Advocacy Update

April 29, 2022: Advocacy Update spotlight on major wins for scope of practice


For over 30 years, the AMA has advocated for a team-based approach to health care, fighting against scope of practice expansion by non-physicians that could threaten patient safety. Physicians, with the highest level of education and clinical training, are the leaders that patients deserve.  

The AMA has worked in strong collaboration with more than 25 state medical associations so far to oppose legislation that would inappropriately expand the scope of practice of non-physicians. The following are significant state legislative victories related to scope of practice.  

  • Alabama: Multiple bills have been defeated, including: 
    • S.B. 120, which would have allowed optometrists to perform eye surgery
    • S.B. 307/H.B. 402, which would have expanded the scope of practice for pharmacists 
    • S.B. 101, which would have expanded the scope of practice of podiatrists 
    • H.B. 268, related to nurse anesthetists passed but included important amendments that preserved physician-led care 
  • Colorado: H.B. 1095 has been defeated. This bill would have expanded the scope of practice of physician assistants by removing physicians from the care team. 
  • Kentucky: H.B. 354, which would have removed the physician collaboration required for advanced practice registered nurses (APRN) prescribing, has been defeated.  
  • Maryland: Multiple bills have been defeated, including legislation that would have expanded the scope of practice for physician assistants, clinical nurse specialists and podiatrists. 
  • Mississippi: S.B. 2178, legislation that would have expanded the scope of practice of APRNs, has been defeated, thereby preserving physician-led care for patients in Mississippi.  
  • South Dakota: S.B. 134 was defeated. This legislation would have removed physicians from the care team, eliminating physician supervision and only requiring physician assistants to have a collaborative practice agreement with a physician. 
  • Tennessee: H.B. 184/S.B. 176, which would have removed physician collaboration for prescriptive authority and allowed nurse practitioners to practice without any physician involvement, was defeated.  
  • Washington: The Washington State Medical Association has defeated multiple bills, including:  
    • S.B. 5542, which would have allowed optometrists to prescribe medications and perform surgeries 
    • S.B. 5088, which would have given prescriptive authority, among other scope of practice expansions, to naturopaths 
    • S.B. 1863, which would have established prescriptive authority for psychologists 
    • S.B. 5704 and S.B. 5222, which would have required insurers to reimburse nurse practitioners at the same rate as physicians 
  • Wisconsin: Governor Tony Evers has vetoed S.B. 394, legislation that would have given independent practice to APRNs. The bill would have removed physician supervision or collaboration requirements for nurse practitioners, nurse anesthetists and clinical nurse specialists after 3,840 clinical care hours in their respective APRN role with a physician or dentist.  

In addition to these victories, Indiana S.B. 239, a Truth in Advertising bill (PDF) spearheaded by the Indiana Physician Coalition, was signed into law. This proactive legislation supported by the AMA requires any advertisements that include a practitioner’s name to prominently state the license or profession (as allowed by the board’s governing statute or rules) held by the practitioner. The bill also limits the use of medical specialty designations such as anesthesiologist, dermatologist, family practice physician, ophthalmologist and surgeon. 

It is important to note that many of these bills have been introduced year after year. The AMA is proud to work alongside state medical associations, and with the help of the Scope of Practice Partnership, to continue to defeat these bills and protect the safety of patients. The AMA will continue to be a strong advocate for physicians and the patients they care for. The AMA will be there every step of the way to fight for physician-led care and defend the practice of medicine against scope of practice expansions that threaten patient safety.