The Association Between Scope of Practice Regulations and Nurse Practitioner Prescribing of Buprenorphine After the 2016 Opioid Bill. (April 2022)

• Record Type: Journal Article
• Authors: Nguyen, Thuy; Muench, Ulrike; Andraka-Christou, Barbara; Simon, Kosali; Bradford, W. David; Spetz, Joanne
• Is Part Of: Medical care research and review. Volume 79:Number 2(2022)
• Page Start: 290
• Page End: 298
• Publication Date: 2022-04
• Subjects: buprenorphine prescribing -- nurse practitioners -- scope-of-practice regulations -- Comprehensive Addiction and Recovery Act; Medical care -- United States -- Periodicals; Medical care -- Periodicals; Medical care -- Research -- United States -- Periodicals; Medical care -- Research -- Periodicals; Medical economics -- United States -- Periodicals; Medical economics -- Periodicals; 362.10973
• DOI: 10.1177/10775587211004311
• Languages: English
• ISSNs: 1077-5587

Abstract

This article examines the relationship between federal regulations, state scope-of-practice regulations on nurse practitioners (NPs), and buprenorphine prescribing patterns using pharmacy claims data from Optum's deidentified Clinformatics Data Mart between January 2015 and September 2018. The county-level proportion of patients filling prescriptions written by NPs was low even after the 2016 Comprehensive Addiction and Recovery Act (CARA), 2.7% in states that did not require physician oversight of NPs, and 1.1% in states that did. While analyses in rural counties showed higher rates of buprenorphine prescriptions written by NPs, rates were still considerably low: 3.7% in states with less restrictive regulations and 1.1% in other states. These results indicate that less restrictive scope-of-practice regulations are associated with greater NP prescribing following CARA. The small magnitude of the changes indicates that federal attempts to expand treatment access through CARA have been limited.