[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-detail-325929-en":59,"doc-seo-325929-105":80},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":5,"data":60},{"doc_id":61,"user_id":62,"nickname":63,"user_avatar":64,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":66,"doc_content":67,"file_id":68,"file_url":69,"file_type":70,"file_size":71,"view_count":72,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":73,"language_code":74,"site_id":75,"html_lang":74,"table_of_contents":76,"faqs":77,"seo_title":78,"seo_description":66,"update_tm":79,"read_time":52},325929,2336478466772,"Ben Jamin","https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","DOT-OST-2021-0036 Notification of Regulatory Review - Request to Recognize Nurse Practitioners","Letter to the U.S. Department of Transportation (DOT) regarding the docket DOT-OST-2021-0036 and a notification of regulatory review. The American Association of Nurse Practitioners (AANP) requests updates to Federal Railroad Administration and Railroad Retirement Board regulations and forms to fully recognize nurse practitioners. It describes nurse practitioners’ advanced training, clinical scope, national prescriptive authority, and impact on primary care and Medicare, and cites support from federal agencies and health-sector organizations to ensure timely, high-quality care for railroad employees and retirees.","May 26, 2021  \nElizabeth Kohl, Attorney-Advisor  \nUnited States Department of Transportation Docket Management Facility  \nRoom W12-140  \n1200 New Jersey Ave. SE Washington, D.C. 20590-0001  \nRE: Notification of Regulatory Review; DOT-OST-2021-0036  \nDear Ms. Kohl,  \nThe American Association of Nurse Practitioners (AANP), representing more than 325,000 nurse practitioners (NPs) in the United States, appreciates the opportunity to comment on the Department of Transportation’s (DOT’s) Notice of Regulatory Review. We agree with the importance of aligning DOT regulations with the President's direction in Executive Order (E.O.) 13990 and E.O. 13992 to “empower our workers, protect our public health” and “confront the urgent challenges facing our nation.”  \nTherefore, we respectfully request the Department update certain Federal Railroad Administration (FRA) and Railroad Retirement Board (RRB) regulations and forms to fully recognize Nurse Practitioners. These changes will ensure access to high-quality health care for railroad employees and retirees in a timely fashion.  \nNPs are advanced practice registered nurses (APRNs) who are prepared at the masters or doctoral level to provide primary, acute, chronic and specialty care to patients of all ages and walks of life. Daily practice includes: assessment; ordering, performing, supervising and interpreting diagnostic and laboratory tests; making diagnoses; initiating and managing treatment including prescribing medication and nonpharmacologic treatments; coordinating care; counseling; and educating patients and their families and communities. NPs practice in nearly every health care setting including clinics, hospitals, Veterans Affairs and Indian Health Care facilities, emergency rooms, urgent care sites, private physician or NP practices (both managed and owned by NPs), nursing homes, schools, colleges, retail clinics, public health departments, nurse managed clinics, homeless clinics, and home health. NPs hold prescriptive authority in all 50 states and the District of Columbia and complete more than one billion patient visits annually.  \nNPs currently provide a substantial portion of the high-quality1, cost-effective2 care that our communities require, and will continue to do so to meet the needs of their communities. As of 2018, there were more than 145,000 NPs billing for Medicare services, making NPs the largest and fastest growing Medicare designated provider specialty.3 NPs have a particularly large impact on primary care as approximately 70% of all NP graduates deliver primary care.4 NPs comprise approximately one quarter of the primary care workforce, with that percentage growing annually.5  \nIt is important to recognize that federal agencies have long recognized NPs as qualified to perform examinations for health or functional impairment and provide ongoing care to patients. As noted previously, performing physical examinations, evaluating a patient’s health condition, and serving as primary care providers is well within the scope of practice for nurse practitioners. NPs have served as  \n1 [https://www.aanp.org/images/documents/publications/qualityofpractice.pd](https://www.aanp.org/images/documents/publications/qualityofpractice.pdf)[f](https://www.aanp.org/images/documents/publications/qualityofpractice.pdf).  \n2 [https://www.aanp.org/images/documents/publications/costeffectiveness.pdf](https://www.aanp.org/images/documents/publications/costeffectiveness.pdf).  \n3 [https://www.cms.gov/files/document/2018-mdcr-providers-6.pd](https://www.cms.gov/files/document/2018-mdcr-providers-6.pdf)[f](https://www.cms.gov/files/document/2018-mdcr-providers-6.pdf).  \n4 [https://www.aanp.org/about/all-about-nps/np-fact-sheet](https://www.aanp.org/about/all-about-nps/np-fact-sheet).  \n5 Rural and Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners, Hilary Barnes, Michael R. Richards, Matthew D. McHugh, and Grant Martsolf, Health Affairs 2018 37:6, 908-914.  \n","cbCaid4cjfKXGXbM","https://ap.wps.com/l/cbCaid4cjfKXGXbM","pdf",298329,14,"English","en",105,"# Notification of Regulatory Review\n## Request to update FRA and RRB regulations and forms\n## Role and scope of nurse practitioners","[{\"question\":\"What is the purpose of the letter to DOT?\",\"answer\":\"The letter responds to DOT’s Notice of Regulatory Review for DOT-OST-2021-0036 and requests regulatory updates to recognize nurse practitioners more fully.\"},{\"question\":\"Which DOT-related agencies and rules does the AANP ask to update?\",\"answer\":\"The AANP requests updates to Federal Railroad Administration (FRA) and Railroad Retirement Board (RRB) regulations and forms.\"},{\"question\":\"What does the letter say about the scope and authority of nurse practitioners?\",\"answer\":\"It describes nurse practitioners as advanced practice registered nurses prepared at the master’s or doctoral level, providing primary and specialty care, ordering and interpreting tests, managing treatment including prescribing medication, and having prescriptive authority in all U.S. states and Washington, D.C.\"}]","DOT-OST-2021-0036 Notification of Regulatory Review - Request to Recognize Nurse Practitioners | PDF",1789971762,{"code":4,"msg":81,"data":82},"ok",{"site_id":75,"language":74,"slug":83,"title":65,"keywords":84,"description":66,"schema_data":85,"social_meta":139,"head_meta":141,"extra_data":143,"updated_unix":144},"dot-ost-2021-0036-notification-of-regulatory-review-request-to-recognize-nurse-practitioners","",{"@graph":86,"@context":138},[87,101,121],{"@type":88,"itemListElement":89},"BreadcrumbList",[90,94,96,99],{"item":91,"name":92,"@type":93,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":95,"name":9,"@type":93,"position":14},"https://docshare.wps.com/document/",{"item":97,"name":35,"@type":93,"position":98},"https://docshare.wps.com/document/healthcare/",3,{"item":100,"name":65,"@type":93,"position":19},"https://docshare.wps.com/document/dot-ost-2021-0036-notification-of-regulatory-review-request-to-recognize-nurse-practitioners/325929/",{"url":100,"name":65,"@type":102,"image":103,"author":108,"headline":65,"publisher":110,"fileFormat":113,"inLanguage":74,"description":66,"dateModified":114,"datePublished":115,"encodingFormat":113,"isAccessibleForFree":116,"interactionStatistic":117},"DigitalDocument",{"url":104,"@type":105,"width":106,"height":107},"https://docshare.wps.com/thumbnails/dot-ost-2021-0036-notification-of-regulatory-review-request-to-recognize-nurse-practitioners/325929.png","ImageObject",300,407,{"name":63,"@type":109},"Person",{"url":91,"name":111,"@type":112},"DocShare","Organization","application/pdf","2026-10-27","2026-09-21",true,{"@type":118,"interactionType":119,"userInteractionCount":72},"InteractionCounter",{"@type":120},"ViewAction",{"@type":122,"mainEntity":123},"FAQPage",[124,130,134],{"name":125,"@type":126,"acceptedAnswer":127},"What is the purpose of the letter to DOT?","Question",{"text":128,"@type":129},"The letter responds to DOT’s Notice of Regulatory Review for DOT-OST-2021-0036 and requests regulatory updates to recognize nurse practitioners more fully.","Answer",{"name":131,"@type":126,"acceptedAnswer":132},"Which DOT-related agencies and rules does the AANP ask to update?",{"text":133,"@type":129},"The AANP requests updates to Federal Railroad Administration (FRA) and Railroad Retirement Board (RRB) regulations and forms.",{"name":135,"@type":126,"acceptedAnswer":136},"What does the letter say about the scope and authority of nurse practitioners?",{"text":137,"@type":129},"It describes nurse practitioners as advanced practice registered nurses prepared at the master’s or doctoral level, providing primary and specialty care, ordering and interpreting tests, managing treatment including prescribing medication, and having prescriptive authority in all U.S. states and Washington, D.C.","https://schema.org",{"og:url":100,"og:type":140,"og:title":65,"og:site_name":111,"og:description":66},"article",{"robots":142,"canonical":100},"index,follow",{"doc_id":61,"site_id":75},1790466601]