Bill on nurse Rx oversight fails
Capitol Bureau ddenwalt@oklahoman.com
The Oklahoma Senate shot down a bill Wednesday that would have ended the financial relationship between advanced practice nurses and the doctors who supervise their drug prescribing power.
Senate Bill 1127 would have banned financial arrangements in which the physician accepts monetary payment in exchange for supervision. In Oklahoma, advanced practice registered nurses must work with a doctor who is able to review and offer guidance on the nurses’ prescription-writing.
On the Senate floor, state Sen. Joseph Silk said nurse practitioners in his district believe the bill would inflict damage to rural Oklahoma’s health care system. If doctors can’t be paid to supervise prescription authority, Silk said, then there will be fewer doctors who take on that role and fewer nurses who are available to write prescriptions.
“If we remove this, they’re scared that depending on their geographic location, they won’t be able to find a doctor,” said Silk, R-Broken Bow.
Toni Pratt-Reid with the Association of Oklahoma Nurse Practitioners said the bill wouldn’t fix anything.
“If we’re mandated to have a collaborative agreement, no one is going to do it pro bono,” Pratt-Reid said. “Our ability to have collaborative agreements with physicians are going to decrease even more than we have now.”
The author, state Sen. Ervin Yen, said he offered the bill because some nurses complained about having to pay doctors for supervision. As chair of the Senate Health and Human Services Committee, he held a public hearing last year on the issue.
“I suspect there are not that many nurse practitioners in the state that aren’t paying physicians because they certainly didn’t come to my study,” said Yen, R-Oklahoma City. “If you believe that this will hurt nurses, then absolutely vote no on this bill and those nurses can continue to pay physicians.”
The bill failed on a 32-12 vote.
After the session ended Wednesday, Yen told The Oklahoman, “I tried.”
House Bill 1013
The senator also said he would continue to block House Bill 1013 from advancing in his committee. The bill is endorsed by nurse practitioners as a solution to the problem of unfair business relationships with doctors and a lack of rural health care. If adopted, it would let nurse practitioners prescribe more freely without having a doctor check their work.
Yen said, however, the bill doesn’t say anything about rural health care. He cited an opioid task force recommendation that mid-level providers shouldn’t be prescribing Schedule 2 drugs like opiates.
He also said the proposal would allow nurse practitioners to use medical devices, which he said could be X-rays, MRI machines and even lasers.
“If it was just about supervision for drugs, why didn’t the bill say that?” he said.