HB 739 — An Act amending the act of May 22, 1951 (P.L.317, No.69), known as The Professional Nursing Law, further providing for title, for definitions, for State Board of Nursing, for dietitian-nutritionist license required, for unauthorized practices and acts not prohibited, for temporary practice permit, for graduates of schools of other states, territories or Dominion of Canada, for persons entitled to practice, for certified registered nurse practitioners and qualifications, for scope of practice for certified registered nurse practitioners, for prescriptive authority for certified registered nurse practitioners, for Drug Review Committee, for professional liability, for reporting of multiple licensure, for continuing nursing education, for punishment for violations, for refusal, suspension or revocation of licenses, for reinstatement of license and for injunction or other process; and providing for the expiration of the State Board of Nursing's power to license certified registered nurse practitioners.

PRINTER'S NO.   763

                  THE GENERAL ASSEMBLY OF PENNSYLVANIA



                      HOUSE BILL
                      No. 739
                                             Session of
                                               2025

     INTRODUCED BY GUENST, WARNER, KHAN, ISAACSON, NEILSON, HOWARD,
        SANCHEZ, WAXMAN, GIRAL, WARREN, BURGOS, HANBIDGE, PIELLI,
        CEPEDA-FREYTIZ, DOUGHERTY, MALAGARI, MAYES, HOHENSTEIN,
        CIRESI, BOROWSKI, HILL-EVANS, DONAHUE, FLEMING, D. WILLIAMS,
        KENYATTA, CERRATO, GREEN, DALEY, SALISBURY, WEBSTER,
        SHUSTERMAN, PASHINSKI, JAMES, RIVERA AND KOZAK,
        FEBRUARY 26, 2025

     REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE,
        FEBRUARY 26, 2025


                                  AN ACT
 1   Amending the act of May 22, 1951 (P.L.317, No.69), entitled "An
 2      act relating to the practice of professional nursing;
 3      providing for the licensing of nurses and for the revocation
 4      and suspension of such licenses, subject to appeal, and for
 5      their reinstatement; providing for the renewal of such
 6      licenses; regulating nursing in general; prescribing
 7      penalties and repealing certain laws," further providing for
 8      title, for definitions, for State Board of Nursing, for
 9      dietitian-nutritionist license required, for unauthorized
10      practices and acts not prohibited, for temporary practice
11      permit, for graduates of schools of other states, territories
12      or Dominion of Canada, for persons entitled to practice, for
13      certified registered nurse practitioners and qualifications,
14      for scope of practice for certified registered nurse
15      practitioners, for prescriptive authority for certified
16      registered nurse practitioners, for Drug Review Committee,
17      for professional liability, for reporting of multiple
18      licensure, for continuing nursing education, for punishment
19      for violations, for refusal, suspension or revocation of
20      licenses, for reinstatement of license and for injunction or
21      other process; and providing for the expiration of the State
22      Board of Nursing's power to license certified registered
23      nurse practitioners.
24      The General Assembly of the Commonwealth of Pennsylvania
25   hereby enacts as follows:
 1      Section 1.    The title of the act of May 22, 1951 (P.L.317,
 2   No.69), known as The Professional Nursing Law, is amended to
 3   read:
 4                                   AN ACT
 5   Relating to the practice of professional nursing and the
 6      practice of advanced practice registered nursing; providing
 7      for the licensing of nurses and for the revocation and
 8      suspension of such licenses, subject to appeal, and for their
 9      reinstatement; providing for the renewal of such licenses;
10      regulating nursing in general; prescribing penalties and
11      repealing certain laws.
12      Section 2.    Section 2(1), (10), (12), (13) and (14) of the
13   act are amended and the section is amended by adding paragraphs
14   to read:
15      Section 2.    Definitions.--When used in this act, the
16   following words and phrases shall have the following meanings
17   unless the context provides otherwise:
18      (1)     The "Practice of Professional Nursing" means diagnosing
19   and treating human responses to actual or potential health
20   problems through such services as casefinding, health teaching,
21   health counseling, and provision of care supportive to or
22   restorative of life and well-being, and executing medical
23   regimens as prescribed by a licensed physician or dentist. The
24   foregoing shall not be deemed to include acts of medical
25   diagnosis or prescription of medical therapeutic or corrective
26   measures, except as performed by [a certified registered nurse
27   practitioner] an APRN-CNP acting in accordance with rules and
28   regulations promulgated by the Board.
29      * * *
30      (10)    "Medical nutrition therapy" means the component of

