On Wednesday, September 28, the U.S. Department of Veterans’ Affairs (VA) transmitted an unreleased final version of the “Advanced Practice Registered Nurses (APRN)” rule to the Office of Management and Budget (OMB) for final review. The earlier, proposed version of the rule granted all VA APRNs so-called “full practice authority,” or the authorization to practice without physician oversight, regardless of state law.
The transmission of the rule to OMB is one of the last steps in the formal rulemaking process as the policy advances towards being released in the Federal Register as a Final Rule for implementation. The OMB posting provides no timeline for release of the Final Rule, nor does it offer insight on the content of the rule, but it does indicate that VA has finished reviewing the comments submitted during the public comment period and that it is continuing to advance at least some of the policies from the proposed rule.
ASA is aware of rumors that VA may have removed nurse anesthetists from the Final Rule, however, the content of the Final Rule will be not available until it leaves OMB and is published in the Federal Register, which can take up to 90 days. ASA believes a full reading of the Final Rule, once issued, will be required before a full assessment of the rule is possible. ASA will continue to monitor the development of this proposal, and will alert members as the rule advances.
Also on September 28, Congressman Phil Roe, M.D., (R-TN-01), introduced H.R. 6277, a bill that would prohibit the implementation of the proposed VA APRN rule. The legislation would bar the VA Secretary from finalizing the “Advanced Practice Registered Nurses” proposed rule, effectively halting VA’s proposal to grant so-called full practice authority to all advanced practice nurses, including nurse anesthetists, within VA, regardless of state law.
Congressman Roe is a physician, and a co-chair of the House Republican “Doc Caucus.” Dr. Roe is also a member of the House Veterans Affairs Committee, where he serves on the Health and Oversight and Investigations Subcommittees. H.R. 6277 was introduced with five co-sponsors, including Rep. Ralph Abraham, M.D. (R-LA-05), Rep. Charles Boustany, M.D. (R-LA-03), Rep. Andy Harris, M.D. (R-MD-01), Rep. Tom Price, M.D. (R-GA-06), and Rep. Larry Bucshon, M.D. (R-IN-08). All of the co-sponsors are members of the House Republican “Doc Caucus.”
Following passage of a continuing resolution (CR) to fund the government for ten weeks, the House of Representatives and the Senate adjourned yesterday to return home for the elections. No action on Congressman Roe’s legislation is expected until Congress resumes activity following the November 2016 election.
Find the OMB posting here.
Read the Proposed Rule here.
Find out more information about H.R. 6277 here.