FTC Staff: West Virginia Should Consider Expanding Advance Practice Registered Nurses' Role in Patient Care

Federal Trade Commission staff, in response to a request from West Virginia State Senator Daniel Foster, provided testimony to a state legislative panel stating that making it simpler for Advanced Practice Registered Nurses (APRNs) to prescribe medications could benefit West Virginia health care consumers by expanding choice for patients, containing costs, and improving access to primary health care services.

According to the FTC staff testimony before Subcommittee A of the Joint Committee on Health of the State of West Virginia Legislature, state law allows APRNs to diagnose and treat patients without physician involvement, but requires APRNs to have a signed collaboration agreement with a physician in order to prescribe medications.  The testimony noted that current shortages of primary care providers in West Virginia are expected to worsen as more West Virginians gain health insurance and seek access to primary health care services and that a recent Institute of Medicine report found advanced practice nurses can help improve access to health care.

“Legislative action to eliminate the collaborative agreement requirement for prescriptive authority may improve access and consumer choice for primary care services, especially for rural and other underserved populations, and also may encourage beneficial price competition that could help contain health care costs,” the FTC staff testimony stated.  “We applaud the West Virginia legislature’s efforts to review and study the statutory limits on APRNs and we recommend that the legislature ensure that such limits are no stricter than patient protection requires.”

The FTC staff testimony asked the legislature to carefully consider available safety evidence on APRN practice in West Virginia and elsewhere. “Absent a finding that there are countervailing patient care and safety concerns regarding APRN practice,” the testimony stated, “suggestions to remove the collaborative agreement for prescriptive authority appear to be a procompetitive improvement in the law that likely would benefit West Virginia health care consumers.”

The comment is part of the FTC’s ongoing efforts to promote competition in the health care sector, which benefits consumers through lower costs, better care, and more innovation.

The Commission vote approving the staff testimony was 5-0.  It was sent to West Virginia State Senator Daniel Foster on September 7, 2012.  A copy of the letter can be found on the FTC’s website and as a link to this press release.  (FTC File No.V120010; the staff contact is Patricia Schultheiss, Office of Policy Planning, 202-326- 2877.)