FTC Backs APRN Scope-of-Practice Bill

Federal regulators say a bill in the Pennsylvania House of Representatives that would allow nurse practitioners to practice independently and write prescriptions would spur competition, improve access to healthcare and benefit consumers.

The Federal Trade Commission has once again sided with nurse practitioners in their long-simmering feud with physicians on scope-of-practice.

At the request of Pennsylvania State Rep. Jesse Topper (R-Bedford), FTC staff this week submitted comments on the competitive impact of a legislative proposal (HB100) that would eliminate a state requirement that APRNs enter collaborative agreements with physicians after they've completed three years of practice, and 3,600 hours of training, under a physician.

The bill also allows APRNs to write prescriptions independently, and eases practice restrictions on APRNs moving into the state.

"Undue regulatory restrictions on APRN practice can impose significant costs on healthcare consumers – patients – as well as both public and private third-party payors," the letter said.

"Removing existing supervision requirements to permit independent APRN-CNP prescribing and practice has the potential to benefit Pennsylvania consumers by increasing competition among health care providers, which likely would improve access to care, contain costs, and expand innovation in health care delivery," the letter said.  

The bill is opposed by the Pennsylvania Medical Society. In a strongly worded rebuttal to a recent editorial written by the PennLive Editorial Board, Society President Theodore Christopher, MD, blasted suggestions that nurse practitioners should be given more autonomy.

“Physicians and nurse practitioners (NPs) are neither professionally equivalent nor interchangeable. And, it is careless to suggest that maintaining the current collaborative relationship between physicians and NPs somehow involves an issue of "freedom," Christopher wrote. "Rather, the current relationship between these two professionals serves to ensure that patients receive the best possible care."

FTC has analyzed APRN regulations in several states. While deferring to the will of state legislatures, FTC staff has been consistently supportive of states' efforts to reduce regulations that restrict scope of practice in healthcare and other professions.   

In 2017, the FTC created the Economic Liberty Task Force which the commission said is "examining professional licensing issues and ways to promote entrepreneurship by avoiding costly and burdensome regulations that harm competition without offering countervailing benefits to consumers."