FDA Vaping Regulations; CMS Scope of Practice; APPs Improve Health Care
FDA Regulates Flavored Vaping Products
Congress returned from the winter holiday season to an administrative announcement (https://www.washingtonpost.com/opinions/trump-backpedals-on-vaping-sad/2020/01/02/7af22ace-2da8-11ea-bcd4-24597950008f_story.html) partially curtailing flavored e-cigarettes and vaping mechanisms. Additionally, the U.S. Food and Drug Administration (FDA) began the year with the announcement of a new policy prioritizing enforcement against certain unauthorized flavored e-cigarette products (http://www.fda.gov/news-events/press-announcements/fda-finalizes-enforcement-policy-unauthorized-flavored-cartridge-based-e-cigarettes-appeal-children?utm_source=CTPEblast&utm_medium=email&utm_term=stratout&utm_content=pressrelease&utm_campaign=ctp-endsguidance) to help curb the youth smoking epidemic (https://voice.ons.org/advocacy/surgeon-general-declares-youth-vaping-an-epidemic). However, to the chagrin of the smoking cessation community, FDA is still allowing menthol and traditional tobacco flavors to be sold as usual, and reports have indicated that teens and other underage users will still opt for traditional products if they’re available (https://www.washingtonpost.com/opinions/2020/01/04/fda-got-it-partially-right-e-cigs-heres-what-else-needs-be-done/).
ONS and the Campaign for Tobacco Free Kids are urging the administration to take a stronger stance on youth vaping. Bipartisan support in Congress is high for a heavier hand, but it will require the president and the Department of Health and Human Services to step up and follow through on their promises. In the meantime, ONS advocates are working with elected officials to highlight the dangers of vaping and tobacco use (https://voice.ons.org/stories/providing-expert-testimony-in-the-virginia-state-senate).
CMS Re-Evaluates Medicare Scope of Practice Restrictions
The Centers for Medicare and Medicaid Services (CMS) are re-evaluating the limitations placed on the scope of practice for many advance practice providers (https://www.healthleadersmedia.com/clinical-care/cms-wants-more-input-medicare-scope-practice-regulations), seeking input from stakeholders throughout the healthcare community. The potential revamp would remove more stringent restrictions found in states that limit healthcare professionals from practicing at the top of their license.
Nursing scope of practice has been a challenging issue in the medical community. The National Academy of Medicine released a report almost a decade ago (http://nationalacademies.org/hmd/reports/2010/the-future-of-nursing-leading-change-advancing-health.aspx) stating that nurses should practice to the full extent of their education and experience, but physician groups were not pleased with that statement (https://journals.lww.com/ajnonline/FullText/2018/03000/AMA_Resolution_Opposes_Independent_Practice_by.7.aspx). Since that time, nursing has expanded its scope in a variety of ways (https://voice.ons.org/news-and-views/nurse-practitioners-enhance-the-oncology-workforce). A CMS review could be transformative. ONS, and many other nursing organizations, has formally submitted statements in support of the review (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/policy-priorities). Change is coming, and nursing’s role will evolve to meet that change.
APPs Can Increase Access, Affordability of Health Care
Access and affordability are two of the biggest components of the ongoing healthcare conversation in the United States. For some, the solution seems simple: expand the role and scope of practice for nurse practitioners (https://www.washingtonpost.com/opinions/heres-an-easy-way-to-increase-access-to-high-quality-affordable-health-care/2020/01/02/46c64768-29d8-11ea-b2ca-2e72667c1741_story.html) to better effect change in primary care. But the backlash to such statements is often strong and comes from other healthcare providers (https://journals.lww.com/ajnonline/FullText/2018/03000/AMA_Resolution_Opposes_Independent_Practice_by.7.aspx) attempting to keep the status quo instead of working to increase access and affordability for more patients.
As people interact with nurse practitioners, they realize they provide efficient and equally important quality care. Care from advanced practice providers has been shown to be economical, so much so that the U.S. Department of Veterans Affairs has supported expanding the role of advanced practice RNs since 2016 (https://voice.ons.org/news-and-views/aprns-now-have-full-medical-authority-in-practice-at-va-hospitals). The nursing community, including ONS, is advocating to expand the role of nurses (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/access-quality-cancer) and ensure that patient-centered care is affordable and accessible for all Americans.