2019 State Policy Priorities

The American Association of Nurse Practitioners (AANP) pursues goals that lead to improved health. We believe that the expertise of the nurse practitioner (NP) should guide health care policy, and that by removing barriers between NPs and their patients, our nation can achieve better health and improved access at a lower cost.

AANP’s 2019 State Policy Priorities reflects these goals and our values. Our priorities are shaped by clinical experience and informed by evidence. AANP actively partners with our members and other stakeholders to make these priorities a reality.

AANP’s 2019 State Policy Priorities:

  1. Modernize State Licensure Laws
    One of the most important challenges facing patients and states is the accessibility of health care providers—especially providers who serve in primary care and across the continuum of care. A solution to this challenge is direct access to NP-provided health care. Nearly half of the states, the District of Columbia and two U.S. territories currently provide patients with this level of access. In these states, NPs are authorized to evaluate patients, diagnose, order and interpret diagnostic tests and initiate and manage treatments—including prescribing medications—under the exclusive licensure authority of the state board of nursing. This licensure model is supported by decades of evidence and recommended by the National Council of State Boards of Nursing, the National Academy of Medicine (formerly the IOM) and other leading health policy experts. Unfortunately, in the remaining states, outdated licensure laws impede access to care and contribute to increased health care costs. AANP is committed to working with states to update their licensure laws and provide patients with direct access to NPs.
  2. Streamline Care Delivery With NP Signature Recognition
    NPs treat more than a billion patients every year. Yet, in some states inefficiencies occur when NPs are unable to “treat the paperwork” that reflects the care they have provided. This disconnect between the existing authority of an NP to provide treatment and the recognition of an NP’s signature on a form verifying that care creates delays and increases health care costs. Signature recognition for NPs is particularly important for patients and caregivers who require documentation for disabled parking placards, verification of immunizations, sports participation clearance, employment physicals, advanced directives and forms pertaining to the daily provision of health care, including admission to health care facilities. AANP calls on policymakers to update policies to recognize the signature of NPs on forms for care that are within the NP scope of practice and to use provider-inclusive/provider-neutral language to prevent creating new challenges.
  3. Flexible, Sustainable Reimbursement and Care Delivery Models
    NPs are the fastest growing members of the primary care provider workforce and are the provider of choice for millions of Americans. Protecting a patient’s right to choose an NP as their health care provider and to have that care covered under their insurance plan is a key priority for AANP. This includes supporting the enactment and enforcement of insurance laws for direct credentialing and reimbursement of NPs, ensuring that reimbursement rates promote sustainable practices and including NPs in network directories. As states experiment with and deploy new models of care delivery and reimbursement, policy decisions must include NPs as primary care providers and leaders of Accountable Care Organizations, Patient-Centered Medical Homes and other coordinated care initiatives. Additionally, full and open participation for NPs in value-based payment models, telehealth and facility governance will be critical as the health care system shifts to promoting integrative, coordinated care. AANP further calls for policies that ensure fair, competitive and level playing fields that support patient choice in providers, network adequacy, meaningful reporting measures and sustainability.
  4. Build and Support Public Health
    Our patients and communities face multiple public health challenges that threaten their health and weigh on the health care system and overall economy. AANP continues to pursue evidence-based policy and practice solutions on a host of public health issues, including access to safe pain care, substance use disorder treatment, immunizations, concussion care, cancer prevention and advancing preventative services and population health.

Learn more and get involved by contacting AANP at statepolicy@aanp.org.

Download AANP's 2019 State Policy Priorities