CLEAR

Changes in scope of practice for advanced practice providers

Several states have recently made changes or rejected changes to scope of practice laws fro nurse practitioners, physician assistants, and pharmacists. Emergency powers and waivers due to the COVID-19 pandemic allowed advanced practice providers to temporarily perform some expanded services. Supporters of expanded scope laws argue for providers to be allowed to practice to the full extent of their education and training, resulting in improved access to care for patients. Opponents of expanded scope cite studies showing that most patients want a physician to be involved in their care and that care provided by advanced practice providers is actually more expensive than care provided by doctors.

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Some states with recent scope of practice changes include

• New York allows nurse practitioners to practice without supervision from a doctor
• Massachusetts expanded the independent practice of physician assistants
• Maryland now allows nurse practitioners, midwives, and physician assistants to perform abortions
• Kansas allows full practice authority for nurse practitioners, read more
• Alabama allows certified registered nurse anesthetists to provide anesthesia services in coordination with a physician, podiatrist or dentist and order certain medications and tests, read more
• Wisconsin's governor vetoed a bill that would have granted independent practice authority to APRNs, read more

 

Louisiana considers licensure bills regarding applicants with prior convictions

A bill under consideration in the Louisiana House would allow interested licensure candidates who have a prior criminal conviction to request a pre-determination from the licensing board as to whether their conviction disqualifies them from obtaining a license before they invest in school or training. The licensing board would have 45 days to make the determination, which would then be binding unless the applicant at time of application has new, pending, or previously undisclosed convictions.

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Ontario: CPD to become mandatory for engineers

A new regulation has been approved by the Professional Engineers Ontario Council and by the Ontario Cabinet to make PEO's continuing professional development program mandatory for license renewal, effective January 2023. PEO will also be able to discipline licensees for non-compliance. PEO's current optional program, Professional Evaluation and Knowledge (PEAK), will form the basis for the new mandatory program. Personalized CPD targets will be determined via a practice evaluation questionnaire.

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Tennessee: new law on judicial/agency deference

A new law in Tennessee instructs courts to review cases involving government agencies de novo ("from the beginning") instead of deferring to the agency's interpretation of its rules and statutes. Courts will resolve any remaining ambiguities against the government agency. The new law aligns with other areas of law and mirrors how ambiguities in criminal cases are resolved in favor of the accused.

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New Zealand: changes to engineering regulation

New Zealand's Ministry of Business, Innovation and Employment has announced changes to engineering regulation, making registration and licensing mandatory. The current Chartered Professional Engineers register is voluntary. The new system will require all practicing engineers to be registered and those working in high-risk fields to be licensed. Engineering New Zealand supports the new regulatory framework.

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Research: warnings to healthcare practitioners prevent repeat PHI breaches

New research published in the Journal of the American Medical Association indicates that email warnings sent to healthcare practitioners after unauthorized access to protected health information prevented a recurrence of the breach in 95% of cases. According to reports by Verizon, "insider security threats are a bigger risk than hacking in healthcare." In the trial, only 4% of employees who received the warning email repeated the unauthorized access, whereas 40% of employees who did not receive the warning repeated the offense.

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Tennessee: licensure law for online auctioneers declared unconstitutional

A US District Court judge has ruled that Tennessee's law requiring all auctioneers, including online auctioneers, to be licensed is unconstitutional, imposing an excessive burden on interstate commerce and violating the commerce clause of the US Constitution. The commerce clause gives Congress the power to regulate commerce among the states and has been interpreted as prohibiting states from passing legislation that burdens interstate commerce.

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Ontario: Law Society cancels online exams

The Law Society of Ontario has changes its scheduled June online examinations to July in-person examinations. An investigation is ongoing into licensing candidates who may have improperly accessed exam content, thus compromising the integrity of the scheduled exam. LSO indicated that a move to in-person delivery is necessary to ensure exam security. A group of licensing candidates has submitted an open letter to the LSO indicating how the change disrupts their exam preparation and travel and creates additional stressors for a class of candidates that has already seen unprecedented disruptions to their education due to the pandemic. Concern was also raised by immuno-compromised students being required to sit for an in-person exam.

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Expanding pharmacist scope of practice

A Kaiser Health News report details expanded scope of practice for pharmacists across the US. At least 12 states have authorized pharmacists to treat minor illnesses such as urinary tract infections, strep throat, and flu after performing rapid point-of-care tests. The National Alliance of State Pharmacy Associations has also noted more states allowing direct prescribing authority instead of collaborative practice agreements.

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AMA article explores physician shortage

According to an Association of American Medical Colleges report, the US faces a projected shortage of 37,800 to 124,000 physicians within 12 years, exacerbated by the COVID pandemic. Rather than expending scopes of practice of other healthcare providers, the American Medical Association supports the Resident Physician Shortage Reduction Act of 2021 to provide 14000 new Medicare-supported GME positions. The AAMC will conduct a survey this year to collect data on physician work hours and patterns, retirement plans, use of telehealth, debt, burnout, and wellness.

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