The Nurse Practitioner Association NYS

2003 Legislative Priority


Workers’ Compensation Nurse Practitioner Access Act


(S2617 Velella/A90 John)


An ACT to amend the workers’ compensation law to authorize Certified Nurse Practitioners to fully participate within and be reimbursed under the workers’ compensation program in New York State


About Nurse Practitioners

Nurse Practitioners are skilled healthcare professionals that provide a wide range of primary and preventive health care services to New Yorkers of all ages.  There are over 10,000 Nurse Practitioners in New York State practicing across a wide range of specialties and practice settings.  As registered professional nurses (RN’s) with advanced education and clinical training, NPs are certified and licensed by the NYS Education Department.  NPs diagnose, treat and prescribe medications with an emphasis on wellness, prevention and self management, avoiding unnecessary complications and referrals.


Complimented by their nursing training and experience, NPs possess a special blend of skills, knowledge and expertise, that make them uniquely qualified to meet the total needs of their patients.


Nurse Practitioners practice in a collegial team model approach in collaboration with physicians, and are widely recognized and respected for their quality, nurturing, individualized care.   Numerous national studies have shown that Nurse Practitioners perform equally as effective as physicians in patient diagnosis, management of specific diseases and conditions and, most importantly, patient outcomes.


Nurse Practitioners Can Help New York Provide Increased Access to Affordable Health Care and Ensure Enhanced Health Care Choices

With the challenges facing today’s health care delivery system – both nationally and in New York State- it is imperative that effective and innovative models of health care delivery be developed.  Nurse Practitioners are ideally suited to be an integral part of such models in addressing challenges surrounding access, quality and cost.  Three decades of practice and research have produced ample evidence of Nurse Practitioners’ ability to provide cost-effective, innovative, high quality primary and preventive care.  A cost analysis undertaken by the State University of New York (SUNY) comparing the cost of providing services at a Nurse Practitioner-managed center for the homeless with other community alternatives revealed earlier and less costly intervention by the Nurse Practitioner-managed center.


Some innovative health insurance plans and HMO’s currently permit direct payment to Nurse Practitioners.  Oxford Health Plans and Columbia Presbyterian Medical Center in New York City have both instituted pilot programs where Nurse Practitioners are placed in the role of primary caregivers for patients.  “We already know that proactive management of patients will reduce ER and office visits,” says an Oxford Vice President.  As an example, asthma patients who are working with Nurse Practitioners at Columbia Presbyterian are less likely to be hospitalized for asthma attacks.


The U.S. Dept. of Health and Human Services reports that the cost of an office visit to see a Nurse Practitioner ranges from 10-40% less than the cost for comparable primary care services provided by a physician practicing alone.


What Needs to Be Done?


Enact The Workers’ Compensation Nurse Practitioner Access Act (S2617/A90)

Assemblywoman Susan John and Senator Guy Velella are sponsoring legislation that seeks to allow full participation by nurse practitioners in the Workers’ Compensation system.


Under the Workers’ Compensation system, injured workers can be examined, diagnosed and treated by a nurse practitioner only if the treatment is supervised by a physician approved by the workers’ compensation board. This is extremely inefficient as nurse practitioners, by virtue of their legal title and scope of practice, do not act while under the direction or supervision of a physician for non-Workers’ Compensation cases.


Currently, nurse practitioners may diagnose illness and physical conditions and perform therapeutic and corrective measures in collaboration with a physician in accordance with a written practice agreement.  Thus, under law and in everyday actual practice, nurse practitioners conduct physical examinations of patients, order tests, prescribe drugs, devices and immunizing agents and, when appropriate, refer patients to other health care providers.


The Workers’ Compensation system requires that nurse practitioners must render care under the direct supervision of a physician who is present in the office and immediately available to provide assistance and direction throughout the time the nurse practitioner is rendering services. The Workers’ Compensation rules further require that the physician must render the bill for the care provided by the nurse practitioners and that reimbursement should be made at the normal physician payment level as if the physician had provided the service. This violates the basic collaborative model as established by statute in 1989, and unnecessarily inflates costs.


This legislation, therefore, seeks to uphold the established collaborative model and scope of practice that is credited with delivering high quality care to patients treated outside the Workers’ Compensation system.


The measure would add no cost to the Workers’ Compensation system nor expand utilization, but would simply permit nurse practitioners to see Workers’ Compensation patients just as they do in non-Workers’ Compensation settings.


This bill seeks to increase choice to injured workers, expand the Workers’ Compensation provider network, and save money by reducing the time that injured persons are out of work and on compensation.


Our Story is Compelling!


General Points


*Nurse Practitioners are a proven response to the evolving trend towards wellness, preventive health care and cost containment.  Their efficacy is driven by consumer demand, federal and state regulation and the needs of private payers.


*The New England Journal of Medicine has published studies indicating that if nurse practitioners were fully employed nationally, up to 20% of the cost of primary care delivery could be saved.  Nationally, up to $8.75 billion could be saved by employing nurse practitioners fully.


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