Pennsylvania nurse practitioners are renewing efforts to practice independently without mandatory physician oversight, citing access-to-care gaps and financial barriers at community health centers. The push comes as neighboring states and the federal Veterans Affairs system allow greater autonomy for these providers.
Current Restrictions and Practice Reality
Pennsylvania is a “reduced practice state,” requiring Certified Registered Nurse Practitioners to maintain written collaborative agreements with licensed physicians. According to the Pennsylvania Coalition of Nurse Practitioners, NPs can assess patients, diagnose conditions, order and interpret tests, develop treatment plans, prescribe medications and coordinate patient care—all under physician consultation and oversight. At Family Practice and Counseling Services Network in Philadelphia, CEO Emily Nichols described how hiring a psychiatric nurse practitioner took nearly six months before treating a single patient due to this requirement. Nichols told the Capital-Star the center could hire four additional psychiatric NPs to meet demand but lacks both resources and collaborating physicians. “We have to pay for (collaborating physicians). We’re a community health center; we’re operating on a pretty thin margin,” she said.
Day-to-day barriers persist even with collaborative relationships. Nichols noted that routine items like specialized shoes for diabetic patients still require physician sign-off, creating unnecessary delays in care delivery.
Legislative Efforts and Support
Sen. Camera Bartolotta (R-Washington) has introduced Senate Bill 25 every year since her term began in 2018 to expand NP practice authority, yet the bill has never reached a governor’s desk. According to Bartolotta’s early versions, 21 other states and the District of Columbia allowed NPs “full practice authority”—a number now at 28. Rep. Nancy Guenst (D-Montgomery) sponsored House Bill 739 this year, mirroring bipartisan support. However, neither bill has received committee hearings.
The Pennsylvania Medical Society remains a significant opponent, according to Bartolotta. The Medical Society generally opposes expanding duties for non-physicians and points to studies suggesting non-physician-led care increases healthcare costs, asserting that “optimal patient care is most effectively delivered through health care teams.”
Federal Implications
Pennsylvania’s status as a reduced practice state affects federal funding eligibility. The state received $193 million last year from the Rural Health Transformation Plan, designed to offset billions in Medicaid losses over the next decade. Despite having the third-largest rural population in the country, Pennsylvania’s per-resident award was just $78, compared to an average of $157 nationwide. The application process emphasizes states that “help rural providers practice at the top of their license.” Sheilah Yohn, president-elect of the NP coalition, noted an Aug. 30 deadline for the state’s next federal application submission.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://cumberlink.com/news/state-regional/pennsylvania/article_e658ce7a-2a15-5d1d-ac30-9443893968fc.html