In a forceful rebuke, the California Medical Association (CMA) joined the American Medical Association and more than 90 other organizations to voice strong opposition to a bill that could compromise care quality for millions of Medicare and Medicaid patients.

The Improving Care and Access to Nurses Act (HR 8812) would expand the scope of practice of nonphysician practitioners (NPPs) — including nurse practitioners, certified nurse midwives, certified registered nurse anesthetists, clinical nurse specialists and physician assistants — allowing them to perform tasks and services outside their education and training, while narrowing or removing supervisory requirements.

“We are deeply concerned that this broad, sweeping bill endangers the care of Medicare and Medicaid patients by expanding the types of services NPPs can perform and removing physician involvement in patient care,” the organizations said in a joint letter sent to ranking members of the U.S. House of Representatives’ Ways and Means and Energy and Commerce committees. “This legislation would allow NPPs to perform tasks and services outside their education and training and could result in increased utilization of services, increased costs, and lower quality of care for our patients.”

The letter reinforced CMA’s long-standing support for physician-led, team-based care.

“While all health care professionals play a critical role in providing care to patients and NPPs are important members of the care team, their skill sets are not interchangeable with those of fully educated and trained physicians,” the letter said. “Patients expect the most qualified person—physician experts with unmatched training, education, and experience—to be diagnosing and treating injured or sick individuals and making often complex clinical determinations. The reality is that NPPs do not have the education and training to make these determinations and we should not be offering a lower standard of care or clinical expertise for our nation’s Medicare and Medicaid patients.”

Click here to read the full letter.