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Call to Action - VICTORY!

June 18, 2015 update:

"Whoever said, 'It's not whether you win or lose that counts,' probably lost."
                                                                                   Martina Navratilova

Great news!  There will be no cuts to NP and PA reimbursements for this fiscal year.  As you know, the State Plan Amendment Rate Committee (SPARC) public hearing was held at the Oklahoma Health Care Authority this morning. As the meeting began, the Committee Chair announced that the agenda item, regarding cuts to NPs and PAs, was removed from the agenda.  OHCA will be able to fund the Medicaid service fee reimbursement for PAs and NPs at 100% for this fiscal year. 

What caused the change? Three possibilities:

  1.  Perseverance. Your response to our Call to Action with phone calls and emails to the various entities. That never can be measured, but we do know it was effective, because they told us it was.
  2. AONP’s attorney, Glen Coffee.  Mr. Coffee attended this meeting, was armed and ready to battle on the fairness issue. It's possible that Mr. Coffee's connections as Legal Counsel for the State Chamber, former President Pro Tempore of the Senate, and former Secretary of State all aided us in the political arena as well.
  3. Toni Pratt-Reid is a leader in this state on this issue. She was informed, carried the AONP on her back, and talked to everyone. I cannot tell you how much I appreciate her help and leadership. A big thank you to her.

So, the cuts have gone away. We can celebrate a victory.  While the big issue, of the devastating affects to NPs practices from these cuts, was primary.  The unfairness of no cuts to physicians was an important factor as well.  In conclusion, we set an important precedent today. AONP will remain vigilant.  We will keep a watchful eye towards this not happening to us again. We all learned a lot and we will use that knowledge going forward. 


June 2015 update:

Thursday, June 18th, is a State Plan Amendment Rate Committee (SPARC) public hearing at the Oklahoma Health Care Authority from 10:00 am - 11:30 am.  The agenda for this public hearing is listed on the OHCA website (click here).  One of the rate cuts they will be recommending is again a cut to reimbursement for NPs and PAs. Instead of the original proposed rate cut of 15% (100% to 85%) of the physician fee schedule, they are now recommending a cut of 5% (from 100% to 95%) of the physician fee schedule.  At the Medical Advisory Committee, on May 21st, the recommendation to OHCA was to make a smaller across-the-board rate cut to all providers, not just a rate cut to NPs and PAs. The SPARC public hearing is similar to the Medical Advisory Committee - where anyone can attend, put their name on the public comments list prior to the start of the meeting and make comments during the meeting.  We need to make our voices heard.


Oklahoma Watch Article, by Scott Carter:  Health Agency Backs Away From Payment Cuts


May 22, 2015 Update:  

AONP members were notified and responded to our Call to Action by attending the, May 21st, OHCA - Medical Advisory Committee meeting regarding the proposed 15% medicaid free for service reimbursements to NPs.  Many NPs and PAs attended and explained the devastating effects the proposed cuts would have on health care in Oklahoma.  AONP provided OHCA alternate cost-saving methods for dealing with their budget shortfall.

The committee voted NOT to reduce NPs fee for service. The committee supported our recommendations of across-the-board reductions to the entire OHCA budget (approximately 4-5%).  While this vote is a recommendation to OHCA - it was a victory.  We made progress, but must continue our efforts on this issue.


May 1, 2015 Call To Action:

Nico Gomez, with the Oklahoma Health Care Authority (OHCA), announced that the OHCA was going to make up budget reductions by cutting the fee for service Medicaid reimbursement for PAs and NPs by 15%. This is in addition to the provider rate cut enacted last year.

Please call Nico Gomez at the Oklahoma Health Care Authority, 405-522-7300, immediately and tell him this will be devastating to NPs across this state who are working to keep Oklahoma out of last place in health care outcomes. In addition, call the Governor’s office, 405-521-2342, and tell the hotline of your concerns and ask the Governor to intervene. Finally, call your legislator, and ask him/her to call Mr. Gomez and let him know our industry cannot stand these cuts. (Click here to look up your state legislator.)

Click here to download and view the OHCA fiscal breakdown.

News article, by Scott Carter, that explains the issues and effects of the OHCA proposed cuts:


About Us

Welcome to the official site of the Association of Oklahoma Nurse Practitioners. The mission of the AONP is to advance, support, and promote the high standards of health care delivered by nurse practitioners.

