State Health Insurance Exchanges, Legislation Keep Scope of Practice Issues Front and Center

WASHINGTON, DC, February 02, 2013 (Press-News.org) While federal healthcare reform efforts are dominating the political conversation, hundreds of state-level laws and policies also are affecting - and potentially hindering - patients' ability to get the care they need.

The National Conference of State Legislatures' (NCSL) Scope of Practice Legislative Database is already tracking more than 500 bills in 2013 that would impact many qualified healthcare professionals' ability to provide services. The proposed laws - many of which were carried over from last year's legislative sessions - include measures that would threaten patients' access to health services by unnecessarily restricting various healthcare professionals who are not medical or osteopathic physicians from providing the range of services they are educated, licensed and/or certified to offer.

For example, a restrictive House bill introduced this month in Iowa would prohibit anyone other than a subgroup of specialty physicians from performing interventional pain management procedures. If passed, the bill would restrict highly qualified certified registered nurse anesthetists (CRNAs) from providing these services, which would limit access to care for pain patients in that state, particularly those living in rural and medically underserved areas. CRNAs are the sole providers of anesthesia care for surgical, obstetrical, trauma, and pain management procedures in 88 of Iowa's 118 community hospitals. Other states such as Tennessee and Missouri have also had restrictive pain management bills introduced in the recent years.

In addition to lawmaking efforts, as part of the Affordable Care Act's (ACA) implementation, states are beginning to roll out their health insurance exchanges. These exchanges will provide the framework for access to care, and depending on how they are structured, could promote or limit the access that patients have to a broad array of health professionals providing care and affordable services, such as psychologists, chiropractors and advanced practice registered nurses.

Though the ACA was thoughtfully crafted to address the valuable roles that all health professionals play in meeting the growing patient demand for care, the Coalition for Patients' Rights (CPR) is concerned that more restrictive regulations will be proposed as states move to implement healthcare reform measures.

"Patients are the ones who stand to lose if policymakers continue to place restrictions on licensed, certified healthcare professionals," said Katherine C. Nordal, Ph.D., spokesperson for the Coalition and a psychologist with the American Psychological Association. "With millions of people poised to gain access to health insurance through the Affordable Care Act next year and our health care system faced with shortages of primary care physicians, every single healthcare professional is needed to care for patients."

For consumers who already are navigating a shifting healthcare landscape, the new laws threaten to block affordable access to key members of their healthcare team. If not implemented carefully, state-based health insurance exchanges, which are slated to be up and running by 2014, could steer patients away from health professionals who are educated, licensed and/or certified to provide the care they need by denying coverage.

"If we've learned anything from the last few years in the healthcare conversation, it's that care is too often fractured and uncoordinated," said Nordal. "If we want to improve outcomes and promote value, it's crucial for policymakers to implement healthcare reform measures that support integrated, interprofessional care in a way that allows all professionals - whether they are psychologists, occupational therapists, advanced practice registered nurses, speech language pathologists or other providers - to practice their profession in a manner consistent with their education, training, and scope of practice as defined by state licensure."

About the Coalition for Patients' Rights
A national coalition of more than 35 professional membership organizations, the Coalition for Patients' Rights (CPR) represents more than three million licensed and certified healthcare professionals who are not medical or osteopathic physicians and is committed to ensuring comprehensive healthcare choices for all patients. Formed in 2006, the Coalition supports a patient's right to choose the healthcare professional who best meets their health needs. To that end, the CPR advocates for the ability of all healthcare professionals to practice to the full extent of their ability, training, certification and licensure and works to ensure that transparent, patient-centered scope of practice guidelines promote consumer access to safe, high-quality and cost-effective healthcare.

The Coalition is comprised of a diverse array of healthcare professionals, including registered nurses, naturopathic doctors, psychologists, speech-language pathologists, audiologists, marriage and family therapists, occupational therapists, physical therapists, advanced practice registered nurses (certified registered nurse anesthetists, nurse practitioners, certified nurse-midwives and clinical nurse specialists), foot and ankle surgeons and chiropractors. To view a full list of members and learn more about the Coalition, visit http://www.patientsrightscoalition.org.