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Northam eases restrictions on nurse practitioners, other providers in response to COVID-19 pandemic

RICHMOND — Gov. Ralph Northam is temporarily easing regulations requiring nurse practitioners to work under the supervision of a physician, among other restrictions on medical providers being lifted in response to the pandemic.

His new executive order, announced Friday, allows nurse practitioners with at least two years of clinical experience to practice without a collaborative agreement with a physician, which requires periodic chart review and “appropriate input” in emergencies and complex clinical cases, according to the Medical Society of Virginia.

Previously, only nurse practitioners with five or more years of experience could practice without a doctor’s supervision, which also required them to apply for an autonomous practice license. The order relaxes those requirements until June 10, the date when his declaration of emergency over the COVID-19 pandemic and accompanying stay-at-home order are set to expire.

“We’re working to help our hospitals and long-term care facilities have the staff they need to take care of their communities,” Northam said at a press briefing.

Nurse practitioners across Virginia have complained that practice agreement requirements are a hindrance as they work to respond to COVID-19 in their communities. The American Association of Nurse Practitioners and Virginia Council of Nurse Practitioners previously called on Northam to loosen the requirements for all nurse practitioners, regardless of clinical experience, pointing to states such as Kentucky, Louisiana and New Jersey that issued similar waivers.

“We’ve got a situation in Virginia where it’s illegal for many NPs to provide services to their patients unless they have a physician relationship documented in writing,” said Tay Kopanos, vice president of state government affairs for the American Association of Nurse Practitioners, in an interview last week.

In March, Northam waived certain licensure regulations for nurses, allowing them to practice provisionally while waiting to sit for their board exam or receive their results.

His new executive order also relaxes restrictions on out-of-state doctors and other providers, making it easier for them to provide services during the pandemic. Under the directive, any license issued to an out-of-state provider in good standing will be considered an active medical license in Virginia — as long as that doctor works at a practice or health facility that also has locations in Virginia.

Out-of-state doctors also are permitted to provide telehealth services to patients in Virginia. There are new allowances for medical interns, residents and fellows, too, allowing them to work in hospitals without a doctor’s supervision. The same applies to fourth-year medical students.

Earlier last week, Northam put out a call for at least 30,000 volunteers to join the Virginia Medical Reserve Corps — a force of 22 local units that can be deployed during public health emergencies.

“As a doctor, I know this pandemic is placing extraordinary demands on our doctors, nurses, nurse practitioners, [physicians’ assistants] and other staff,” Northam said Friday. “This order will allow us to expand our workforce so that more trained medical professionals can step up, step in, and help meet the need.”


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