Including Nurse Practitioners and Physician Assistants In Medical Reform Bills

I recently came across a letter on the Florida Nurse Practitioner Network site that I felt was important enough to pass on to you. Please consider passing it along to your fellow readers and coworkers. If we are not diligent and make sure that we are included in Florida, we will be left behind.

To Whom It May Concern

Florida HB 7107 passed as a Medicaid reform bill during 2011 legislative session. Line 1168 of this bill specifies that enrollees must choose a primary care physician as a primary care agent.

We respectfully request that the word physician be changed to the word provider to legally ensure that Advanced Practice Nurses (ARNPs & Certified Nurse Midwives) as well as Physician assistants are included as a recipient’s primary care provider of record.

This will ensure that enrollees will have a choice in whom their primary provider will be and allow increased access to health care services in their region. Presently, it is estimated that approximately only 5% of physicians accept Medicaid patients.

Currently the managed care contract definition includes advanced registered nurse practitioners (ARNPs) as primary care providers (PCP). As noted here:

Primary Care Provider (PCP) A Health Plan staff or contracted physician practicing as a general or family practitioner, internist, pediatrician, obstetrician, gynecologist, advanced registered nurse practitioner, physician assistant or other specialty approved by the Agency, who furnishes primary care and patient management services to an enrollee.

While neither HB 7107 nor HB 7109 precludes the use of ARNPs as Primary Care Providers, the language in the bill is specific that enrollees MUST choose a primary care PHYSICIAN and does not use the term “Provider”. It is critical for this change to be included in order to expand the access to care as described above

If the current language is NOT changed, a patient may not be able to enroll under a Nurse Practitioner or Nurse Midwife as the provider of choice thus creating further delays in care and widening gaps in healthcare.I feel that it is important to start including nurse practitioners in the wording of these bills because many of my panel are Medicaid patients and they choose me over other physicians. I think that it says a lot about nurse practitioners as a group because it happens all over the State of Florida.

In conclusion, changing the word “physician” to “provider” in HB 7107 line 1168 will increase the efficiency of enrollment, provide increased access and ensure choices for Medicaid recipients when selecting their Medicaid provider.

Thank you for your consideration in this matter.

Please contact me if you have further questions and concerns