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Senate Panel Clears Path Toward Negotiation on ARNP Independent Practice Proposal

FMA President Dr. Allen Pillersdorf argues against expanded nurse powers in the House Health Innovation Committee on 3/25/15.
The Florida Channel

The Florida Senate is moving closer to the House when it comes to letting nurse practitioners work independently of doctors. The Senate’s Appropriations Committee has teed the issue up for consideration before the full chamber.

The Senate proposal lets Advanced Registered Nurse Practitioners offer primary care in areas with a shortage of doctors. Health insurance companies wouldn’t be able to give ARNP’s preference. The Florida Academy of Physician Assistants’ Corinne Mixon says, physician assistants shouldn’t be left out.

“Physician assistants, as many of you are aware, practice completely interchangeably with nurse practitioners on a daily basis. Certainly, both practitioner groups are highly, highly qualified.” 

"Sometimes the Senators have to do things that are difficult to be a leader that may not be popular," said Pinellas County Medical Association's Aron Schlau. He was cut off by Senate Appropriations Chairman Rob Bradley when he mentioned House Speaker Jose Oliva. 

" We don’t talk about individual senators or the Speaker or Individual House Members," Bradley said. 

Oliva has made it clear this proposal is his priority. He’s not been shy about noting a state budget likely hinges on the Senate approving this proposal.

“I think its promising…they’re having the conversation. Just a few weeks ago, that would have seemed far more difficult…so far we’re very encouraged," Oliva said recently of the Senate's efforts on his healthcare reform bills. 

As of Monday afternoon, neither chamber had released allocations—the bottom line figures that upcoming negotiations are based on. The legislature is running out of time to iron out a series of issues.

The fight over ARNP’s and PA independent practice has raged for years. On one side are the doctors. Fourth-year medical student Elizabeth Sanders voiced her opposition to the plan and came with research.

“Studies have shown that when mid-level substitute for physicians provide care, they’ve been found to order an increased number of tests, write unnecessary specialist referrals that increase costs and prescribe increased volumes of narcotics and antibiotics," she said.

On the other side are nurse and PA groups who have their own studies. They point to the 30 other state’s already letting these healthcare providers independently see patients. Chris Lyon is with the Florida Association of Nurse Anesthetists.

“Thirty other states have independent practice for ARNPs, 22 have independent practice for CRNA’s. We have years of data, hundreds of thousands of patients sampled from these states. The data shows there is no difference in patient outcomes…and as Sen. Hutson mentioned, none of those states have ever walked those laws back," said the Florida Association of Nurse Anestetists Chris Lion. 

CRNA's are also not included in the Senate plan.

After a nearly two hours of back-and-forth on the proposal, the Senate’s Appropriations Committee cleared it for a full chamber vote.

Follow @HatterLynn

Lynn Hatter is a Florida A&M University graduate with a bachelor’s degree in journalism. Lynn has served as reporter/producer for WFSU since 2007 with education and health care issues as her key coverage areas.  She is an award-winning member of the Capital Press Corps and has participated in the NPR Kaiser Health News Reporting Partnership and NPR Education Initiative. 

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