Oct. 23, 2020 / Press Release

By Rep. Jesse Topper (R-Bedford/Franklin/Fulton) 

Earlier this year, the media’s focus on COVID-19 centered on fears that the virus would overwhelm America’s health care services. In response, state governors—including Gov. Tom Wolf—began suspending regulations to improve capacity and care. These suspensions contained the implicit understanding that some regulations in health care do more harm than good. Why else suspend them during a crisis?

In Pennsylvania, among the changes was expanding the scope of practice for nurse practitioners, which empowers them to increase access to care and offer cost savings to patients. Over the long term, this change would benefit countless Pennsylvanians.

After all, during the COVID-19 crisis, almost half of Pennsylvania’s non-emergency care facilities reduced their medical staff—despite the need for more medical professionals. Unfortunately, this trend will likely continue after the pandemic subsides. That is why I’m thankful to my colleagues in the state House for acting to relieve the burden of this outdated licensure law and to make health care more accessible and affordable. With half of Pennsylvanians struggling to afford health care, this expansion should be a no-brainer.

As Pennsylvanians continue to express concern about the price of health care, nurse practitioners can help counter the rising costs. By giving nurse practitioners full practice authority, Pennsylvanians could save $6.4 billion over the next decade—without decreasing the quality of care.

What defines “full practice”? Nurse practitioners (NPs) are high-level health care providers who hold at least a master’s degree in their area of specialty. According to renowned medical economist Jeffery Bauer, after reviewing more than 100 published reports, “not a single study has found that nurse practitioners provide inferior services within the overlapping scopes of licensed practice.”

Though NPs are trained to provide essential services, such as diagnostic testing and treatment of chronic conditions, state regulation makes it difficult for NPs to practice.

Many health care professionals want to meet the demands in their communities, but they’re hindered by burdensome regulations that limit how and when they can practice their craft. Take the story of Doris Yoder, a nurse practitioner in Lancaster County who serves patients in retired communities. In 2017, Yoder observed that seniors with limited ability to travel had few options for primary care. Yoder decided to open a practice that was accessible to these elderly patients. Unfortunately, she subsequently faced stringent regulations that made it difficult to provide care to those very patients.

Currently, NPs must work under a physician—in fact, they’re required to secure collaborative agreements with two physicians at any given time. If they change locations, they must undergo a lengthy process to find new physicians and resubmit a state application.

But finding a new physician isn’t easy: many physicians are restricted with regards to their collaborations, or have malpractice insurance that does not cover NPs. Even if a physician is willing to sign, the NP will still need to negotiate how much he or she must pay a physician for a contract.

The COVID-19 outbreak underscored the need for NPs to practice independently and to their full capability.

My legislation, House Bill 100, would codify the benefits of the waiver put into place during the pandemic into permanent law or create a path to independent practice. House Bill 100, which passed committee in late September and the full House on Oct. 20, would create a pilot program through which NPs can provide primary care in underserved areas. In other words, experienced NPs could care for patients in flexible locations without the complex process of contracting with new physicians. At the conclusion of the pilot program, a study will be released on both patient outcomes and cost savings in these underserved areas.

NPs have the training to provide Pennsylvanians with up to 90% of services in primary care. Today, they need our help to remove legislative barriers. I hope to continue this work to ensure medical personnel on Pennsylvania’s front lines are empowered to care for their patients. After all, increased access to care at lower prices is an issue that creates agreement on both sides of the aisle.

Representative Jesse Topper
78th District
Pennsylvania House of Representatives

Media Contact: Greg Gross
RepTopper.com / Facebook.com/RepTopper