Las Vegas — More than 5,500 nurse practitioners have gathered in Las Vegas at the American Association of Nurse Practioners (AANP) 2013 National Conference for five days of education, career development, legislative advocacy discussions and networking opportunities.

“This year’s theme, ‘Shaping the Future, Celebrating the Past,’ signifies the tremendous accomplishments achieved by NPs and our resolve to keep working toward an improved health care system that allows us to deliver best possible patient care,” AANP president Angela Golden, NP, said in a statement.

During the opening session, Donna Shalala, PhD, president of the Univesity of Miami and former secretary of the U.S. Department of Health and Human Services, addressed the changing role of NPs in the context of healthcare reform, acknowledging the unique opportunities NPs now have to play a larger part in shaping the nations health.

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“If you want to make a change, do it when the system is expanding. Do it when more people are coming into the system,” Shalala said. “We’ve spent years arguing for independence for NPs […] This is the opportunity of a lifetime. This is the Golden Age of Nursing.”

In a seperate session, AANP founding member Jan Towers, PhD, NP-C, FNP, director of health policy at the organization, highlighted more specifically some of the recent legislative advances for the NP profession made possible by the Patient Protection and Affordable Care Act (ACA).

These benefits include:

  • Recognition from the federal government that nurse practitioners are independent primary care providers
  • Reauthorization of Title VIII nursing education funding that allocates $50 million to train advanced practice nurses for primary care and community health programs over five years
  • Recognition of NPs as accountable care organization (ACO) leaders

Towers also acknowledging the challenges of meeting guidelines set forth in the bill amidst myriad uncertainties. The threat of repeal, uncertainty over whether certain provisions of the ACA would be included in the final legislation and the phased implementation process for provisions like health insurance exchanges were among the difficulties she outlined. 

“This is not a perfect piece of legislation by any means, but it certainly goes beyond anything we’ve ever had before, and there are certain benefits that we as nurse practitioners do not want to give up,” Towers said.

However, several laws and regulations that require physician oversight for Medicare policies continue to restrict NP practice and highlight the importance of NPs taking on advocacy roles for their profession.

Legislative areas that need NP attention include requirements that physicians certify face-to-face medical evaluations for durable medical equipment, conduct admitting exams and alternate routine visits for patients at skilled nursing facilities, be on site for cardiac/pulmonary rehabilitation, and conduct admitting exams for rehabilitation centers

Furthermore, although NPs will qualify for Medicaid payment increases for some Medicare rates for primary care services in 2013 and 2014, these conditions apply only if care is provided under the “personal supervision” of physicians. Currently, these regulations exclude “independently practicing nonphysicians” regardless of state law, according to Towers.

And despite increased funding for NP education under the ACA, budget cuts due to sequestration are set to eliminate scholarships and funding for advance practice registered nurse programs.

So how can NPs get more involved in advocating for the profession? Getting to know state legislators by attending town hall meetings and inviting law makers to visit NP practices, writing editorials for local media outlets and supporting political campaigns that are friendly to NP causes are just some of the ways Towers suggested.

“NP issues are not partisan,” she emphasized. “We need to support members of both parties to advance our agenda and meet the needs of our patients.”


Abstract # 13.2.64 “Affordable Care Act Update: Where Are We and Where Do We Go From Here?” Presented at: American Association of Nurse Practitioners 2013 National Conference. June 19-23, 2013; Las Vegas.