Medicaid Payment for Nonphysician Practitioners: An Access Issue

As part of congressional efforts in the 1980s to expand access to care for Medicaid mothers and children, states were required to pay for services provided by certain advanced practice nurses. These mandates created the impetus in many states to expand payment policies for nonphysician practitioners. State Medicaid payment policies are often less restrictive than those of the Medicare program. However, not all states have been receptive to policy expansions and do not cover nonphysician practitioner services to the extent that professional practice acts allow. A few states have yet to meet the 1989 federal mandates.