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 1   nutrition therapy that concerns determining and recommending
 2   nutrient needs based on nutritional assessment and medical
 3   problems relative to diets prescribed by a licensed physician or
 4   an APRN-CNP, including:
 5      (i)    tube feedings;
 6      (ii)    specialized intravenous solutions;
 7      (iii)     specialized oral solutions; and
 8      (iv)    interactions of prescription drugs with food or
 9   nutrients.
10      * * *
11      [(12)     "Certified registered nurse practitioner" means a
12   registered nurse licensed in this Commonwealth who is certified
13   by the board in a particular clinical specialty area.]
14      (13)    "Collaboration" means a process in which [a certified
15   registered nurse practitioner] an APRN-CNP who has less than
16   three (3) years and three thousand six hundred (3,600) hours of
17   practice works with one or more physicians to deliver health
18   care services within the scope of [the certified registered
19   nurse practitioner's] an APRN-CNP's expertise. The process
20   includes all of the following:
21      (i)    Immediate availability of a licensed physician to [a
22   certified registered nurse practitioner] an APRN-CNP through
23   direct communications or by radio, telephone or
24   telecommunications.
25      (ii)    A predetermined plan for emergency services.
26      (iii)     A physician available to [a certified registered nurse
27   practitioner] an APRN-CNP on a regularly scheduled basis for
28   referrals, review of the standards of medical practice
29   incorporating consultation and chart review, drug and other
30   medical protocols within the practice setting, periodic updating

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 1   in medical diagnosis and therapeutics and cosigning records when
 2   necessary to document accountability by both parties.
 3      [(14)    "Drug Review Committee" means the committee
 4   established in section 8.4 whose function is to approve or
 5   disapprove, by addition or deletion, the categories of drugs
 6   that may be prescribed by certified registered nurse
 7   practitioners.]
 8      * * *
 9      (18)    "Advanced practice registered nurse-certified nurse
10   practitioner" means a registered nurse licensed in this
11   Commonwealth to practice independently in a population focus
12   area in which the registered nurse is certified by a Board-
13   recognized national certification program.
14      (19)    "APRN-CNP" means an advanced practice registered nurse-
15   certified nurse practitioner.
16      (20)    "Population focus area" means a category of patients
17   for which an APRN-CNP has the educational preparation to provide
18   care and services. The categories of population focus include:
19      (i)    Family and individuals across the lifespan.
20      (ii)    Adult Gerontology.
21      (iii)    Neonatal.
22      (iv)    Pediatrics.
23      (v)    Women's health and gender-related health.
24      (vi)    Psychiatric and mental health.
25      (21)    "Controlled substance" means a drug designated as a
26   controlled substance under the act of April 14, 1972 (P.L.233,
27   No.64), known as "The Controlled Substance, Drug, Device and
28   Cosmetic Act."
29      (22)    "Nonproprietary drug" means a drug containing a
30   quantity of a controlled substance or a drug which is required

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 1   by an applicable Federal or State law to be dispensed only by
 2   prescription.
 3      (23)     "Proprietary drug" means a nonprescription, non-
 4   narcotic medicine or drug which may be sold without a
 5   prescription and which is prepackaged for use by the consumer
 6   and labeled in accordance with the requirements of the statutes
 7   and regulations of the Federal Government and the Commonwealth.
 8      (24)     "Licensed independent practitioner" means an APRN-CNP
 9   licensed to provide care and services within the scope of the
10   practitioner's license.
11      (25)     "Practice of Advanced Practice Registered Nursing"
12   means the practice of an APRN-CNP to assess, diagnose, treat,
13   prescribe and order, within a population focus approved by the
14   board that includes the APRN-CNP's scope of practice. The term
15   shall include, but not be limited to, performing acts of medical
16   diagnosis or prescription of medical therapeutic or corrective
17   measures.
18      Section 3.     Sections 2.1(k) and (l), 3.1(b), 4, 4.1, 7(b), 8,
19   8.1, 8.2, 8.3, 8.4, 8.7, 11.1, 12.1(g)(1), 13(b), 14(a)(1), (2)
20   and (4) and (b)(6), 15.2 and 15.4 of the act are amended to
21   read:
22      Section 2.1.     State Board of Nursing.--* * *
23      (k)    The Board shall have the right and duty to establish
24   rules and regulations for the practice of professional nursing,
25   the practice of advanced practice registered nursing, the
26   practice of dietetics-nutrition and the administration of this
27   act. Copies of such rules and regulations shall be available for
28   distribution to the public.
29      (l)    Any powers and duties imposed on the State Board of
30   Medicine or jointly imposed on the State Board of Medicine and

