American Nurses Association: Include APRNs in Health Insurance Exchange Plan Networks

The American Nurses Association has recommended to CMS that health insurers seeking to offer plans on state health insurance exchanges need to include a certain number of advanced practice registered nurses in the plan’s network to qualify for the exchange.

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The ANA proposed that each plan must have a minimum number of APRNs in its provider network to be considered for the exchange. Under the ANA proposal, the minimum number would vary by state and would be set equal to 10 percent of the APRNs who independently bill for Medicare Part B in a given state.

“Findings from several decades of research consistently demonstrate that APRNs provide safe, quality care with comparable patient outcomes to physicians and even higher patient satisfaction rates. As many more millions of uninsured or underinsured seek primary care services through these exchanges, they will need access to qualified primary care providers. That will not happen if private insurers continue to exclude or restrict APRNs from their provider networks,” Karen Daley, PhD, RN, president of the ANA, said in a news release.

About 250,000 APRNs, which includes nurse practitioners, certified nurse midwives, clinical nurse specialists and certified registered nurse anesthetists, are licensed nationwide, according to the ANA.

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