, Maine, Minnesota, Nebraska, Nevada, South Dakota, Vermont), seven reduced or restricted practice states have transition to practice requirements (Arizona, California, Florida, Illinois, New York, Virginia, West Virginia), and 19 reduced or restricted practice states have no transition to practice requirements (Alabama, Georgia, Indiana, Kansas, Kentucky, Louisiana, Missouri, Michigan, Mississippi, North Carolina, New Jersey, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Wisconsin) ( Table 1 ) ( Phillips, 2022 ).…”

“…Other advances in scope of practice authority occurred in Virginia, where transition to practice requirements were reduced from 5 years to 2 years. In six other states (Florida, Illinois, Louisiana, North Carolina, Oklahoma, and Pennsylvania), select practice authority restrictions have eased ( Phillips, 2022 ).…”

“…In Maine, CRNA services must now be covered. In Washington State, reimbursement was increased for APRN Medicaid providers ( Phillips, 2022 ).…”

“…The implementation of the APRN Compact will be enacted when seven states have enacted the legislation necessary to become a compact state ( NCSBN, n.d.-a , n.d.-b ). At present, Delaware, North Dakota, and Utah are compact states; Delaware had a companion bill to the APRN compact while North Dakota was a FPA state prior to joining the APRN Compact ( NCSBN, n.d.-a , n.d.-b ; Phillips, 2022 ).…”

Toward a Uniform Classification of Nurse Practitioner Scope of Practice Laws

“…When classifying SOP laws, many researchers rely on the Nurse Practitioner Annual Legislative Update (NPALU) as the source for the SOP laws (see Tables A1 and B1 in Supplemental Appendices A and B). This source publishes annual state-by-state summaries of SOP laws pertaining to practice, reimbursement, and prescription (Phillips, 2022). While the NPALU offers a long history of changes to SOP laws-the first version was published in 1989-it is not aimed at researchers.…”