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 1   the State Board of Nursing, with respect to [certified
 2   registered nurse practitioners] APRN-CNPs, by or pursuant to law
 3   or regulation shall, after the effective date of this
 4   subsection, be exercised solely by the State Board of Nursing.
 5   This subsection shall not apply to 49 Pa. Code §§ 21.283(4)
 6   (relating to prescribing and dispensing drugs) and 21.321
 7   (relating to performance of tasks without direction; performance
 8   of tasks without training; other) unless the State Board of
 9   Nursing promulgates a regulation to exercise the duties imposed
10   on the State Board of Medicine by those sections.
11      Section 3.1.   Dietitian-Nutritionist License Required.--* * *
12      (b)   Nothing in this section shall be construed to require or
13   preclude third-party insurance reimbursement. Nothing herein
14   shall preclude an insurer or other third-party payor from
15   requiring that a licensed dietitian-nutritionist obtain a
16   referral from a licensed physician, an APRN-CNP, a dentist or
17   podiatrist or that a licensed dietitian-nutritionist file an
18   evaluation and treatment plan with the insurer or third-party
19   payor as a precondition of reimbursement.
20      Section 4.   Unauthorized Practices; Acts not Prohibited.--
21   This act confers no authority to practice dentistry, podiatry,
22   optometry, chiropractic, medicine or surgery, nor does it
23   prohibit--
24      (1)   Home care of the sick by friends, domestic servants,
25   nursemaids, companions, or household aides of any type, so long
26   as such persons do not represent or hold themselves out to be
27   licensed nurses, licensed registered nurses, or registered
28   nurses; or use in connection with their names, any designation
29   tending to imply that they are licensed to practice under the
30   provisions of this act nor services rendered by any physicians,

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 1   osteopaths, dentists or chiropractors, podiatrists,
 2   optometrists, or any person licensed pursuant to the act of
 3   March 2, 1956 (P.L.1211, No.376), known as the "Practical Nurse
 4   Law."
 5      (2)     Care of the sick, with or without compensation or
 6   personal profit, when done solely in connection with the
 7   practice of the religious tenets of any church by adherents
 8   thereof.
 9      (3)     The practice of professional nursing or the practice of
10   advanced practice registered nursing by a person temporarily in
11   this Commonwealth licensed by another state, territory or
12   possession of the United States or a foreign country, in
13   compliance with an engagement made outside of this Commonwealth,
14   which engagement requires that such person accompany and care
15   for a patient while temporarily in this Commonwealth: Provided,
16   however, That said engagement shall not be of more than six (6)
17   months' duration.
18      (4)     The practice of professional nursing or the practice of
19   advanced practice registered nursing, pursuant to a temporary
20   practice permit, by a graduate of an approved program of
21   professional nursing in Pennsylvania or any other state, working
22   under qualified supervision, during the period not to exceed one
23   (1) year between completion of his or her program and
24   notification of the results of a licensing examination taken by
25   such person, and during such additional period as the Board may
26   in each case especially permit.
27      (5)     The practice of professional nursing or the practice of
28   advanced practice registered nursing, pursuant to a temporary
29   practice permit, by a person who holds a current license or
30   other evidence of the right to practice professional nursing, as

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 1   that term is defined in this act, issued by any other state,
 2   territory or possession of the United States or the Dominion of
 3   Canada, during the period that an application filed by such
 4   person for licensure in Pennsylvania is pending before the
 5   Board, but not for a period of more than one (1) year and during
 6   such additional period as the Board may in each case especially
 7   permit.
 8      (6)    The practice of professional nursing[, within the
 9   definition of this act,] or the practice of advanced practice
10   registered nursing by any person when such person is engaged in
11   the practice [of nursing] as an employee of the United States.
12      Section 4.1.   Temporary Practice Permit.--(a)   In order for a
13   person to practice professional nursing or to practice advanced
14   practice registered nursing during the one (1) year period from
15   completion of his or her education program or the one (1) year
16   period from the application for licensure by a person who holds
17   a current license issued by any other state, territory or
18   possession of the United States or the Dominion of Canada, the
19   Board may issue a temporary practice permit which is
20   nonrenewable and valid for a period of one (1) year and during
21   such additional period as the Board may in each case especially
22   permit, except that the temporary practice permit shall expire
23   if such person fails the licensing examination.
24      (b)    Within ninety (90) days of the date a temporary practice
25   permit to practice as an APRN-CNP is issued by the Board to an
26   individual who was licensed or certified by another state,
27   territory or possession of the United States or a foreign
28   country, the individual shall comply with the requirements under
29   sections 8.2 and 8.3 with regard to acting in collaboration with
30   a physician and in accordance with a collaborative or written

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 1   agreement with a physician, unless the individual qualifies for
 2   the exception from the collaboration requirement according to
 3   the Board under section 8.1(l).
 4      Section 7.   Graduates of Schools of Other States, Territories
 5   or Dominion of Canada.--* * *
 6      (b)   The Board may issue a [certification to registered nurse
 7   practitioners who have] license as an APRN-CNP to a registered
 8   nurse who has completed a course of study considered by the
 9   Board to be equivalent to that required in this State at the
10   time such course was completed or who is licensed or certified
11   by another state, territory or possession of the United States
12   or a foreign country as deemed equivalent to Pennsylvania's
13   [certification] licensure requirements in accordance with the
14   [joint] rules and regulations of the [Boards of Nursing and
15   Medicine] Board.
16      * * *
17      Section 8.   Persons Entitled to Practice.--(a)   The Board
18   shall issue to each person who meets the professional nursing
19   licensure requirements of this act, a certificate setting forth
20   that such person is licensed to engage in the practice of
21   professional nursing and entitled to use the title "registered
22   nurse" and the letters "R.N."
23      (b)   The Board shall issue to each person who meets the
24   dietitian-nutritionist licensure requirements of this act a
25   certificate setting forth that such person is licensed as a
26   dietitian-nutritionist and entitled to use the title "licensed
27   dietitian-nutritionist" and the letters "L.D.N." A record of
28   [all persons] each person licensed as [dietitian-nutritionists]
29   a dietitian-nutritionist in this Commonwealth shall be kept in
30   the office of the Board and shall be open to public inspection

