Maryland’s Nurse Practitioners Gain Full Practice Authority

In a win for the profession of nurse practitioners and their patients in Maryland, Governor Hogan signed the Certified Nurse Practitioners – Authority to Practice bill in May 2015. This was a hard-fought victory for nurse practitioners in Maryland who had been trying to gain this status for ten years.

A long and substantive body of data suggests that the care provided by nurse practitioners is comparable to doctors and is often much cheaper for the health care system.

Full practice authority is highly significant in Maryland, especially in the rural southern areas of the state that lack adequate numbers of physicians.   Previously, nurse practitioners in Maryland could not practice autonomously without the signature of a collaborating physician and the oversight of the Board of Physicians. Obtaining this oversight proved very difficult in areas that did not have practicing physicians.

This situation resulted in a shortage of providers for Medicaid patients who were forced to get their medical care through emergency room visits. Data from other states that grant full practice authority to their nurse practitioners suggest that Maryland will save a tremendous amount of money by taking this step.

The Maryland Academy of Advanced Practice Clinicians crunched the numbers to estimate the cost savings in the state from granting full practice authority to nurse practitioners. Statistics that states with full practice authority have gathered showed 4.9% fewer avoidable Medicaid hospitalizations. Based on this, the Maryland Academy of Advanced Practice Clinicians predicted that Maryland could save $33 million a year on Medicaid hospital stays. The academy also estimated that Maryland could save $8 million a year on Medicaid well visits.

Previously, insurance companies in Maryland would not reimburse nurse practitioners for treating Medicaid patients in Managed Care Organizations without a credential from a physician. Thus, granting full practice authority to nurse practitioners should increase Medicaid patient access by two thirds.

Maryland now joins the 21 other states that have allowed nurse practitioners to work independent of physicians, and that subsequently assure better access to medical care for their residents.


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