July 13, 2023

ACEP Opposes Bill That Would Expand Nurse Practitioner, Physician Assistant Scope of Practice

ACEP and more than 100 organizations wrote Congress to strongly oppose H.R. 2713, the “Improving Care and Access to Nurses (I CAN) Act.

This letter counters many of the misperceptions about non-physician scope expansion that continue to fuel misguided legislative efforts in state legislatures.

The letter states:

“The data is clear—scope expansions have not led to increased access to care in rural and underserved areas.

While all health care professionals play a critical role in providing care to patients and non-physician practitioners are important members of the care team, their skill sets are not interchangeable with those of fully educated and trained physicians.”

There is strong evidence that increasing the scope of NPs and PAs contributes to an increase in health costs. The letter cites research that found: 

  • Nurse practitioners ordered more tests and formal consults than physicians and were more likely than physicians to seek information from external sources such as X-rays and CT scans.
  • They also saw worse health outcomes, raising 30-day preventable hospitalizations by 20% percent, and increasing length of stay in the emergency department.
  • Altogether, nurse practitioners practicing independently increased health care costs by $66 per emergency department visit.


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