This week, Texas State Representative John Smithee and State Senator Kel Seliger introduced HB 1225/SB 654, which would eliminate restrictions preventing advanced practice registered nurses (APRNs) from seeing Medicaid patients. Medicaid is the state’s health insurance program that serves 4 million citizens, including nursing homes patients, foster care children, and needy mothers and children. If passed, HB 1225 and SB 654 would go a long way towards increasing health care access in rural and medically underserved areas of Texas.
“Texas needs more providers for Medicaid patients and in rural and medically underserved areas of our state,” said Jan Zdanuk, President of Texas Nurse Practitioners. “Advanced practice registered nurses are already serving many of these patients, and HB 1225/SB 654 will allow us to serve more patients in more areas of the state. This legislation would have a big impact on rural health care providers and their patients. We applaud Rep. Smithee and Sen. Seliger for taking such an important step to improve rural health care.”
Unlike many states, Texas requires APRNs to have a delegating physician in order to practice and see patients, even though the physician may never see or treat any of the APRN’s patients or even live in the county. Texas also has a further restriction that most states, including many of our neighbors, don’t impose: APRNs can only accept a Medicaid insurance plan if their delegating physician also accepts that plan. As a result, when a delegating physician chooses not to participate in a Medicaid plan, so must the APRN — a huge problem for nurse practitioners in rural areas and an even bigger problem for rural patients.
HB 1225/SB 654 eliminates this arbitrary insurance requirement, and allows APRNs to freely choose to serve patients in any or all of the 16 Medicaid plans. The bill also helps physicians by avoiding the need for them to go through the needless red tape of getting set up for and enrolling in Medicaid plans that serve patients the physician may never see.
In 2000, 67 percent of Texas physicians accepted all new Medicaid patients. Today, that number is closer to 34 percent, making the proposed legislation all the more necessary. Without a change in policy, fewer and fewer APRNs will be able to see Medicaid patients, even if they would choose to do so on their own.
“In rural Texas, the next closest health care provider could be many miles away and that could mean the difference between life and death,” said Zdanuk. “This bill would give more options to rural patients to access the vital care they need.”