20250HB0739PN0763                    - 9 -
 1   and copying upon payment of a nominal fee for copying the
 2   record.
 3      (c)    The Board shall issue to each person who meets the APRN-
 4   CNP licensure requirements of this act a certificate stating
 5   that such person is licensed as an APRN-CNP and entitled to use
 6   the title "advanced practice registered nurse-certified nurse
 7   practitioner" and the letters "APRN-CNP." A record of each
 8   person licensed as an APRN-CNP in this Commonwealth shall be
 9   kept in the office of the Board and posted on the Board's
10   publicly accessible Internet website.
11      Section 8.1.    Certified Registered Nurse Practitioners;
12   Qualifications.--[(a)    The board may certify a licensed
13   registered nurse as a certified registered nurse practitioner in
14   a particular clinical specialty area if the nurse satisfies the
15   requirements established by this act and regulations promulgated
16   by the board. Certification of a nurse by the board shall expire
17   on the same date as the license of that nurse expires.
18      (b)    (1)   Beginning on the effective date of this section, a
19   nurse shall not qualify for initial certification by the board
20   under subsection (a) unless the nurse:
21      (i)    is a graduate of an accredited, board-approved master's
22   or post-master's nurse practitioner program; and
23      (ii)    holds certification as a certified registered nurse
24   practitioner from a board-recognized national certification
25   organization which required passing of a national certifying
26   examination in the particular clinical specialty area in which
27   the nurse is seeking certification by the board.
28      (2)    This subsection shall not apply to a nurse who:
29      (i)    holds certification from the board as a certified
30   registered nurse practitioner on the effective date of this

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 1   subsection; or
 2      (ii)    would otherwise qualify for certification as a
 3   certified registered nurse practitioner under section 7(b).
 4      (3)     In order to provide a transition period for persons who
 5   completed or were enrolled in an approved educational program on
 6   the effective date of this section and to permit those persons
 7   to apply for certification under the rules in existence
 8   immediately prior to the effective date of this section, the
 9   board shall issue initial certification to any person who,
10   within two (2) years of the effective date of this section:
11      (i)     submits evidence of having completed or been enrolled in
12   an approved educational program on the effective date of this
13   section; and
14      (ii)    fulfills all administrative requirements of the board
15   and possesses all of the other qualifications for certification
16   in effect immediately prior to the effective date of this
17   section.
18      (c)     As a condition for biennial renewal of certification by
19   the board, a certified registered nurse practitioner must, in
20   the two (2) years prior to renewal, complete at least thirty
21   (30) hours of continuing education approved by the board. In the
22   case of a certified registered nurse practitioner who is
23   prescribing medical therapeutic or corrective measures pursuant
24   to section 8.3, that continuing education must include at least
25   sixteen (16) hours in pharmacology in that two-year period.]
26      (d)     A registered nurse who holds current certification by
27   the Board on the effective date of this subsection as a
28   certified registered nurse practitioner in a population focus
29   area shall automatically be deemed to be licensed by the Board
30   as an APRN-CNP in the population focus area for which the

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 1   registered nurse is certified. The Board shall issue appropriate
 2   written notice of the license as an APRN-CNP, except that the
 3   issuance of that notice shall not be a condition precedent to
 4   practice in accordance with the license.
 5      (e)   Except as provided in subsection (d), an individual
 6   shall not qualify for an initial license as an APRN-CNP on or
 7   after the effective date of this subsection unless the person
 8   meets the following criteria:
 9      (1)   Holds a current license in this Commonwealth as a
10   registered nurse.
11      (2)   Is a graduate of an accredited, Board-approved nurse
12   practitioner program at the master's, post-master's or doctoral
13   level.
14      (3)   Holds current certification as an APRN-CNP from a Board-
15   recognized national certification program that requires passage
16   of a national certifying examination in a population focus area
17   for which the registered nurse is certified and is seeking
18   licensure by the Board.
19      (f)   (1)   An initial license under subsection (d) as an APRN-
20   CNP shall expire on the same date as the registered nurse's then
21   current license as a registered nurse is scheduled to expire.
22   The license as an APRN-CNP shall thereafter be renewed
23   biennially on the same date as the nurse's license as a
24   registered nurse.
25      (2)   An initial license under subsection (e) or section 7(b)
26   as an APRN-CNP shall expire on the same date as the registered
27   nurse's then current license as a registered nurse is scheduled
28   to expire. The license as an APRN-CNP shall thereafter be
29   renewed biennially on the same date as the nurse's license as a
30   registered nurse.

