Advanced Practice Nurses 
                   of New Jersey


Health And Policymaker Recommendations


APNs have been providing exceptional healthcare for nearly fifty years. This track record coupled with over four decades of research demonstrating the consistent quality and safety of APN-provided healthcare has policy makers calling for the modernization of practice laws and the adoption of full practice authority for Advanvced Practice Nurses aka APRNs or Nurse Practitioners. 

The following excerpts are from leading health, policy, and consumer advocacy organizations regarding nurse practitioner practice and regulation. To download and view the full report, click on the association name. 

Robert Wood Johnson Foundation 

"In communities across the nation, patients still encounter delays in treatment, difficulty locating primary care and other services, and trouble finding practitioners who accept Medicaid reimbursement. These gaps result—at least in part—from state, federal, and institutional restrictions that limit how APRNs may practice, and from federal and private insurance policies that govern payment for their services.

These practice barriers persist despite a growing body of research indicating that the quality of APRN care in states that give APRNs full practice authority is comparable to the care they deliver in states that require some form of physician oversight—unnecessarily restricting the public’s access to affordable, high-quality care.

Institute of Medicine—Future of Nursing Report: 

“Recommendation 1: Remove scope-of-practice barriers. Advanced practice registered nurses should be able to practice to the full extent of their education and training” 

“Now is the time to eliminate the outdated regulations and organizational and cultural barriers that limit the ability of nurses to practice to the full extent of their education, training, and competence.” 

“The current conflicts between what APNs can do based on their education and training and what they may do according to state and federal regulations must be resolved so that they are better able to provide seamless, affordable, and quality care. “ 

National Governors Association—The Role of Nurse Practitioners in Meeting Increasing Demand for Primary Care: 

“Expanded utilization of NPs has the potential to increase access to health care, particularly in historically underserved areas.” 

“In light of the research evidence, states might consider changing scope of practice restrictions and assuring adequate reimbursement for their services as a way of encouraging and incentivizing greater NP involvement in the provision of primary health care.” 

The CDC: Practical Implications of State Law Amendments Granting Nurse Practitioner Full Practice Authority

"Allowing health professionals to practice at the top of their licensure and training is also a strategy to facilitate interprofessional team-based health care and coordinated models of high- quality, cost-effective service delivery."

White House: Reforming America’s Healthcare System Through Choice and Competition

"Extremely rigid collaborative practice agreements and other burdensome forms of physician and dentist supervision are generally not justified by legitimate health and safety concerns. Thus, many states have granted full practice authority to APRNs, but there is significant room for improvement in other states and for other professions"

Bipartisan Policy Center—What Is Driving U.S. Health Care Spending?: 

“Due to various regulations and restrictions, many professionals are not practicing at the “top of their license,” meaning that they are not performing the work that reflects the fullest extent of their education and training.” 

“Scope of practice restrictions vary across the nation, limiting the ability of certain professionals to provide cost- effective care.” 

“Physician oversight of work that can be performed autonomously by other professionals can lead to unnecessary repetition of orders, office visits and services, thus increasing total costs without any additional benefit to patients.” 

Josiah Macy Foundation—Who will provider primary care and how will they be trained?: 

“Variations in scope of practice and regulatory policies affect the primary care workforce differently in different states. Results from recent studies indicate that more restrictive states lose potential NPs to states that have more supportive practice acts and regulations that govern NP practice.” 

“State and national policies should be changed to clarify the scope of practice of NPs as independent primary care providers. Subsequently, insurers’ policies, including Medicare and Medicaid, should be revised to link reimbursement to practice.” 

Brookings Instutute

“Important productivity gains could be achieved by altering the mix of labor inputs used in the health-care sector. However, the potential for these gains is sharply limited by anticompetitive policy barriers in the form of restrictive scope of practice (SOP) laws imposed on physician assistants and advanced practice registered nurses.

Kaiser Family Foundation

 In the context of a broader set of strategies to shape a health care workforce and delivery systems that meet the needs of all Americans, optimizing our existing primary care capacity by removing barriers to NPs’ full deployment is a step that states, public and private health insurance programs, and managed care plans are in a position to take in the immediate term.

American Enterprise Institute                                                                                                                                         Nurse practitioners: A solution to America’s primary care crisis

  • A large and growing body of research shows that the quality of care provided by nurse practitioners is as good and, in some cases, even better than the care provided by primary care physicians. But in many states, nurse practitioners are held back by laws that restrict their scope-of-practice.
  • Lawmakers, hospital administrators, health care systems, and others involved in assuring access to primary care should remove restrictions on nurse practitioners that limit their scope-of-practice, and physicians should work with nurse practitioners to build a workforce that is more responsive to communities’ health needs.

AARP—The Policy Book-AARP Public Policies 2011-2012 

“States should allow all professionals to provide services to the full extent of their current knowledge, training, experience and skills where evidence indicates services can be provided safely and effectively. States should allow and expect different professions to share overlapping scopes of practice.” 

“States should amend current scope of practice laws and regulations to allow nurses, APRNs to perform duties for which they have been educated and certified.” 

“Current state nurse practice acts and accompanying rules should be interpreted and/or amended where necessary to allow APRNS to full and independently practice as defined by their education and certification.” 


  National Council of State Boards of Nursing (NCSBN) Model Nurse Practice Act language - Model statutes and rule language for regulating NP practice for full practice authority. 

  Clinical Outcomes: The Yardstick of Educational Effectiveness – Appropriate educational evaluation and comparison markers

  Nurse Practitioner Cost-Effectiveness - An introduction to the body of evidence supporting NPs as cost-effective providers of high-quality care.

  Quality of Nurse Practitioner Practice - An overview of the research supporting the value the nurse practitioner brings to high-quality care.

The AANP welcomes the opportunity to work with state stakeholders to shape legislation that is beneficial and appropriate for patients, nurse practitioners and the healthcare community. (512) 732-2320. 



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