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HHS Wants to Hear from YOU About How Scope of Practice Restrictions Hurt Patients

At the end of 2019, President Trump issued an Executive Order that could become a major milestone for extending advanced practitioners’ scope of practice across the country.

The document calls on Secretary of Health and Human Services Alex Azar to reduce the restrictions Medicare places on NPs and PAs, which are often stricter than those imposed by state laws. In addition, the order requested APPs be able to bill at 100 percent of the Medicare fee schedule, as physicians do.

Why Does HHS Want Feedback?

In response to the president’s long-awaited move, the Centers for Medicare & Medicaid Services (CMS), helmed by Seema Verma, is calling on physician assistants and APRNs to provide feedback. Doing so will help identify “additional Medicare regulations, which contain more restrictive supervision requirements than existing state scope of practice laws, or which limit health professionals from practicing at the top of their license.”

According to the statement from CMS, the agency has already decided to change several regulations, including: “redefining physician supervision for services furnished by PAs, allowing therapist assistants to perform maintenance therapy under the Medicare home health benefit and reducing the minimum level of physician supervision required for all hospital outpatient therapeutic services.”

What are the Professional Orgs Saying About it?

Dozens of professional organizations representing APRNs and PAs have applauded the request. In a letter, the American Association of Nurse Practitioners (AANP), along with 86 other NP groups, praised the work that’s already been done and called for Azar to implement the complete the rest of Executive Order that addresses APPs.

“The current system has exacerbated clinician shortages, creating barriers to care that put seniors’ health at risk,” said AANP CEO David Hebert, JD, in a statement. “By removing burdensome regulations and allowing all clinicians to work to the top of their profession, our nation will improve patient access to care while lowering costs.”

How Can You Submit Your Feedback?

The CMS is asking providers and other health professionals to submit their feedback via email to with “Scope of Practice” in the subject line. All submissions are due January 17. The agency also specified that any emails sent to this address with this specific subject line only discuss practice restrictions on APPs.

If you’re not sure what to write, the AANP has composed a note that you can send with your personal information through their website. PAs can check out the various letters the American Academy of Physician Assistants has sent to CMS regarding fee schedules, documentation and more.

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