APRNs and FECA
Background
Advanced practice registered nurse (APRN) is an umbrella term given to a registered nurse (RN) who has attained advanced expertise in the clinical management of health problems. Under this umbrella there are four principal types of APRNs; Nurse Practitioners (NPs), Certified Nurse Midwives (CNM), Clinical Nurse Specialists (CNSs), and Certified Registered Nurse Anesthetists (CRNAs).
The Federal Employee Compensation Act (FECA) provides health care services to federal employees who are injured on the job. This compensation Program is one of the last major health care programs to deny patients’ access to APRNs. APRNs are covered medical providers in Medicare, Medicaid, Tri-Care and private insurance plans. They serve as medical providers in the Veterans Administration, the Department of Defense and the Indian Health Service. In fact, most federal employees have access to APRNs through their federal employee health benefit plan.
As introduced during the 110th Congress, the Improving Access to Workers’ Compensation for Injured Federal Workers Act (H.R. 2561, S. 1149), would have covered the full compliment of services provided by nurse practitioners (NPs) and physician assistants (PAs) under FECA. While ANA supports the inclusion of NPs in FECA, we urge Congress to recognize that certified nurse-midwives, certified registered nurse anesthetists, and clinical nurse specialists should also be covered.
The American Medical Association (AMA) is asking Congress to amend these bills to restrict the scope of practice of NPs. If Congress were to accept the AMA change, APRNs would be prohibited from originating and prescribing medical services. ANA opposes this change.
Rationale
APRNs work with physicians and other health professionals to coordinate health services for the best outcome for the patient. Decades of research have shown that APRNs provide high quality services that often incur fewer costs than care provided by physicians alone. In addition, APRNs are more likely to provide services in medically underserved areas. For these reasons, ANA urges Congress to support efforts to provide Federal workers access to the full compliment of services provided by all APRNs.