The FTC issued a policy paper last week, cautioning states that certain advanced practice nurse restrictions limit competition in health care markets. Acknowledging that licensure and scope of practice regulations provide critical consumer protection objectives, including safety and quality, the FTC counsels that the goal of regulations “should be to avoid imposing restraints that may tend to impair competition in a way that is greater than necessary to address legitimate health and safety concerns.” The FTC noted that “there is increasing agreement among health authorities that APRNs could safely provide an even broader range of primary care services, if regulatory and reimbursement policies would permit them to do so.”. Such practices may exacerbate the projected health care “bottleneck,” in which demands for health care outpace the supply of providers—and that, the report argues, is anti-competitive. APRNs can fulfill unmet health care needs when they are free from undue supervision requirements and practice restrictions. 7. (2012). Retrieved from: http://www.aafp.org/dam/AAFP/documents/about_us/initiatives/AAFP-PCMHWhitePaper.pdf. [Weblog comment]. ; however, the information and materials do not, and are not intended to, constitute legal advice. (2012). © 2015 National Council of State Boards of Nursing, Inc. Hauer, K. E., Durning, S. J., Kernan, W. N., Fagan, M. J., Mintz, M., O’Sullivan, P. S., ... & Schwartz, M. D. (2008). The Federal Trade Commission (FTC) has a well-established role in promoting competition in the health care industry through enforcement, study and advocacy. The FTC report, coupled with other research, has linked states with excessive SOP regulation to barriers in accessing primary care2. © 2001–2018 Robert Wood Johnson Foundation. Some states, for instance, require that NPs practice within a certain distance of a collaborating physician. Neither transmission nor receipt of such information and materials will create an attorney-client relationship between the sender and receiver. 8. These medical homes aim to provide comprehensive primary care that is evidence-based, high-quality, and holistic5. Copyright © 2014 Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C. BACKGROUND ON APRNS AND SCOPE OF PRACTICE ISSUES 7 II.A. Staff members cite research suggesting that APRNs provide safe and effective care within the scope of their training, certification and licensure. privacy@rwjf.org The FTC identified several potential competitive harms that may result from certain APRN scope or practice restrictions that limit APRNs’ access to the marketplace, consequently depriving health care consumers of the benefits of competition among different types of health care providers. Paul Hornback, Commonwealth of Ky. State Senate (Mar. It is easy to see how such requirements could present a challenge in some rural or urban communities, where the nearest doctor can be many miles away. Consumer Preferences Toward Non-Physician Providers. The report also argues that while SOP policies may be intended as a form of consumer protection, they may have the opposite effect. The major question the report tackles is: “Do current SOP laws and regulations impair competition?”  Competition, it argues, is good for the health care market, as it is for the larger economy, because it can spur improved quality and help contain costs. Get informed: Receive the latest news, research, and funding opportunities from RWJF each week. 5. Users are advised not to take, or refrain from taking, any action based upon the information and materials contained herein without consulting legal counsel engaged for a particular matter. Health Affairs, 32(6), 1135-1142. The views and opinions expressed here are those of the authors. (2013, October 3).

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