State Legislators Should Carefully Evaluate Proposals to Limit Advanced Practice Registered Nurses’ Scope of Practice

Washington, DC - Federal Trade Commission staff has issued a policy paper suggesting that state legislators should be cautious when evaluating proposals to limit the scope of practice of Advanced Practice Registered Nurses (APRNs). By limiting the range of services APRNs may provide and the extent to which they can practice independently, such proposals may reduce competition that benefits consumers, the paper states.

“[E]ven even well-intentioned laws and regulations may impose unnecessary, unintended, or overbroad restrictions on competition, thereby depriving health care consumers of the benefits of vigorous competition,” the staff policy paper states.

The policy paper, called “Policy Perspectives: Competition and the Regulation of Advanced Practice Nurses,” notes the potential benefits of improved competition in the provision of primary health care services. Staff cites research suggesting that APRNs provide safe and effective care within the scope of their training, certification, and licensure. In addition, health policy experts have warned of significant shortages of primary care practitioners across the United States, and they have suggested that APRNs might help to alleviate health care access problems if undue regulatory burdens were reduced. Moreover, effective collaboration among health care providers, including team-based care, does not always require physician supervision of APRNs.

The policy paper sets forth recommended principles for evaluating APRN scope of practice proposals. As the policy paper states, “Numerous expert health care policy organizations have concluded that expanded APRN scope of practice should be a key component of our nation’s strategy to deliver effective health care efficiently and, in particular, to fill gaps in primary care access. Based on our extensive knowledge of health care markets, economic principles, and competition theory, the FTC staff reach the same conclusion: expanded APRN scope of practice is good for competition and American consumers.”

The policy paper is part of the FTC’s ongoing efforts to promote competition in the health care sector, which benefits consumers through lower costs, better care, and more innovation.

The Commission vote to issue the staff Policy Paper was 4-0.  (FTC File No. V140006; the staff contact is Daniel J. Gilman, Office of Policy Planning, 202-326-3136).

The FTC’s Office of Policy Planning works with the Commission and its staff to develop long-range competition and consumer policy initiatives, consistent with the FTC’s unique mission to conduct research and engage in advocacy on issues that affect competition, consumers, and the U.S. economy.

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