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Institute for Justice Calls on States to Allow Nurse Practitioners to Help with COVID-19 Relief

Unnecessary physician supervision requirements bar qualified nurses from offering their services

Arlington, Va.—The Institute for Justice (IJ) sent open letters to six states calling on authorities to suspend requirements that nurse practitioners may only work in hospitals under the supervision of a physician. The supervision requirements in California, Florida, Georgia, North Carolina, Texas and Virginia prevent many nurse practitioners from helping patients in overburdened hospitals, even as volunteers.

“Physician supervision requirements are completely unnecessary and are hurting states’ efforts to respond to COVID-19,” said IJ Senior Attorney Erica Smith. “Nurse practitioners want to be able to volunteer now, but they are getting caught in red tape.”

Nurse practitioners are nurses with advanced degrees that allow them to diagnose symptoms, treat patients and prescribe medicine. Twenty-eight states and the District of Columbia do not require any supervision for nurse practitioners or only require supervision at the beginning of their careers. The remaining 22 states impose myriad restrictions ranging from requiring limited supervision for only certain types of practices to requiring full-time supervision. California, Florida, Georgia, North Carolina, Texas and Virginia have some of the strictest physician supervision requirements in the country.

Multiple organizations and individuals, including the U.S. Secretary of Health and Human Services, have called on states to lift restrictions on nurse practitioners during the pandemic. And many have. Kentucky, Louisiana, Massachusetts, Michigan, New Jersey, New York and Wisconsin have already loosened or lifted supervision requirements.

“At a time when we need healthcare workers, many states have lifted unnecessary restrictions on nurse practitioners,” said IJ Special Projects Manager Kendall Morton. “Unfortunately, some states have done nothing. The Institute for Justice hopes that our open letters will spur these states to take action.”

Multiple studies, including an extensive 2018 report from the Brookings Institution, have found that empowering nurse practitioners could have significant benefits for health care efficiency without sacrificing quality of care. Instead, the evidence suggests that restrictions on nurse practitioners serve only to raise prices and protect doctors from competition. With many hospitals in desperate need of medical personnel during the COVID-19 pandemic, it may also cost lives.

Nurse practitioners across the country have struggled to find physicians to supervise them to work for a variety of reasons. Some physicians are unable to supervise nurse practitioners because of limitations in their medical malpractice insurance, while others cannot take on additional responsibilities during this chaotic time. In addition, nurse practitioners must often pay physicians thousands of dollars for supervision.

The Institute for Justice (IJ) is a national nonprofit organization that has worked to remove and reduce licensing restrictions for 30 years, including in medical professions. For example, IJ has sued several states regarding their unduly burdensome regulations for certificates of need, telemedicine and physician dispensing of medications. In addition, IJ drafts model legislation and advises state legislatures on licensing matters nationwide. The letters are part of IJ’s overall efforts to respond to the current health and economic crisis by working to cut red tape hampering individuals’ ability to help one another.

IJ Senior Attorney Erica Smith is available for interviews via phone and teleconference services. To schedule, please contact Andrew Wimer, IJ Assistant Communications Director, (703) 298-5938 or awimer@ij.org.

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