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ACNM Policy Update - 5/23/2014

1.  Congratulations to Minnesota! APRN Bill Signed into Law!
2.  Selected State Policy Developments from Colorado, Delaware, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, Missouri, North Carolina

1.  Congratulations to Minnesota!   APRN Bill Signed into Law!

The following is excerpted from a brand new blog post by a member of Minnesota’s policy team, Brielle Stoyke, Affiliate Legislative Chair.

On May 1, 2014 the Senate passed S.F.511 (the APRN bill) unanimously with compromised language from the agreement made with opposing physician groups. One week later on May 8th the House passed the same language 119-13. Starting in Jan 2015, all four roles of APRNs will have autonomous practice and autonomous prescriptive authority. Exceptions to this include:

1. New graduate nurse practitioners (NPs) and clinical nurse specialists (CNSs) will need to practice under a collaborative agreement with an APRN or physician in a clinical system that includes physicians and APRNs for the first 2080 hours of practice.

2. Certified registered nurse anesthetists (CRNAs) will need to practice under a collaborative agreement and maintain a prescriptive agreement with a physician when treating patients for chronic pain.

3. An APRN Advisory Committee to the Board of Nursing is created to review practice trends, prescribing and complaint date in the aggregate, and advise the Board of Nursing on emerging practice and regulatory standards.

4. MN Department of Health will gather data from the past 36 months related to chronic pain procedures performed by MDs, DOs and CRNAs in MN.

Previously, although CNMs by law did not need a written agreement by state statute, many insurance companies and hospital bylaws required that CNMs have a written collaborative agreement. One theory for this signature requirement is that in the past NPs had this requirement and because there are many more NPs than CNMs in MN (3,787 NPs to 274 CNMs), the hospitals and insurance companies just included CNMs in the requirement as well. Starting in January 2015, hospitals and insurance companies may forgo the written agreement for NPs and CNMs too.

Interested members can read more about Minnesota’s experience and the importance of this law in the full blog post, available online.

2.  Selected State Policy Developments from Colorado, Delaware, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, Missouri, North Carolina

Colorado S.187 proposes to create the Colorado Commission on Affordable Health Care to analyze health care costs in the state and make recommendations regarding health care affordability and quality of care. The bill has passed both chambers as of May 1.

Delaware H.319 expands the statutory consideration of the role and scope of CPMs and CMs, both of which are already legal in the state, by removing the requirement for a written collaborative agreement, among other things. The bill was introduced on May 1.

Florida H.7113, a bill that would create a pathway for autonomous CNM practice and authorize prescriptive authority for controlled substances, passed the House with bipartisan support on April 25.

Hawaii S.2491 replaces references to advanced practice registered nurse recognition with advanced practice registered nurse licensure to align Hawaii's law with national standards. The purpose of the bill is to eliminate a barrier to licensure in other state boards that question the equivalency of Hawaii advanced practice registered nurse recognition to the standard of advanced practice registered nurse licensure. The bill was signed into law on April 23.

Hawaii S.2649 requires equivalent insurance reimbursement for services provided by a health care provider to a patient regardless of whether the service is provided through telehealth or face-to-face contact. The bill clarifies that telehealth providers include primary care providers, mental health providers, oral health providers, physicians and osteopathic physicians, advanced practice registered nurses, psychologists, and dentists. It has passed both chambers as of May 2.

Illinois S.2998 provides that an applicant for licensure to practice as an advanced practice nurse shall have successfully completed requirements to practice as, and holds and maintains a current, national certification as a nurse midwife, clinical nurse specialist, nurse practitioner, or certified registered nurse anesthetist from the appropriate national certifying body. The bill has passed both chambers as of May 9.

Louisiana S.659 provides for the establishment of the Louisiana State Health Care Profession Institute. Its duties would include, among other things, to examine and study the scope of practices of health care professionals and recommend needed reforms and to recommend such changes in the law as it deems necessary to modify or eliminate antiquated and inequitable scope of health care profession issues, and provide assistance to the legislature to bring the laws and regulations of the state into harmony with modern health care conditions. The bill passed the Senate on April 23.

Maine H.881 proposed to expand Medicaid coverage for family planning services to adults and adolescents who have incomes less than or equal to 200% of the nonfarm income official poverty line as defined by the federal Office of Management and Budget. The bill was vetoed on April 28.

Maryland H.779 creates the Health Care Provider-Carrier Workgroup to provide a mechanism for health care providers and carriers to resolve disputes on issues over which no state agency has authority. The bill was signed into law on May 15.

Missouri H.1898 would have established
the Perinatal Advisory Council and required the Council to establish standards for all levels of hospital perinatal care, among other things. The bill failed to pass the House on May 1.

North Carolina:  H. 1169/S. 819, a bill to remove physician supervision requirements for CNMs, was introduced on May 22.


Should you have questions about federal issues, please contact Jesse Bushman, ACNM’s Director of Advocacy and Government Affairs at [email protected] or 240-485-1843.

Should you have questions about state issues, please contact Cara Kinzelman, ACNM’s Manager of State Government Affairs at [email protected] or 240-485-1841.  

Want to take action or get involved?  Contact ACNM's Government Affairs Committee.
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