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 1      (3)    As a condition for biennial renewal by the Board of a
 2   license as an APRN-CNP, the nurse must do all of the following:
 3      (i)    Maintain a current license in this Commonwealth as a
 4   registered nurse.
 5      (ii)    Maintain current certification through a Board-
 6   recognized national certification program in the population
 7   focus area in which the registered nurse is licensed as an APRN-
 8   CNP by the Board.
 9      (iii)    In the two (2) years prior to renewal, complete at
10   least thirty (30) hours of continuing education approved by the
11   Board. For an APRN-CNP who is prescribing medical therapeutic or
12   corrective measures under section 8.3, the continuing education
13   shall include at least sixteen (16) hours in pharmacology in the
14   two-year period.
15      (g)    The Board shall establish a procedure by which a license
16   as an APRN-CNP may be amended prior to the biennial renewal date
17   in order to authorize a registered nurse to practice in a
18   population focus area in which the nurse was not certified on
19   the effective date of this subsection or on the date on which
20   the nurse's current license as an APRN-CNP was issued or
21   renewed. The Board shall authorize an APRN-CNP to practice in an
22   additional population focus area only if the nurse holds current
23   certification from a Board-recognized national certification
24   program that requires passage of a national certifying
25   examination in the additional population focus area.
26      (h)    (1)   The use of the terms "certified registered nurse
27   practitioner," "registered nurse practitioner," "certified nurse
28   practitioner" and "nurse practitioner" in any other act shall be
29   deemed to include a person licensed as an APRN-CNP under this
30   section or section 7(b) and shall be entitled to practice in

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 1   accordance with this act, notwithstanding any other provision of
 2   law.
 3      (2)    A registered nurse who is licensed by the Board as an
 4   APRN-CNP in a population focus area is entitled to use the title
 5   "advanced practice registered nurse-certified nurse
 6   practitioner" and the letters "APRN-CNP." It shall be unlawful
 7   for any other person to use the title "advanced practice
 8   registered nurse-certified nurse practitioner" or the letters
 9   "APRN-CNP."
10      (i)    (1)   An APRN-CNP may form a professional corporation
11   with one or more of the following:
12      (i)    Other registered nurses.
13      (ii)    Other health care practitioners who treat human
14   ailments and conditions and are licensed to provide health care
15   services in this Commonwealth without receiving a referral or
16   supervision from another health care practitioner.
17      (2)    This subsection shall be construed to abrogate the
18   requirement that the State Board of Medicine and the State Board
19   of Osteopathic Medicine expressly authorize the combined
20   practice of APRN-CNPs with doctors of medicine or doctors of
21   osteopathic medicine, respectively, found in 15 Pa.C.S. §
22   2903(d)(1)(ii) (relating to formation of professional
23   corporations).
24      (j)    An APRN-CNP who has engaged in the practice of
25   professional nursing in collaboration with a physician for a
26   period of not less than three (3) years and not less than three
27   thousand six hundred (3,600) hours in accordance with a written
28   collaborative agreement with a physician shall not be subject to
29   collaboration.
30      (k)    An APRN-CNP who qualifies for the exception under

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 1   subsection (j) shall file a form with the Board attesting to
 2   having engaged in the practice of professional nursing in
 3   collaboration with a physician for a period of not less than
 4   three (3) years and not less than three thousand six hundred
 5   (3,600) hours. The form shall be developed by the Board.
 6      (l)   A registered nurse who was licensed or certified by
 7   another state, territory or possession of the United States or a
 8   foreign country and received a license as an APRN-CNP issued by
 9   the Board or a temporary practice permit to practice as an APRN-
10   CNP under section 4.1 may qualify for the exception under
11   subsection (j) if the APRN-CNP satisfactorily demonstrates to
12   the Board the completion of no less than three (3) years and no
13   less than three thousand six hundred (3,600) hours of practice
14   in collaboration with a physician deemed equivalent to the
15   requirements of subsection (j) which occurred in this
16   Commonwealth or in one or more other states, territories or
17   possessions of the United States or foreign countries where the
18   APRN-CNP was previously, or is currently, licensed.
19      (m)   The APRN-CNP shall be accountable to patients, the
20   nursing profession and the Board and shall:
21      (1)   Comply with the requirements of this chapter and the
22   quality expectations of advanced nursing care rendered.
23      (2)   Recognize limits of knowledge and experience.
24      (3)   Plan for the management of situations beyond the APRN-
25   CNP's expertise.
26      (4)   Consult with or refer patients to other health care
27   providers, as appropriate.
28      Section 8.2.    Scope of Practice for [Certified Registered
29   Nurse Practitioners.--(a)    A certified registered nurse
30   practitioner while functioning in the expanded role as a

