Expert Policy Analysis

This is an updated issue brief regarding the Supreme Court decision that the actions of the North Carolina Board of Dental Examiners to prevent non-dentists from offering teeth-whitening services were an unlawful attempt to suppress competition. The issue brief update provides additional discussion and analysis of the opinion and provides resources for organizations and individuals regarding advocacy (including FTC Staff Guidance on Active Supervision of State Regulatory Boards Controlled by Market Participants and a document from the Citizen Advocacy Center entitled Addressing the Supreme Court’s North Carolina Decision: Options for States

The Supreme Court ruled that the actions of the North Carolina Board of Dental Examiners to prevent non-dentists from offering teeth-whitening services were an unlawful attempt to suppress competition. Though the case pertained to dentistry, ANA joined an amicus (friend of the court) brief in this case which will have far reaching implications beyond dentistry and will have a significant, positive impact for nursing practice. This issue brief provides background of the case and recommends next steps for states.

Changes from more traditional practice behaviors necessitate examination of options for licensure portability. This document is intended to provide nurses with information about current and potential processes for nursing licensure portability, enabling them to engage in informed discussions and influence decision-makers for the benefit of the profession and health care consumers/health care consumer/patients.

The Affordable Care Act provides for development of State Health Insurance Exchanges. Exchanges will be portals where individuals and small businesses can buy affordable and qualified health benefit plans. They will be designed to enhance competition in the health insurance market, improve choice of affordable health insurance to individuals, and give small businesses the same purchasing clout as large businesses. The intent is to create a level playing field for insurers and consumers that will reduce health care costs and increase quality.

The Obama Administration has stepped up efforts to discover and penalize fraud and abuse in health care services. Nurses, especially APRNs, need to take steps to identify and avoid fraud and abuse. Even honest mistakes could result in charges.

Breastfeeding has tremendous economic and health benefits. Education, encouragement, and policy support of breastfeeding are key to promoting this public health strategy. Nurses should enhance national efforts to support breastfeeding, and advocate for nursing-friendly hospitals - both for the patients and the staff.

Immigration continues to be a politically divisive issue. However, ANA firmly believes immigrants, whether documented or not, should have access to quality health care, including the opportunity to purchase insurance. Contrary to common belief or political rhetoric, giving this population access to insurance is an evidence-based way to actually reduce health care costs.

The Patient Protection and Affordable Care Act — or PPACA — roughly follows the key areas that ANA has set forth as necessary for effective health reform; the latest iteration of this policy was ANA’s Health System Reform Agenda (2008).

PPACA directs renewed attention and substantially more resources and incentives to promote those elements of care which are also the backbone of nursing practice. These essentials include patient-centered care; care continuity; coordination and integration across settings and providers; chronic disease management; patient education; prevention and wellness care; and information management.

NPs and CNMs are qualified to lead medical homes for all types of populations and health conditions, and will be invaluable in the looming gap in primary care services.

Unresolved issues of legal, ethical, and professional considerations of disaster medical response remain a challenge, and could hamper the ability of nurses to respond. A concerted effort to solving these problems is needed, with nurses and stakeholders at the national, state, and local levels.

APRNs across the U.S. have obtained a National Provider Identifier that facilitates their electronic direct billing to Medicare, Medicaid, and private health plans. By obtaining NPIs, APRNs can help give a good picture of billing and reimbursement.

Professional nurses are instrumental in working collaboratively with families, communities, and other professionals to eliminate the health hazard of childhood obesity.

The US government estimates that RNs are the occupation that would experience the greatest absolute increase in the number of jobs over the 2008-2018 timeframe. They project an increase of 582,000 jobs for registered nurses, a 22 percent in-crease over the 2008 levels.