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33 Annals Health L. & Life Sciences 101 (2024)
Expanding the Scope of Practice for Nurse Practitioners and Physician Assistants to Enhance Healthcare

handle is hein.journals/anohl33 and id is 8 raw text is: Expanding the Scope of Practice for Nurse Practitioners and Physician Assistants to Enhance Healthcare Steve Waxman, MD, JD* & James Dechene, JD, PhD** I. INTRODUCTION Healthcare delivery depends on a sufficient supply of providers and adequate access for all patients. The United States spends more money total and per capita on health care compared to any other country; however, problems related to access and delivery continue to frustrate lawmakers due to the shortage of medical providers.1 The nurse practitioner (NP) and physician assistant (PA) programs were developed in the 1960s to help address the shortage of physicians in rural and underserved areas of the country.2 However, current practice restrictions limit the extent NPs and PAs can address that shortage.3 More recently, the Patient Protection and Affordable Care Act (PPACA), enacted in 2010, increased insurance coverage, improved healthcare delivery methods and lowered costs.4 The COVID-19 pandemic highlighted the persistent lack of healthcare providers in the United States.5 NPs and PAs could enhance the delivery of healthcare to patients in underserved areas of the country if allowed to practice the full extent of their training and capabilities. Each state regulates the degree of autonomy of NPs and PAs (APPs) through licensing and scope of practice laws that affect their ability to treat * MD, JD, LLM - Graduate of Loyola University Chicago School of Law, Urologist at Leavenworth VA hospital ** JD, PhD - Professor of Law, Loyola University Chicago School of Law 1 Gabriel Scheffler, The Dynamism of Health Law: Expanded Insurance Coverage as the Engine ofRegulatory Reform, 10 U. C. IRVINE L. REv. 729, 730 (2020); see NHE Fact Sheet, CTRS. FOR MEDICARE & MEDICAID SERVS. (July 31, 2023, 04:23 PM), https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and- Reports/NationalHealthExpendData/NHE-Fact-Sheet (stating that in 2021, U.S. spent $4.3 trillion or $12,914 per person). 2 Clay C. Johnson, A Case for an Efficient System: How Relaxing Midlevel Provider Supervision and Prescriptive Authority Laws will Reduce Costs and Increase Access to Health Care in Alabama, 45 CUMBERLAND L. REv. 565, 567 (2015). 3 Id. at 594. 4 Patient Prot. and Affordable Care Act, Pub. L. No. 111-148, 124, Stat. 119-124, 111th Cong. (2010) (hereinafter the PPACA). 5 Benjamin J. McMichael, The Access-To-Care Epidemic, 56 WAKE FOREST L. REv. 547, 549 (2021); Benjamin J. McMichael, Socially Distant Health Care, 96 TUL. L. REv. 423, 423 (2021). 101

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