2016 Bills

SB58: Removing Arbitrary Limits on Nurse Practitioners

This bill was modified from its original version, and then passed both chambers of the legislature unanimously.

Government mandates often unreasonably drive up the cost of health care, as regulations place direct burdens on health care providers or function to reduce their number operating in the marketplace. These regulations violate the principles of a free market that is otherwise (in theory) guaranteed by the Utah Constitution.

Under current Utah law, advanced practice registered nurses (APRN), or “nurse practitioners,” are required to pay a doctor under a “consultation and referral plan” (C&R) before being able to prescribe certain medications—despite receiving advanced training in order to be able to prescribe medications. These nurse practitioners are already licensed by the state, registered by the Drug Enforcement Agency (DEA), and permitted to make such prescriptions under their professional scope of practice, but are still subject to this arbitrary arrangement.

Moreover, the requirement does not specify what “consultation and referral” must include and does not specify the type of doctor. Thus, a legally compliant C&R plan could be for a mental health nurse in St. George to pay a podiatrist in Logan to sign their form. In some cases, these C&R’s have become little more than an extra revenue source for doctors—while creating financial barriers for nurse practitioners. This requirement is particularly onerous in rural areas where there are already shortages of doctors; nurse practitioners can help meet the need, but are discouraged from doing so due to this mandate.

Registered nurses who undergo advanced training to become APRN’s and who already have DEA registrations permitting them to prescribe medication should not be subjected to additional arbitrary state regulations. Senate Bill 58, sponsored by Senator David Hinkins, removes the mandate for advanced practice registered nurses to enter into consultation and referral plans with doctors prior to being permitted to prescribe schedule II and III prescription medications.

Free market reforms aimed at removing arbitrary barriers to entry ensure that the supply of goods and services in a market can meet demand. This system is what will produce the most competitive prices for consumers, the best quality, and employment opportunities for producers. This is particularly true in health care. Government should seek to reduce regulations that unnecessarily drive up the cost of delivering health care. With so many locations in Utah suffering from health care provider shortages, it is important that we ensure all health care providers are permitted to practice their profession to the full extent of their training and professional scope of practice.