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House backs more power for nurse practitioners

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TALLAHASSEE, Fla. – Advanced practice registered nurses in Florida moved closer to being able to practice without supervising physicians after the House passed legislation Wednesday.

The bill (HB 821), filed by Rep. Cary Pigman, an Avon Park Republican who is a physician, passed the House in a 75-37 vote.

Pigman said the move would help enhance access to quality care.

“This bill removes the barriers to providers practicing to the full extent of their education and training,” Pigman, chairman of the House Health Market Reform Subcommittee, said.

Allowing the nurses to practice independently from physicians is a priority for House Speaker Jose Oliva, who has long supported efforts to expand their roles. It also is part of broader efforts by Oliva to revamp and eliminate health-care regulations as part of an effort to reduce costs and expand access to care.

Oliva, R-Miami Lakes, has said Florida is “way behind the curve’” in its health-care delivery system.

Medical groups, such as the Florida Medical Association, have long been influential in the Capitol. Lawmakers have been reluctant to expand practice areas for types of providers, such as nurses, who are not physicians.

But the Legislature in recent years has expanded the “scope” of practice for advanced practice registered nurses. In 2016, lawmakers authorized advanced nurses to prescribe controlled substances. But the law maintained the requirement that the advanced nurses have supervisory relationships with physicians.

The bill passed Wednesday would authorize advanced nurses and certain physician assistants to practice without written agreements with supervisory physicians.

Pigman said allowing nurses to work independently also would free up physicians, allowing them to focus on providing “direct patient care,” which is a better use of their skills.

The Florida Association of Nurse Practitioners issued a statement following the vote that praised Pigman and the House.

“This important legislation will help modernize our state's health care laws by allowing nurse practitioners to better use the skills they have learned to meet the primary care needs of our state's residents,” Susan Lynch, CEO of the group, said. “We urge the Florida Senate to join in increasing access to health care for millions of Floridians.”

But the Florida Senate has not considered its version of the bill (SB 972). The 60-day legislative session is slated to end May 3.

“I always worry, that’s my job,” said Jeff Scott, a lobbyist for the Florida Medical Association, the state’s largest physicians’ group. “But I haven’t seen any indication that it will move in the Senate.