Covid-19 Response – Temporary Altering of Nurse Practitioner Scope of Practice Requirements

David Brust, Class of 2022, Belmont Law

In response to the COVID-19 pandemic, twenty-three states made temporary changes to their scope of practice requirements for nurse practitioners (twenty-two of the states are classified as reduced or restrictive practice states). One of the most common changes states made was suspending or modifying physician supervision or collaboration requirements. These changes ranged from simply allowing physicians to supervise more nurse practitioners than normal to completely suspending the requirement that a nurse practitioner have a supervising physician. One noticeable trend is that states with larger rural areas, such as Kansas, Louisiana, West Virginia, and Wisconsin, took the more drastic step of suspending collaboration agreement requirements. Likewise, states where COVID-19 cases were initially very high, such as New York, New Jersey, and Massachusetts, also chose to suspend collaboration agreement requirements.

Other popular changes included modifications to licensure renewal or prescribing authority. For example, Kentucky temporarily waived its requirement that nurse practitioners have a supervising physician in order to prescribe controlled substances. A move that is largely unrelated to COVID-19 but allows other medical services to continue uninterrupted during unprecedented times. Moreover, South Carolina issued an emergency order that allowed nurse practitioners licensed in neighboring states North Carolina and Georgia to practice in South Carolina, so long as they continue the collaborative agreements within their home state. This change was made to allow South Carolina citizens to continue seeing their providers who live in North Carolina or Georgia by utilizing telemedicine.

Here in Tennessee, nurse practitioners authorized to prescribe medication were temporarily able to do so without a supervising physician. Additionally, Tennessee suspended notice requirements related to collaboration agreements and waived the requirement for chart reviews and monthly supervising physician visits. However, Governor Bill Lee allowed said changes to expire with Executive Orders 15 and 28 on May 12, 2020 and they have not been renewed.

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