Under a Veterans Affairs proposal put forward this spring, advanced practice registered nurses would provide wider array of services without direct clinical oversight from a physician, and regardless of restrictions in state or local law.
Staff of the FTC's Office of Policy Planning and its Bureaus of Competition and Economics responded to the VA's request for public comments and wrote that removing the remaining state law-based supervision restrictions for APRNs working within the Veterans Health Administration system could benefit VA patients nationwide "by improving access to care, containing costs, and expanding innovation in healthcare delivery," FTC said.
"To the extent that the VA's actions would spur additional competition among healthcare providers and generate additional data in support of safe APRN practice, we believe those benefits could spill over into the private healthcare market as well," FTC staff wrote.
When the VA released the proposal in May, it said that full practice authority would expand the pool of qualified healthcare professionals authorized to provide primary healthcare and other related health care services to the full extent of their education, training, and certification to Veterans without the clinical supervision of a physician.
The American Medical Association responded in May that " this proposal will significantly undermine the delivery of care within the VA" and urged the VA to maintain its physician-led model of care.
Under the new policy, APRNs would be able to evaluate VA patients, order diagnostic tests for them, and manage their treatments without physician involvement or approval as long as they do so within the limits of their professional education and training.
The four APRN roles are:
- Certified Nurse Practitioner
- Clinical Nurse Specialist
- Certified Registered Nurse Anesthetist
- Certified Nurse Midwife