As a statewide professional association, we focus on the common needs of our members. We recognize the professional and political concerns facing nurse practitioners. AONP has always played a major role in facilitating and supporting changes in legislation that advance the role of the nurse practitioner. AONP believes that by providing better networking among our members, we will be better able to promote high standards of health care and thereby enhance the identity and continuity of nurse practitioners in our state.

What is a Nurse Practitioner?

A Nurse practitioner (NP) is a registered nurse who is prepared, through advanced education and clinical training, to provide a wide range of preventive and health care services to individuals of all ages. NPs complete graduate-level education preparation that leads to a master's and/or doctoral degree. NPs provide physical examinations, diagnose and treat many common acute and chronic problems, interpret laboratory results and X-rays, prescribe and manage medications and other therapies, provide training and supportive counseling with an emphasis on prevention of illness and health maintenance, and refer patients to other health professionals as needed.

These informative videos explain the value of receiving health care from a nurse practitioner.

National Medical Report
Nurse Practitioners Leading the Charge

Ask The Expert


Question (May 2015): It is common practice for RMAs to be clinic "nurses" as LPNS and RNs are trained predominately for hospital/nursing home settings whereas RMA training is specific to the clinic setting. There is some concern regarding whether as APRNs we are able to work with an RMA as our "nurse" versus needing an actual nurse in our clinics. Can you please clarify according to the nursing act or other legalities how to better navigate this gray area/area of concern? 

Answer: NPs cannot delegate to unlicensed personnel, as stipulated by the Nursing Practice Act.  Medical assistants are not regulated by any board since they are not licensed. For further clarification, an APRN can't delegate like a medical administrator would do to unlicensed personnel, but we can assign non-nursing duties, such as urine tests, swabs etc.  If it is a non- licensed person, we have to give our own shots, meds etc. We can't have them do for us - they must be a licensed RN or LPN. 

Question (May 2015):  Are there staffing requirements and regulations for Walk In Clinics which are run by APRN's. I am doing a research paper and trying to find what staffing is as far as Medical Assistance, Nurses, etc. Are there differences when there is only one APRN and when there is more? Thanks.

Answer: APRNs cannot give medical assistants orders. Medical assistants can only receive orders from a physician. It is not the Nurse Practice Act that says that, it is the Medical Assistants act that makes physicians the only one that can give medical assistants orders


Question (April 2015): Can doctoral prepared nurses (DNP, DNAP) identify themselves as Doctor So and So to their patients in Oklahoma?

Answer: A distinguishing mark of nursing is the pursuit of lifelong learning. The number of nurses earning advanced degrees, including doctoral degrees, is increasing. The practice of addressing a person with a doctoral degree as "doctor" began many centuries ago as did the tradition of addressing a physician as "doctor." The titles of healthcare professionals with earned doctoral degrees may be confusing to the public and members of the healthcare team.

The Oklahoma Nursing Practice Act addresses the use of the term “doctor.” All nurses must know and comply with federal, state and local laws and are defined in the Nursing Practice Act [Rule §485:10-13-1 ]. To comply with this law, any practicing nursing shall possess a valid Oklahoma license. The APRN who is practicing in a role that requires APRN licensure must use the title “Advanced Practice Registered Nurse” or “APRN” and the APRN role title, i.e., “Certified Nurse Practitioner” or “CNP”, “Clinical Nurse Specialist” or “CNS”, “Certified Registered Nurse Anesthetist” or “CRNA”, or “Certified Nurse- Midwife” or “CNM” in their representations to the public, which may include, but are not limited to, name tags, signatures in medical records and on prescriptions, and signage. The Oklahoma Nursing Practice Act does not designate the order of the credentials; whether the credentials are to be separated by a dash or a comma; or whether the APRN may add other credentials to their title, such as specialty certifications and educational credentials.

According to the Oklahoma Nursing Practice Act, the use of the term "doctor" must be in accordance with Oklahoma law: 59 O.S. Supp. 2009, §725.1, et seq. which states that doctorally prepared nurses cannot identify themselves as Dr. APRNs must include the academic credentials and licensure level with their appropriate APRN title.


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