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 1   professional nurse] Advanced Practice Registered Nurse-Certified
 2   Nurse Practitioners.--(a)   An APRN-CNP shall practice within the
 3   scope of practice of the [particular clinical specialty]
 4   population focus area in which the nurse is [certified] licensed
 5   by the board. Notwithstanding any other provision of law, an
 6   APRN-CNP who meets the requirements under section 8.1 is
 7   entitled to all of the following:
 8      (1)   To practice as a licensed independent practitioner
 9   within the scope of practice of a particular population focus
10   area.
11      (2)   To be recognized as a primary care provider under
12   managed care and other health care plans.
13      (b)   [A certified registered nurse practitioner] Except as
14   provided under section 8.1(j) or (l), an APRN-CNP may perform
15   acts of medical diagnosis [in collaboration] pursuant to a
16   written collaborative agreement with a physician and in
17   accordance with regulations promulgated by the board.
18      (c)   Except as provided in subsection (c.1), [a certified
19   registered nurse practitioner] an APRN-CNP may prescribe medical
20   therapeutic or corrective measures if the nurse is acting in
21   accordance with the provisions of section 8.3.
22      (c.1)   [Except as limited by subsection (c.2), and in] Except
23   as provided for under section 8.1(j) or (l), in addition to
24   existing authority, [a certified registered nurse practitioner]
25   an APRN-CNP shall have authority to do all of the following,
26   provided that the [certified nurse practitioner] APRN-CNP is
27   acting within the scope of the [certified registered nurse
28   practitioner's] APRN-CNP's written collaborative [or written]
29   agreement with a physician and the [certified registered nurse
30   practitioner's specialty certification] APRN-CNP's population

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 1   focus area:
 2      (1)    Order home health and hospice care.
 3      (2)    Order durable medical equipment.
 4      (3)    Issue oral orders [to the extent permitted by the health
 5   care facilities' by-laws, rules, regulations or administrative
 6   policies and guidelines].
 7      (4)    Make physical therapy and dietitian referrals.
 8      (5)    Make respiratory, speech and occupational therapy
 9   referrals.
10      (6)    Perform disability assessments for the program providing
11   Temporary Assistance to Needy Families (TANF).
12      (7)    Issue homebound schooling certifications.
13      [(8)    Perform and sign the initial assessment of methadone
14   treatment evaluations, provided that any order for methadone
15   treatment shall be made only by a physician.
16      (c.2)     Nothing in this section shall be construed to:
17      (1)    Supersede the authority of the Department of Health and
18   the Department of Public Welfare to regulate the types of health
19   care professionals who are eligible for medical staff membership
20   or clinical privileges.
21      (2)    Restrict the authority of a health care facility to
22   determine the scope of practice and supervision or other
23   oversight requirements for health care professionals practicing
24   within the facility.]
25      (8)    Perform and sign the initial assessment of methadone
26   treatment evaluations and order methadone treatment.
27      (c.2)     Notwithstanding any provision of the act of July 19,
28   1979 (P.L.130, No.48), known as the "Health Care Facilities
29   Act," no regulation or order of the Department of Health, the
30   Department of Human Services or the Insurance Department shall

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 1   preclude the decision of the governing body of a health care
 2   facility that the types of health care professionals who are
 3   eligible for medical staff membership or clinical privileges at
 4   the facility include APRN-CNPs when practicing as licensed
 5   independent practitioners.
 6        (d)    Nothing in this section shall be construed to limit or
 7   prohibit [a certified registered nurse practitioner] an APRN-CNP
 8   from engaging in those activities which normally constitute the
 9   practice of professional nursing as defined in section 2.
10        Section 8.3.    Prescriptive Authority for [Certified
11   Registered Nurse Practitioners.--(a)       A certified registered
12   nurse practitioner] Advanced Practice Registered Nurse-Certified
13   Nurse Practitioners.--(a)      An APRN-CNP may prescribe medical
14   therapeutic or corrective measures if the nurse:
15        (1)    has successfully completed at least forty-five (45)
16   hours of coursework specific to advanced pharmacology at a level
17   above that required by a professional nursing education program;
18        (2)    (i)   except as provided under subparagraph (ii), is
19   acting in collaboration with a physician as set forth in a
20   written collaborative agreement which shall, at a minimum,
21   identify the following:
22        [(i)] (A)     the area of practice in which the nurse is
23   certified;
24        [(ii)] (B)     the categories of drugs from which the nurse may
25   prescribe or dispense; and
26        [(iii)] (C)     the circumstances and how often the
27   collaborating physician will personally see the patient; [and]
28   or
29        (ii)    is an APRN-CNP that qualifies for the exception under
30   section 8.1(j) or (l) and is practicing within a population

