Nurse Practitioners, Physician Assistants Near Prescribing Authority Florida

Legislation that grants nurse practitioners and physician assistants prescribing authority for controlled substances like painkillers and medicines for attention deficit disorder awaits Florida Gov. Rick Scott’s signature, ending decades of opposition by a rare holdout state.

Florida is the last state in the country balking at giving nurse practitioners the ability to prescribe and the second to last state standing in the way of physician assistant prescribing authority for controlled substances. Only Kentucky remains as a holdout for PA prescribing of such controlled medications, which are expanding in number and use by patients who can’t get them without a prescription.

“ Florida would become the 50th and final state to authorize NPs controlled substance prescriptive authority after House Bill 423 is signed into law, said Taynin Kopanos, vice president of state government affairs for the American Association of Nurse Practitioners. “The bill has passed the legislature and is headed to the Governor’s desk.”

The PAs and NPs say this will be key to providing more access to patients, particularly Florida’s aging population of retirees and elderly. With a nationwide shortage of physicians and the move to get patients low-cost preventive care upfront, supporters of the legislation say it increases quality, potentially reduces cost and expands access. There are an estimated 25,000 NPs and PAs in Florida who would get prescribing authority for controlled substances.

“Individuals across the country, and especially those residing in southern states, continue to face significant challenges in directly accessing the full scope of healthcare that nurse practitioners are qualified to provide,” Kopanos said. “It’s encouraging to see the Florida legislature take this initial step toward reducing unnecessary barriers to care that patients other 49 other states do not face.”

State lawmakers say they are essentially granting physician assistants and nurse practitioners the ability to do what they are trained to do. Most PAs have a two-year master’s degree, often from a program that runs about two years and includes three years of healthcare training, according to the American Academy of PAs.

PAs and NPs work in doctor’s offices, retail clinics and other locations and their work includes diagnosing illnesses, writing prescriptions and counseling patients on preventive care.

“There is a clear body of evidence substantiating the valuable care and access PAs provide in our healthcare system, when we can practice to the full extent of our education and training,” said Jeffrey Katz, president of the American Academy of PAs. “Yet a crucial step to help increase patient access is to remove antiquated barriers to PA practice. These bills continue that momentum and represent an historic victory, not just for the PAs of Florida but also for their patients.”

NPs are the primary caregivers at retail clinics operated by Walgreens, CVS Health and Walmart as well as grocery store chains like Kroger . Nurse practitioners are educated to perform myriad primary care functions, diagnose, prescribe medications and conduct physical exams and they are increasingly doing more as retailers offer more services.

The moves by the Florida legislature to expand the scope of practice for NPs and PAs comes as trends in insurance payment under the Affordable Care Act as well as the private sector encourage health systems to get patients more care upfront, whether it be in a doctor’s office, health center or retail clinic.

“Florida remains one of the more restrictive states in the country,” Kopanos said. NP and PA lobbyists in Florida said it’s taken 22 years to get the legislation through the Florida legislature.

Physician assistants are increasingly an integral part of value-based care models proliferating across the country like accountable care organizations (ACOs) and patient-centered medical homes that contract with insurers, Medicare and Medicaid programs. Major insurers like Aetna , Anthem , UnitedHealth Group and Blue Cross and Blue Shield plans are increasing their contracts with ACOs as insurers move away from fee-for-service medicine.