Nurse practitioners ask lawmakers to update insurance rules to match full practice authority

The Massachusetts Coalition of Nurse Practitioners asked the Joint Committee on Financial Services to update state insurance statutes so that insurers recognize nurse practitioners with full practice authority as the provider of record for coverage determinations and orders.

Katharine MacKinnon, executive director of the coalition, said that although eligible nurse practitioners have had full practice authority in Massachusetts since 2020, many insurance rules still require physician involvement to establish medical necessity, conduct diagnostic evaluations or issue written orders. "When insurers refuse to recognize NPs as the provider of record on the basis of outdated statutes, patients face denials in coverage, delays in care, and are forced to seek physician referrals when physician providers are not readily accessible," MacKinnon said.

She emphasized that the proposed legislation would not expand NP scope of practice; rather it would ensure state-regulated plans recognize licensed NPs' existing authority so patients do not lose coverage because an insurer requires a physician signature. MacKinnon said nurse practitioners are often the sole primary-care source in rural and underserved areas and that aligning statutes with current practice would reduce denials and administrative delays.

The committee did not act at the hearing; MacKinnon requested a favorable report on the companion bills.