Nonphysician Clinicians Regulation

In which states do nurse pracitioners have the broadest scope of practice?

A July 2012 IOM report recommends changing state laws to allow “nurse practitioners and physician assistants to practice to the full extent of their educational preparation.”¬† Based on information from the¬†American Academy of Nurse Practitioners (AANP), not all states currently allow permit NPs this flexibility.

Currently 16 states and the District of Columbia (see below) allow full plenary authority to NPs, meaning that they have independent authority to practice and to write prescriptions in clinical practice. These states tend to be inclusive of large rural areas (e.g., Alaska, Hawaii, Oregon, Washington, North Dakota, and Iowa). However, there are states with significant rural areas and provider shortages that have very restrictive regulations for NPs (e.g., Georgia and Alabama) where such regulations may be impacting the workforce and numbers of potential providers.

As I have mentioned in previous posts, I am an advocate for liberalizing medical licensing laws.

The jurisdictions granting full plenary authority to NPs are

  • Alaska
  • Arizona
  • Colorado
  • District of Columbia
  • Hawaii
  • Idaho
  • Iowa
  • Maine
  • Montana
  • New Hampshire
  • New Mexico
  • North Dakota
  • Oregon
  • Rhode Island
  • Vermont
  • Washington
  • Wyoming

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