Advocacy Update

Jan. 26, 2024: State Advocacy Update


Scope of practice continues to be a top priority for the AMA, state medical associations and national specialty societies across the country. The AMA is happy to report an early victory in New Jersey with the defeat of an APRN bill that was introduced in 2022.

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The legislation, S. 1522/A. 2286, would have allowed advanced practice nurses and nurse anesthetists to provide care to patients without any physician involvement, including ordering medications and devices, and administering anesthesia. Due to strong advocacy efforts of the Medical Society of New Jersey (MSNJ), with support from the AMA and specialty societies, MSNJ was able to declare victory when the session officially ended on Jan. 9, 2024. Defeating this bill and preserving physician-led care is a huge win for the health and safety of patients in New Jersey.  

In other scope news, the AMA recently sent a letter to the chair of the South Dakota House Health and Human Services Committee expressing opposition to H.B. 1099, which would allow optometrists to perform a range of complex surgical procedures on the eye. Emphasizing the importance of a physician’s education and training, the letter stated “[p]atient safety and quality of care demand that patients be assured that individuals who perform invasive procedures, including eye surgery, have the appropriate medical education and training. Optometrists do not have the education, training, or experience to inject medications or perform any type of surgery, including laser surgery involving the eye or tissues surrounding the eye.”  

AMA also sent a letter (PDF) to South Dakota House and Senate members expressing strong opposition to H.B. 1013, which would adopt the APRN Compact in South Dakota. While the AMA generally supports the concept of health care professional licensure compacts, the AMA strongly opposes the APRN Compact. This is because, unlike every other health care professional licensure compact, the APRN Compact preempts state scope of practice laws. This preemption language is why previous versions of the compact failed to garner enough support and were eventually scrapped. Still, despite strong opposition from organized medicine, H.B. 1013 unfortunately passed both chambers and is headed to Governor Noem’s desk for signature.   

Finally, the AMA sent a letter (PDF) and testified against psychologist prescribing legislation in Washington. While the AMA supports the role of psychologists as behavioral health experts and key members of the health care team, they simply do not have adequate training to prescribe and manage powerful psychotropic medications. James L. Madara, MD, AMA CEO and executive vice president, states in the letter that “granting psychologists prescriptive authority will put patients in danger without meaningfully increasing access to mental health services in Washington. This well-intentioned proposal would only expose vulnerable patients—including children, adolescents, seniors, and pregnant women—to substandard mental health care, while risking patient safety.” Scott Ferguson, MD, a member of the AMA board of trustees, also testified during a committee hearing on the bill. In his testimony, Dr. Ferguson expressed AMA’s strong concern with granting psychologists who have zero medical training the ability to prescribe potentially dangerous psychotropic medications. In both the letter and testimony, the AMA encouraged committee members to vote “no” on the bill. 

On Jan. 11-13, more than 300 physician leaders and medical society staff joined the AMA in Amelia Island, Florida, for the annual State Advocacy Summit. Attendees had the opportunity to: 

  • Hear from national experts on the critical issues impacting medicine at the state level 
  • Strategize with advocacy leaders on their organizations’ state legislative and regulatory priorities 
  • Network with other physician leaders and colleagues from across the country

Abraham Verghese, MD, set the stage for the meeting with his keynote address, which offered his uniquely humanistic view on the future of health care. Conference content—with 40+ expert outside speakers—covered key health care topics that states are likely to address in their upcoming legislative sessions, including sessions such as: 

  • Insurance barriers to care: Denials, prior authorizations, appeals and the data informing reform efforts 
  • Scope of practice expansions beyond primary care 
  • Medical student and physician wellness 
  • Augmented intelligence: The promise, potentials and needed guardrails 

Make sure to save the date for the 2025 AMA State Advocacy Summit—Jan. 9-11 at the Omni La Costa Resort & Spa in Carlsbad, California.  

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