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Florida TaxWatch and FMA Clash on Roles of APRNs

March 17, 2014 - 7:00pm

Two of the most prominent groups in Tallahassee clashed Tuesday on the roles of Advanced Practice Registered Nurses (APRNs) in the Sunshine State.

Florida TaxWatch released a study which shows allowing APRNs a greater role in Floridas health care would save the Sunshine State almost $340 million, as well as improve access for patients.

"Improving the quality of care for Florida's families through increased access to professionally trained APRNs will ensure our state has the foundation for a sustainable health-care system for the future," said Dominic Calabro, the president and CEO of Florida TaxWatch. "APRNs can fill a need stemming from Florida's shortage of doctors and provide much of the primary care that patients are not receiving due to this shortage."

"To move Florida forward and balance access, quality, and cost, both physician and nurse practitioner perspectives need to be considered, always with the patient's best interest coming first," said Tamara Demko,the director of Florida TaxWatchs Center for Health and Aging. "Florida's health-care needs will continue to increase, and every health-care practitioner plays an important role in addressing those needs."

The Florida Medical Association (FMA), which has opposed giving more responsibilities to APRNs, responded on Tuesday, insisting the report was incorrect.

"This report, which is based largely on a government memorandum that is now 4 years old, is so fundamentally flawed and misleading, it requires immediate correction," said Jeff Scott, the general counsel for the FMA. "The report is based on numerous assumptions that are demonstrably and irrefutably false. The FMA calls on TaxWatch to correct these inaccuracies and reissue the document with those corrections."

The FMA insisted the report was incorrect, relying on the upper limits of the potential financial savings for Florida and using limited, flawed research. The FMA also jabbed the report on other grounds, arguing it falsely assumes that 100 percent of primary care in Florida would be performed by nonphysicians" and creates an alternate reality in which doctors do not exist and do not provide any primary care services."

Scott attacked TaxWatchs report as intellectually dishonest and vowed the FMA would continue advocating its position.

The FMA will not stand by and allow this organization to recommend public policy to the Florida Legislature that is based in fantasyland," Scott said. "We call on TaxWatch to recall its report, analyze the facts instead of conjecture, and reissue a report that policymakers can actually use."

Florida TaxWatch responded on Tuesday afternoon and stood behind its report.

"Florida's health-care system is unable to sustain Florida's long-term health care needs, said Robert Weissert, the chief research officer and general counsel of Florida TaxWatch.

This problem will only get worse as the state's aging population grows, and it is exacerbated by a shortage of physicians and primary care providers in the state. This report, 'Diagnosing the Debate,' analyzes the varying perspectives among Florida's health practitioners on expanding access to care.

"The report presents the unique challenges and scope of practice restrictions placed on health care practitioners in a balanced and informative way, Weissert added. Our goal is to use the report to reopen the discussion between interested groups to design and implement a solution for providing care to all Floridians. TaxWatch is pleased that the report is generating discussion among the medical and public policy community. We hope that it will drive these groups to thoughtfully work through differing points of view to make informed decisions that meet Florida's growing health care needs by reflecting on the patient first while seeking to balance access, quality, and cost."

Weissert defended the report's analysis that more APRNs could offer Floridians major savings.

"The report cites potential cost savings of up to $339 million, which is a properly cited and disclaimed estimate from the Office of Program Policy Analysis and Government Accountability (OPPAGA), the Florida Legislature's well-respected research arm, Weissert said, citing the report.

"TaxWatch recognizes that, regardless of the OPPAGA assumptions, there are cost-savings opportunities to removing barriers to care provided by nonphysician health care practitioners, such as APRNs and PAs, Weissert added. The report clearly indicates that the OPPAGA cost-saving figure may not be fully realized, but we stand by the citation of the most recently available research.

"Now, more than ever, it is crucial to expand access to care for Floridians. Allowing our state's APRNs and PAs, who are qualified medical professionals, to practice with fewer restrictions would expand access opportunities to our state's residents and provide significant savings for Florida and its hard-working taxpayers, Weissert said in conclusion. TaxWatch will continue to follow new information as it becomes available to make recommendations based on what is best for the people of Florida and its most vulnerable citizens."

With Florida and Alabama being the only two states in the nation that don't allow APRNs to prescribe controlled medicine, nurses have been active without success in lobbying the Legislature to change the law.

Reach Kevin Derby at

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