Tennessee Nurse Practitioners Return To Pre-Pandemic Paperwork As Emergency Rules Expire

Tennessee nurse practitioners hope looser regulations during the pandemic have shown they don’t need a medical doctor checking their work — often for a fee. They’ve battled mandatory chart reviews in the legislature for years.

Nurse practitioners and physician assistants were temporarily freed from what they see as merely paperwork oversight in mid-March with Executive Order 15 from Gov. Bill Lee. The sweeping order also relieved advanced practice nurses of site visits from a doctor every 30 days.

“It just calls into question whether this is even needed at all,” says Vanderbilt University Medical Center’s April Kapu, who will soon lead the American Association of Nurse Practitioners.

It would take an act of the legislature to make the looser regulations permanent, and advance practice nurses had already reignited their lobbying effort in Tennessee prior to the pandemic. They argue Tennessee is more restrictive than most states when it comes to the “scope of practice” for advanced clinicians.

But the governor opted not to renew the emergency rules. It’s now difficult to argue there’s no time for the paperwork since most practices have too few patients, not too many. A spokesperson for the Tennessee Department of Health says the emergency rules for nurse practitioners and PAs “served their purpose” and could be revived if they’re needed again.

Some other emergency rules were extended in Executive Order 36 last week. Those include allowing out-of-state doctors to practice in Tennessee, loosening telehealth restrictions and suspending continuing education requirements.