April 02, 2020

Waivers provide greater access to delivery of health care by advanced practice registered nurses

Governor grants approval at the request of the Missouri Departments of Health and Senior Services and Commerce and Insurance in response to the COVID-19 crisis

Effective immediately, the Governor’s office is temporarily allowing the Department of Health and Senior Services (DHSS) and the Department of Commerce and Insurance (DCI) to waive regulations requiring advanced practice registered nurses to practice with the collaborating physician continuously present for at least a one-month period of time before practicing in a setting where the collaborating physician is not continuously present.

Additionally, the Governor’s Office approved to temporarily waive the requirement that the collaborating physician, or any other physician designated in the collaborative practice arrangement, review the advanced practice registered nurse’s delivery of health care services through a review of a minimum of 10 percent of the charts every 14 days.

This waiver does not include the review of the percentage of cases where the advanced practice registered nurse prescribed controlled substances.

“We greatly appreciate APRNs’ willingness to put themselves on the front lines during this health care emergency,” said Dr. Randall Williams, director of DHSS. “They are contributing greatly to health care access by helping hospitals to manage potential surge and provide care in rural areas.”

This waiver, put in place in response to the COVID-19 public health crisis, will be in effect until the expiration of the Governor’s Executive Order 20-02.

Statutes and Regulations affected by this waiver:

334.104.3, RSMo
20 CSR 2200-4.200(4)(E)
334.104.9, RSMo
20 CSR 2200-4.200(2)(C)

On March 30, the Missouri Department of Commerce and Insurance announced that the Governor’s office has also temporarily waived the regulation requiring that a collaborating physician and APRN be within 75 miles of each other.