The AMA's fight against expanded scope of practice legislation

The American Medical Association said a coalition it leads has been working to stop what it deems inappropriate scope-of-practice expansion legislation in states.

The policies it has worked to block would expand scope of practice for nonphysician health professionals. This could mean, for instance, optometrists being allowed to perform eye surgery or nurse practitioners being allowed to diagnose and treat patients without physician supervision.

"We've been working on this issue for 30 years, but — absolutely — it is becoming more and more important each and every day," Kimberly Horvath, a senior attorney with the AMA Advocacy Resource Center, said in a May 18 AMA article.

The AMA Scope of Practice Partnership — a coalition of 108 national, state and specialty medical societies — has worked with 25 state medical associations in 2022 on this issue, according to Ms. Horvath.

Blocked efforts cited by the AMA include:

  • Alabama legislation that would have allowed optometrists to perform eye surgery.       
  • Colorado legislation that would have removed physician supervision requirements for physician assistants.       
  • A Kentucky bill that would have removed the physician collaboration requirement for advanced practice registered nurses for prescribing medication.

The AMA said the group's efforts are expected to continue and have involved informing policymakers about the differences in education and training of physicians compared with nonphysician health professionals.

Although some scope of practice legislation has been derailed, other bills have passed. Michigan recently became the 20th state to allow certified registered nurse anesthetists to practice without physician supervision. Additionally, Kansas Gov. Laura Kelly signed a bill into law April 15 granting nurse practitioners full practice authority, making it the second state to do so this year, after New York, and the 26th state overall.

The American Association of Nurse Practitioners and the American Association of Nurse Anesthesiology have applauded the legislation that has passed, saying it removes barriers to care access.

Read more about the AMA efforts here

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