Scope Expansion Bills: HB 4399 & SB 268

HB 4399 and corresponding SB 268 introduce changes that warrant opposition regarding their proven impacts on patient care and access to healthcare services. Here's how the proposed scope expansion to allow Nurse Practitioners and Physician Assistants to order imaging without the oversight of Medical Doctors will affect healthcare:

Cost Impact

• Studies have shown removing physicians increases out-of-pocket expenses for patients managed by non-physicians, adding up to $119 monthly.¹
• Inappropriate referrals will exacerbate costs, counteracting potential savings.¹

Referral Rates and Costs

• Patients under non-physician care, such as nurse practitioners (NPs), exhibit higher rates of specialist referrals and diagnostic imaging. ²
• These increased referrals and tests contribute to higher overall healthcare expenses.²

Overprescribing Risks

• NPs with independent prescription authority, as proposed in SB 268 and HB 4399, heighten the risk of opioid overprescribing.³
• This raises significant concerns for patient safety and medication oversight.³

Quality of Care Concerns

• Studies indicate higher patient satisfaction with physicians compared to NPs.⁴
• Patients co-managed on a physician led healthcare team have the best outcomes of all.¹
• Independent NP care raises safety and quality concerns in certain clinical situations.⁴

Access Challenges

• Nursing reports have shown that granting NP full practice authority has not universally improved access to care.⁵
• Questions remain about the effectiveness of such policies in addressing healthcare shortages in underserved areas.⁵
• Some studies do suggest that collaborative models (NPs working with MDs) are used to address provider shortages and can improve access while maintaining quality.⁶