State Policy

Our policy team monitors state laws and regulations to identify opportunities to support and advance nurse-led care. Our priorities include full practice authority, scope of practice, and credentialing. We alert members to breaking news in their state that can affect their practice. Learn more about our work below.

Full Practice Authority

Twenty-two states and DC currently allow nurse practitioners to practice independent of physician supervision. Research shows that when nurse practitioners and other advance practice nurses are permitted to practice at the full extent of their licensure and training access to care increases and costs decrease. In addition to monitoring scope of practice developments in the states, we work with local nurse advocates to remove legal and regulatory barriers that prevent nurses from carrying out the functions they are legally trained and licensed to perform.


States introduced over 200 pieces of telehealth legislation in 2017. Our policy team works to ensure that these telehealth policies:

  • Use provider-neutral language that allows nurses to access the technology without unnecessary physician supervision
  • Recognize nurse-led practices sites as originating sites
  • Reimburse nurse-led practices using telehealth at the same level as other providers

Medicaid Credentialing and Managed Care Contracting

In some states it can take as many as six to eight months for nurses acting as primary care providers to enroll and meet the credentialing requirements for state Medicaid programs. During this lag time, nurses are either not able to see Medicaid patients or they cannot get reimbursed for the care they provide. NNCC advocates for state policy makers to streamline the credentialing and enrollment process by removing unnecessary obstacles and requirements.

As part of the credentialing process, nurses enrolling in managed care organizations must be recognized as primary care providers. Unfortunately, 25% of the nation’s managed care organizations do not recognize nurse practitioners as primary care providers. Every two years, we conduct a national survey of managed care organizations to determine what percentage recognize nurse primary care providers and document the reasons nurse primary care providers are being denied. The survey results inform the development of strategies designed to increase the recognition of nurse primary care providers.

State Policy Resources

 Access Our Policy Resources 


For More Information


MaryGrace Joyce photo

MaryGrace Joyce, MS
Policy Specialist