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 1   focus area in which the nurse is certified by a Board-recognized
 2   national certification program; and
 3      (3)   is acting in accordance with regulations promulgated by
 4   the board.
 5      (b)   [A certified registered nurse practitioner who satisfies
 6   the requirements of subsection (a) may prescribe and dispense
 7   those categories of drugs that certified registered nurse
 8   practitioners were authorized to prescribe and dispense by board
 9   regulations in effect on the effective date of this section,
10   subject to the restrictions on certain drug categories imposed
11   by those regulations. The board shall add to or delete from the
12   categories of authorized drugs in accordance with the provisions
13   of section 8.4.] An APRN-CNP who satisfies the requirements of
14   subsection (a) may prescribe and dispense proprietary and
15   nonproprietary drugs and controlled substances, subject to any
16   restrictions imposed by Board regulations or by Federal law.
17      Section 8.4.   [Drug Review Committee.--(a)   The Drug Review
18   Committee is hereby established and shall consist of seven
19   members as follows:
20      (1)   The Secretary of Health or, at the discretion of the
21   Secretary of Health, the Physician General as his or her
22   designee, who shall act as chairman.
23      (2)   Two certified registered nurse practitioners who are
24   actively engaged in clinical practice, appointed to three-year
25   terms by the Secretary of Health.
26      (3)   Two licensed physicians who are actively engaged in
27   clinical practice, appointed to three-year terms by the
28   Secretary of Health, at least one of whom shall, at the time of
29   appointment, be collaborating with one or more certified
30   registered nurse practitioners in accordance with section 8.3(a)

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 1   (2).
 2      (4)   Two licensed pharmacists who are actively engaged in the
 3   practice of pharmacy, appointed to three-year terms by the
 4   Secretary of Health.
 5      (b)   (1)   The board shall submit to the Drug Review Committee
 6   any proposed change to the categories of drugs that certified
 7   registered nurse practitioners were authorized to prescribe
 8   pursuant to board regulations in effect on the effective date of
 9   this section. The board shall not change, by addition or
10   deletion, the categories of authorized drugs without prior
11   approval of the Drug Review Committee.
12      (2)   Within sixty (60) days of a submission by the board
13   under paragraph (1), a majority of the Drug Review Committee
14   shall vote to approve or disapprove the proposed change.
15      (3)   If a majority of the Drug Review Committee fails to vote
16   to approve or disapprove the proposed change within sixty (60)
17   days of receipt of a submission by the board under paragraph
18   (1), the Drug Review Committee shall be deemed to have approved
19   the proposed change.] (Reserved).
20      Section 8.7.   Professional Liability.--[A certified
21   registered nurse practitioner] (a)      An APRN-CNP practicing in
22   this Commonwealth shall maintain a level of professional
23   liability coverage as required for a nonparticipating health
24   care provider under the act of March 20, 2002 (P.L.154, No.13),
25   known as the "Medical Care Availability and Reduction of Error
26   (Mcare) Act," but shall not be eligible to participate in the
27   Medical Care Availability and Reduction of Error (Mcare) Fund.
28      (b)   An APRN-CNP who qualifies for the exception under
29   section 8.1(j) or (l) and practices without collaboration shall
30   satisfy the liability coverage requirement under subsection (a)

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 1   by maintaining an individual policy in the APRN-CNP's own name.
 2      Section 11.1.    Reporting of Multiple Licensure.--Any licensed
 3   professional nurse or dietitian-nutritionist of this
 4   Commonwealth who is also licensed to practice nursing, advanced
 5   practice registered nursing or dietetics-nutrition in any other
 6   state, territory, possession or country shall report this
 7   information to the Board on the biennial registration
 8   application. Any disciplinary action taken in other states shall
 9   be reported to the Board on the biennial registration
10   application or within ninety (90) days of final disposition,
11   whichever is sooner. Multiple licensure shall be noted by the
12   Board on the licensee's record, and such state, territory,
13   possession or country shall be notified by the Board of any
14   disciplinary actions taken against said licensee in this
15   Commonwealth.
16      Section 12.1.    Continuing Nursing Education.--* * *
17      (g)   In lieu of meeting the requirements of this section:
18            (1)   [Certified registered nurse practitioners] APRN-CNPs
19      and dietetics-nutrition licensees shall fulfill the
20      requirements for continuing education in accordance with
21      sections 8.1 and 11, respectively.
22            * * *
23      Section 13.    Punishment for Violations.--* * *
24      (b)   In addition to any other civil remedy or criminal
25   penalty provided for in this act, the Board, by a vote of the
26   majority of the maximum number of the authorized membership of
27   the Board as provided by law or by a vote of the majority of the
28   duly qualified and confirmed membership or a minimum of five (5)
29   members, whichever is greater, may levy a civil penalty of up to
30   one thousand dollars ($1,000) on any current licensee who

