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NP legislation inches forward. At the federal level, the Medicare Patient Access and Quality Improvement Act of 2013 (HR 2810) was set to be taken up by the Ways and Means Committee after the August Congressional recess. A July amendment to this bill strikes "physician" and inserts "nurse practitioner and physician's assistant" and "provider" into several sections. These changes, backed by the American Association of Nurse Practitioners (AANP), are a first step toward reforming the fee-for-service payment system, allowing reimbursement for NP management of complex chronic conditions. Amendments proposed to Pennsylvania's Professional Nursing Law (SB 1063) would provide patients full and direct access to NP care, according to the Pennsylvania Coalition of Nurse Practitioners. For continuing updates on these bills and other NP-related federal and state legislation, visit the AANP Web site at