Legislative Updates

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SB 263 will update the Code of Virginia to reflect contemporary practice patterns, provide for revision of regulations, and permit Nurse Practitioners to practice within their full scope of practice according to their education and certification. Research supports findings that Nurse Practitioners provide safe, high quality care with excellent outcomes and patient satisfaction.

SB 263 addresses these problems that limit access to care and create unnecessary regulatory burdens.

  • The statutes governing nurse practitioner practice have not been updated since 1973. According to statute, Nurse Practitioners are supervised by physicians regardless of their education and experience. This bill seeks to remove the supervision language. The term, supervision, written into the Code has led to the development of policies and procedures by providers, institutions, and insurers that negatively affect access to care by nurse practitioners. As an example, some clinics have had to shut down their services if no “supervising” physician is available. Virginia is one of only 12 states that require physician supervision.
  • In order for Nurse Practitioners to prescribe drugs, supervising physicians may supervise only four nurse practitioners and must “regularly practice” in the same setting. Maintaining a rigid ratio limits the ability of a practice to provide healthcare services, and if a physician is unable to “regularly practice,” however that is defined, patients are unable to receive medications in a timely manner.
  • Regulation of Nurse Practitioners is outdated and in need of modernization. Nurse Practitioners are licensed and regulated jointly by the Boards of Nursing and Medicine. Virginia is one of only 7 states that require joint regulation. There is no evidence to support continued joint regulation.

SB 263 provides these solutions to increase access to care and remove regulatory burdens.

  •  Allows the Board of Nursing to develop guidelines for Nurse Practitioners to practice within their optimum scope of practice and enable them to function maximally as a member of the interdisciplinary healthcare team.
  • Removes requirements for Nurse Practitioners to be supervised and directed by a physician. The relationship between physicians and Nurse Practitioners will be detailed in regulations. This bill will allow physicians and Nurse Practitioners to determine the process of consultation and referral within their practice to provide effective, safe, and timely care to their patients
  • Allows Nurse Practitioners to prescribe drugs and devices consistent with their education and certification governed by regulations developed by the Board of Nursing in consultation with the Board of Pharmacy.
  • Removes regulation of Nurse Practitioners by both the Boards of Nursing & Medicine and authorizes regulation by the Board of Nursing advised by an Advisory Committee consisting of physicians, Nurse Practitioners, and pharmacists.

Mary Duggan
Chair, Government Relations Committee
Virginia Council of Nurse Practitioners

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