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 1   violates any provision of this act or on any person who
 2   practices nursing, practices advanced practice registered
 3   nursing or holds himself or herself forth as a licensed
 4   dietitian-nutritionist without being properly licensed to do so
 5   under this act or on the responsible officers or employes of any
 6   corporation, copartnership, institution or association violating
 7   any of the provisions of this act. The Board shall levy this
 8   penalty only after affording the accused party the opportunity
 9   for a hearing, as provided in Title 2 of the Pennsylvania
10   Consolidated Statutes (relating to administrative law and
11   procedure).
12         Section 14.   Refusal, Suspension or Revocation of Licenses.--
13   (a)    The Board may refuse, suspend or revoke any license in any
14   case where the Board shall find that--
15         (1)   The licensee is on repeated occasions negligent or
16   incompetent in the practice of professional nursing, advanced
17   practice registered nursing or dietetics-nutrition.
18         (2)   The licensee is unable to practice professional nursing
19   or the practice of advanced practice registered nursing with
20   reasonable skill and safety to patients by reason of mental or
21   physical illness or condition or physiological or psychological
22   dependence upon alcohol, hallucinogenic or narcotic drugs or
23   other drugs which tend to impair judgment or coordination, so
24   long as such dependence shall continue. In enforcing this clause
25   (2), the Board shall, upon probable cause, have authority to
26   compel a licensee to submit to a mental or physical examination
27   as designated by it. After notice, hearing, adjudication and
28   appeal as provided for in section 15, failure of a licensee to
29   submit to such examination when directed shall constitute an
30   admission of the allegations against him or her unless failure

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 1   is due to circumstances beyond his or her control, consequent
 2   upon which a default and final order may be entered without the
 3   taking of testimony or presentation of evidence. A licensee
 4   affected under this paragraph shall at reasonable intervals be
 5   afforded an opportunity to demonstrate that he or she can resume
 6   a competent practice of professional nursing or the practice of
 7   advanced practice registered nursing with reasonable skill and
 8   safety to patients.
 9      * * *
10      (4)    The licensee has committed fraud or deceit in:
11      (i)    the practice of nursing, the practice of advanced
12   practice registered nursing or in securing his or her admission
13   to such practice or nursing school; or
14      (ii)    the practice of dietetics-nutrition or in securing his
15   or her license as a dietitian-nutritionist.
16      * * *
17      (b)    When the Board finds that the license of any nurse or
18   dietitian-nutritionist may be refused, revoked or suspended
19   under the terms of subsection (a), the Board may:
20      * * *
21      (6)    Restore or reissue, in its discretion, a suspended
22   license to practice professional or practical nursing, advanced
23   practice registered nursing or dietetics-nutrition and impose
24   any disciplinary or corrective measure which it might originally
25   have imposed.
26      Section 15.2.    Reinstatement of License.--Unless ordered to
27   do so by Commonwealth Court or an appeal therefrom, the Board
28   shall not reinstate the license of a person to practice nursing,
29   advanced practice registered nursing or dietetics-nutrition
30   which has been revoked. Any person whose license has been

20250HB0739PN0763                   - 23 -
 1   revoked may reapply for a license, after a period of at least
 2   five (5) years, but must meet all of the licensing
 3   qualifications of this act for the license applied for, to
 4   include the examination requirement, if he or she desires to
 5   practice at any time after such revocation.
 6      Section 15.4.   Injunction or Other Process.--It shall be
 7   unlawful for any person to practice or attempt to offer to
 8   practice nursing, practice advanced practice registered nursing
 9   or hold himself or herself forth as a licensed dietitian-
10   nutritionist[, as defined in this act,] or an APRN-CNP without
11   having at the time of so doing a valid, unexpired, unrevoked and
12   unsuspended license issued under this act. The unlawful practice
13   of nursing [as defined in this act] or unlawful practice of
14   advanced practice registered nursing may be enjoined by the
15   courts on petition of the Board or the Commissioner of
16   Professional and Occupational Affairs. In any such proceeding,
17   it shall not be necessary to show that any person is
18   individually injured by the actions complained of. If it is
19   determined that the respondent has engaged in the unlawful
20   practice of nursing or the unlawful practice of advanced
21   practice registered nursing, the court shall enjoin him or her
22   from so practicing unless and until he or she has been duly
23   licensed. Procedure in such cases shall be the same as in any
24   other injunction suit. The remedy by injunction hereby given is
25   in addition to any other civil or criminal prosecution and
26   punishment.
27      Section 4.   The authority of the State Board of Nursing to
28   certify a licensed registered nurse as an advanced practice
29   registered nurse-certified nurse practitioner shall expire on
30   the effective date of this section.

20250HB0739PN0763                  - 24 -
 1      Section 5.   Within 90 days after the effective date of this
 2   section, the State Board of Nursing, the Department of Health,
 3   the Department of Human Services and other affected agencies
 4   shall initiate the promulgation of regulations necessary to
 5   carry out the provisions of this act. The promulgation of the
 6   regulations shall not be a condition precedent to the
 7   applicability of this act.
 8      Section 6.   All other acts and parts of acts are repealed
 9   insofar as they are inconsistent with this act.
10      Section 7.   This act shall take effect in 60 days.




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