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Section addressing nursing:
“Nursing (MSN/DNP): The Department determined that neither the MSN nor the DNP would satisfy the professional degree definition because, for example, the degrees are not necessary for entrance into the nursing profession. While holders of an MSN or a DNP may obtain licensure as a nurse practitioner, students entering degree programs which lead to an MSN, or a DNP, are already licensed nurses when they begin the degree program. Therefore, Department does not believe that the MSN or the DNP satisfy a core aspect of the definition of professional degree.
Additionally, while the Department acknowledges that nurse practitioners engage in different forms of work than other nurses, the Department is hesitant to treat them as being distinct for the purpose of this regulation, primarily due to the fact that their practice authority (and therefore, their scope of work) differs substantially from state to state. For example, full practice authority states permit all nurse practitioners to evaluate patients; diagnose, order, and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing, while restricted practice authority states require career-long supervision, delegation, or team management by another health provider in order for the nurse practitioners to provide patient care. Because a substantial portion of states substantially restrict the types of work that can be performed by nurse practitioners and require them to be supervised by physicians, just as other nurses are, the Department believes that nurse practitioners cannot be said to be part of a distinct profession, meaning that the MSN and DNP are not requirements for entrance into a profession.
Finally, the Department does not believe that the statute permits the classification of degrees as “professional” when the degree leads to employment where the employee must be supervised by another professional who has, as required by their license and degree, more education, training, and qualifications than the person being supervised.
None of the state-required degrees in the illustrative list in the regulation that was codified by the OBBB require another profession to supervise their practice. In that, the list provides support for the idea that professional degrees enable those who obtain them, after licensure, to practice in an unsupervised manner. As noted above, a substantial portion of states significantly restrict the types of work that can be performed by nurse practitioners and generally require them to be supervised by or enter into formal collaboration agreements with physicians, even in states where nurse practitioners have full practice authority ( i.e., where nurse practitioners are authorized to “evaluate patients, diagnose, order and interpret diagnostic tests and initiate and manage treatments—including prescribing medications—under the exclusive licensure authority of the state board of nursing”). Such practice authority is often more limited in scope than that of medical doctors, i.e., several states where nurse practitioners possess full practice authority preclude them from prescribing medications unless they have a formal relationship with a physician. Likewise, a substantial portion of the states where nurse practitioners possess full practice authority condition a nurse practitioner’s ability to exercise that authority on the nurse practitioner having completed a requisite number of “transition to practice hours” where the nurse practitioner must be supervised by a physician. This is very different from residency requirements in fields such as medicine, dentistry, and clinical psychology, where a resident is supervised by another member of their own profession. For these reasons, the Department believes it would be inaccurate to classify an MSN or a DNP as meeting the definition of professional degree.”
Section on operative definition of “professional degree”:
“The operative definition provided in the OBBB establishes a three-part test: First, the degree must signify completion of the academic requirements for beginning practice in a given profession. The word “signify” means to be a sign of something ( https://www.merriam-webster.com/dictionary/signify). Here, it means when the degree is completed, the recipient has completed all academic requirements to begin practicing in a profession, even if some additional training is required.
Second, the profession the graduate enters must require a level of professional skill beyond what is normally required for a bachelor’s degree. This means that the profession must require skill(s) that students who only have a bachelor’s degree (or training below a bachelor’s degree level) would not normally have. The term “normally” connotes that this rule will be followed in almost every circumstance, but it does not rule out the possibility per se of some exception to the rule.
Third, the profession that a degree holder would enter after graduating generally requires professional licensure. This means that before beginning practice, the degree recipient must obtain additional authorization to begin practicing, which would typically flow from a government or standard setting organization. Like the second part, the third part requires licensure “generally,” which connotes that this rule will be followed in almost every circumstance, but it does not rule out the possibility per se of some exception to the rule.”