Massachusetts Coalition of Nurse Practitioners

Committed to Massachusetts Nurse Practitioners and the Citizens of the Commonwealth by working to support advanced practice nursing and increased access to high quality health care for all.

About Nurse Practitioners

Nurse practitioners are registered nurses with advanced Master’s or Doctoral level education and are nationally certified in advanced practice nursing specialties.

There are more than 9,000 nurse practitioners in Massachusetts who work in a variety of health care settings providing primary and specialty care to patients.

Nurse Practitioners have the education, knowledge, and experience necessary to deliver high-quality cost-effective health care to patients.

Nurse Practitioners provide comprehensive health care services including performing physical examinations, prescribing medications, ordering and interpreting diagnostic tests, and treating and managing acute, episodic, and chronic conditions.  

Nurse practitioners work closely with physicians and other members of the healthcare team and like physician colleagues, may consult with specialists when needed. 

NPs often treat the most vulnerable members of society including the elderly, people living in poverty, patients with complex chronic illnesses, and patients with opioid addictions.

Although federal law allows NPs to prescribe life-saving medication assisted treatment for patients with opioid addiction, waiver trained NPs in Massachusetts are restricted from prescribing these medicatons unless they have a physician who will allow this and is willing to supervise them. 

NPs are often underutilized despite being qualified to provide primary care at a lower cost than other providers.


What will Passing H. 2351/S. 1257 do for Massachusetts


H. 2351/S. 1257 will allow nurse practitioners in Massachusetts to practice to the full extent of their education and training and update the MA Nurse Practice Act by removing antiquated and unnecessarily restrictive licensing requirements. Despite leading the nation’s healthcare reform initiatives, Massachusetts has the most restrictive and antiquated licensing requirements for NPs and is the only New England state that has yet to remove them.

Passage of H.2451/S. 1257 would align the Massachusetts Nurse Practice Act with national recommendations for professional licensure and with 22 states plus D.C, where Full Practice Authority legislation for Nurse Practitioners has already been advanced. Such a change here in Massachusetts would ensure greater consistency in practice and better care for patients.   

Passage of H.2451/S. 1257 would help close gaps in access to care and help decrease health care costs.  Lack of access to primary and specialty care is a problem for patients throughout the Commonwealth, and in particular for patients with Masshealth and those who live in Western MA and Cape Cod. As long as NP care is dependent upon supervisory care models that dictate and limit panel size and participation in state sponsored insurance plans, NPs cannot be effectively deployed to fill gaps in access to care. Lack of timely access to primary and specialty care forces patients to rely on more costly services provided in emergency room settings and increases the cost of care paid by the Commonwealth.

Passage of H.2451/S. 1257 would help decrease administrative costs for health care services and potentially save the Commonwealth millions of dollars per year. The price of retrospective NP prescription reviews by physicians is estimated to cost tens of millions of dollars annually. The review of prescriptions that have already been written has not been shown to increase patient safety but has been shown to divert valuable MD and NP time and resources away from patient care and further drive up the cost of providing health care services in the state.

Passage of H.2451/S. 1257 would remove financial disincentives for innovative practice models that save money and improve health care outcomes. The regulatory requirement to enter into costly prescribing agreements with a supervising physician creates financial disincentives for nurse practitioners to participate in innovative practice models that improve healthcare outcomes and decrease healthcare costs. NP led programs for chronic disease management and home based care of the elderly are just a few examples of such models that have demonstrated significant cost savings.

Passage of H.2451/S. 1257 would remove an additional barrier for patients seeking medication assisted treatment for opioid dependence. The opioid epidemic continues to plague the Commonwealth as a public health crisis, and struggling patients are facing long wait times and limited access to medication assisted treatment (MAT) programs. As of January 2017 less than 500 of the 36,000 actively licensed physicians in Massachusetts are waivered MAT prescribers. 
Although federal law allows for NPs to prescribe these life-saving medications, eligible NPs in Massachusetts are restricted from prescribing MAT unless they have a physician who will allow this and is willing to supervise them.

Passage of H.2451/S. 1257 would protect vulnerable patients who are dependent upon supervisory practice agreements that can be unexpectedly terminated. In 2013, more than 1,200 Massachusetts patients were left without access to psychiatric care when a group of 10 psychiatric NPs lost their supervising physician. Unable to prescribe medications under the existing licensing model in MA, these NPs were forced to refer many of their patients to emergency departments to obtain their medications for ADHD, bipolar disorder, and schizophrenia.

RESOURCES

2009 Rand Report 
Controlling Health Care Spending in Massachusetts: An Analysis of Options Submitted to: Commonwealth of Massachusetts Division of Health Care Finance and Policy
AUGUST 2009

Massachusetts Action Coalition Report
The Advanced Practice Nurse in Massachusetts
November 2014

Robert Wood Johnson - Charting Nursing’s Future Report
March 2017 • ISSUE NO. 30
 
The Case for Removing Barriers to APRN Practice