Public Health Emergency ANA Impact Survey

March 24, 2023

The Public Health Emergency (PHE) that was activated at the onset of the COVID-19 pandemic will end on May 11, 2023. The Consolidated Appropriations Act of 2023 extended many of the telehealth flexibilities authorized during the PHE through 2024.  Waivers which allowed Advanced Practice Registered Nurses (APRNs) to practice to the full scope of their license are slated to expire May 11, 2023.

ANA continues to advocate to members of Congress, the White House, and Centers for Medicare and Medicaid Services, to take action to extend these waivers which have benefited vulnerable patients who struggle to access healthcare.

WHAT CAN NURSES DO?

ANA has a short form at https://p2a.co/F3ws0UF , and encourages Nurses to share how these waivers have helped patients gain access to the care they would not have otherwise received.  

ANA will use these stories to communicate with policymakers the reasons these waivers need to be made permanent,  and the negative consequences for patients should the waivers be allowed to expire.   Nurses' voices are critical, as we cannot allow our nation’s health care to go backward.

Below are the expiring waivers of most concern:

  • Physician Services. 42 CFR §482.12(c)(1)–(2) and §482.12(c)(4): Waiving requirements that Medicare patients admitted to a hospital be under the care of a physician, allowing APRNs to practice to the top of their licensure, and authorizing hospitals to optimize their workforce strategies.
  • Responsibilities of Physicians in Critical Access Hospitals (CAHs). 42 CFR § 485.631(b)(2): Making the physician physical presence waiver permanent allows certain APRNs in CAHs to practice to the full extent of their education, clinical training and licensure;  and enables the entire health care team to practice to its fullest capacity in provider shortage areas.
  • Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs): Physician Supervision of NPs in RHCs and FQHCs. 42 CFR 491.8(b)(1): Waiving the physician supervision of NPs in RHCs and FQHCs has provided workforce flexibility in rural and underserved communities where provider shortages have increased the most.
  • Anesthesia Services. 42 CFR §482.52(a)(5), §485.639(c) (2), and §416.42 (b)(2): Allowing certified registered nurse anesthetists (CRNA), in accordance with a state emergency plan, to practice to the full extent of their license by permanently extending the CMS waiver removing physician supervision as a Condition of Participation.