These new requirements will come into effect on June 1, 2019. NPs and SNS enrolled in Medicaid or wishing to register should act now to bring their cooperation agreements into compliance. We reviewed an overview of the literature for the State of Michigan, all recent studies that investigate the effects of extending the scope for PRs. It appears to improve access to supply; This is something that is relatively consistent throughout the literature. In addition, there appear to be some improvements in the patient experience, although there have been no studies over time on other aspects of quality of care. There is nothing in my review to indicate that there would be a reduction in quality or a breach of patient safety with full practical autonomy. There is no doubt that Michigan`s HB 5400 represents a huge leap forward in the fight for full exercise. It`s no surprise that groups like the Michigan State Medical Society, which represents 15,000 doctors in the state, have opposed. In its own professional interest, the MSMS believes that health teams should be led primarily by physicians and argues that NPS do not have adequate training to ensure safe care in a comprehensive practical environment. It should be noted that there is little evidence to support the MSMS`s claims.
On the contrary, more restrictive practical environments for PRs have been associated, among other things, with decreased access to health services, reduced consumer choice, higher costs, insurance reimbursement issues, and inefficient health care delivery. Snc is a relatively new category of special certifications available to a registered nurse (“RN”) in Michigan (click here to access MSA Bulletin 19-10). The CNS Medicaid registration and coverage rules essentially mirror those that apply to a Nurse Practitioner (NP), a long-established special certification for RNs in Michigan. NPS and SNS, as well as Specialized Nurse Midwives (“NJC”) fall under the Advanced Practice Registered Nurse or APRN category, which have an expanded independent scope of business pursuant to recent amendments to the Michigan Public Health Code (“Code”). The NP/CNS must notify MDHHS if the cooperation agreement is terminated by one of the parties, which may lead to a cross on the Medicaid NP/CNS. Dr. Hershey is a professor in msu`s PhD and DNP programs.