AMCNO Agrees to Changes to HB 216 (APRN Scope of Practice); Bill is Approved in Ohio House, Moves to Senate

The Academy of Medicine of Cleveland & Northern Ohio (AMCNO) and a coalition which includes the Ohio State Medical Association (OSMA) and several other statewide medical associations won a victory this week when a provision contained in HB 216 that would have given Advanced Practice Registered Nurses (APRNs) authority to practice independently and carry out medical services typically reserved for physicians was taken out of the bill. 

Another provision removed from the bill would have expanded APRNs scope of practice to allow them to order and interpret diagnostic tests, prescribe addictive narcotics, and develop treatment plans for patients without consulting a physician. A patient suffering from an illness or injury could have received medical treatment without ever actually being helped or seen by a physician.

The AMCNO continues to support a physician-led, team-based approach to patient care and believes that there are aspects of HB 216 that could enhance this relationship.

The physician coalition working on this bill, which included the AMCNO, agreed to the following changes to HB 216 that the Ohio House approved on Wednesday:

  • Eliminates the inclusionary formulary for prescribing and replaces it with an exclusionary formulary with a committee comprised of an equal number of APRNs and physicians; 
  • Modifies the ratio from 3 to 5 APRNs that a physician can collaborate with when prescribing;
  • Expands the pool of collaborating physicians that mental health clinical nurse specialists may collaborate with to include family and primary care physicians as well as pediatricians;
  • Imposes a grace period of 120 days to allow the APRN to continue practicing without a collaborating physician if the physician is no longer able to collaborate;
  • Adds residential care facilities to the list of facilities where APRNs can prescribe schedule II drugs; 
  • Deletes restrictions on furnishing samples of drugs;
  • Revises certain insurance and Medicaid statutes to cover follow-up care directed by an APRN;
  • Grants testimonial privilege to APRNs;
  • Creates an Advisory Committee to the Board of Nursing on APRN issues;
  • Modifies licensure and continuing education requirements.

The bill now heads to the Ohio Senate for consideration.  The AMCNO will continue to work with the statewide coalition evaluating this bill and provide our input as the bills moves through the Senate. 

The Pollen Line is now closed. See you in the spring!

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