SB 507 — An Act amending the act of December 20, 1985 (P.L.457, No.112), entitled "An act relating to the right to practice medicine and surgery and the right to practice medically related acts; reestablishing the State Board of Medical Education and Licensure as the State Board of Medicine and providing for its composition, powers and duties; providing for the issuance of licenses and certificates and the suspension and revocation of licenses and certificates; provided penalties; and making repeals," further providing for definitions, for midwifery and for nurse-midwife license; and providing for certified midwife license.

PRINTER'S NO.   456

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                        SENATE BILL
                        No. 507
                                               Session of
                                                 2025

     INTRODUCED BY BROWN, J. WARD, COMITTA, BAKER, SCHWANK,
        PENNYCUICK, FONTANA, COSTA, CAPPELLETTI, HAYWOOD, SAVAL AND
        VOGEL, MARCH 21, 2025

     REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE,
        MARCH 21, 2025


                                    AN ACT
 1   Amending the act of December 20, 1985 (P.L.457, No.112),
 2      entitled "An act relating to the right to practice medicine
 3      and surgery and the right to practice medically related acts;
 4      reestablishing the State Board of Medical Education and
 5      Licensure as the State Board of Medicine and providing for
 6      its composition, powers and duties; providing for the
 7      issuance of licenses and certificates and the suspension and
 8      revocation of licenses and certificates; provided penalties;
 9      and making repeals," further providing for definitions, for
10      midwifery and for nurse-midwife license; and providing for
11      certified midwife license.
12      The General Assembly of the Commonwealth of Pennsylvania
13   hereby enacts as follows:
14      Section 1.    The definitions of "medical training facility"
15   and "midwife or nurse-midwife" in section 2 of the act of
16   December 20, 1985 (P.L.457, No.112), known as the Medical
17   Practice Act of 1985, are amended to read:
18   Section 2.   Definitions.
19      The following words and phrases when used in this act shall
20   have the meanings given to them in this section unless the
21   context clearly indicates otherwise:
 1      * * *
 2      "Medical training facility."        A medical college, hospital or
 3   other institution which provides courses in the art and science
 4   of medicine and surgery and related subjects for the purpose of
 5   enabling a matriculant to qualify for a license to practice
 6   medicine and surgery, graduate medical training, [midwife]
 7   nurse-midwife certificate or physician assistant license.
 8      * * *
 9      "Midwife [or nurse-midwife]."           An individual who is licensed
10   as a [midwife] nurse-midwife under section 35 or a certified
11   midwife under section 35.1 by the board.
12      * * *
13      Section 2.        Section 12(b) of the act is amended to read:
14   Section 12.     Midwifery.
15      * * *
16      (b)   Use of title.--A [midwife may ] nurse-midwife and a
17   certified midwife may also use the title midwife[, nurse-
18   midwife] or an appropriate abbreviation of [those titles] the
19   title.
20      * * *
21      Section 3.        Section 35(c) and (d) of the act are amended and
22   the section is amended by adding subsections to read:
23   Section 35.     Nurse-midwife license.
24      * * *
25      (c)   Authorization.--
26            (1)   A nurse-midwife is authorized to practice midwifery
27      [pursuant to a collaborative agreement with a physician and
28      regulations promulgated by the board.] under the following
29      conditions:
30                  (i)    A nurse-midwife who is not an employee of a

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 1        public or private health system, hospital, licensed birth
 2        center or part of an interdisciplinary group practice in
 3        which at least one physician practices in the specialty
 4        area of the care provided by the nurse-midwife shall
 5        practice under a collaborative agreement with a physician
 6        or physician interdisciplinary group practice in
 7        accordance with the regulations promulgated by the board.
 8              (ii)   A nurse-midwife who is an employee of a public
 9        or private health system, hospital or licensed birth
10        center or part of an interdisciplinary group practice in
11        which at least one physician practices in the specialty
12        area of the care provided by the nurse-midwife shall
13        obtain and maintain clinical staff privileges at the
14        public or private health system, hospital or licensed
15        birth center and shall adhere to the established internal
16        mechanisms at the facility of the public or private
17        health system, hospital or licensed birth center for
18        quality improvement, consultation, collaboration or
19        referral in accordance with the nurse-midwife's clinical
20        practice privileges and the facility's policies and
21        procedures as approved by the Department of Health.
22        (2)   A nurse-midwife who possesses a master's degree or
23    its substantial equivalent and national certification may
24    prescribe, dispense, order and administer drugs, including
25    legend drugs and Schedule II through Schedule V controlled
26    substances, as defined in the act of April 14, 1972 (P.L.233,
27    No.64), known as The Controlled Substance, Drug, Device and
28    Cosmetic Act, provided that the nurse-midwife demonstrates to
29    the board that:
30              (i)    The nurse-midwife has successfully completed at

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 1        least 45 hours of coursework specific to advanced
 2        pharmacology at a level above that required by a
 3        professional nursing education program.
 4             (ii)    As a condition of biennial license renewal by
 5        the board, a nurse-midwife shall complete the continuing
 6        education requirement as required by the act of May 22,
 7        1951 (P.L.317, No.69), known as The Professional Nursing
 8        Law. In case of a nurse-midwife who has prescriptive
 9        authority under this act, the continuing education
10        required by The Professional Nursing Law shall include at
11        least 16 hours in pharmacology in that two-year period.
12             [(iii)       The nurse-midwife acts in accordance with a
13        collaborative agreement with a physician which shall at a
14        minimum identify the categories of drugs from which the
15        nurse-midwife may prescribe or dispense and the drugs
16        which require referral, consultation or comanagement.]
17             (iv)    The nurse-midwife acts in accordance with the
18        following restrictions:
19                    (A)    A nurse-midwife shall not prescribe,
20             dispense, order or administer a controlled substance
21             except for a woman's acute pain[.], for a woman's
22             medication-assisted treatment for opioid use disorder
23             or for primary gynecologic health conditions.
24                    (B)    In the case of a Schedule II controlled
25             substance for acute pain, the dose shall be limited
26             to 72 hours and shall not be extended except with the
27             approval of [the] a collaborating physician.
28                    (C)    In the case of a Schedule III or IV
29             controlled substance, the prescription shall be
30             limited to 30 days and shall only be refilled with

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 1                   the approval of [the] a collaborating physician.
 2                          [(B)   A nurse-midwife shall prescribe, dispense,
 3                   order or administer psychotropic drugs only after
 4                   consulting with the collaborating physician.]
 5                          (D)    A nurse-midwife when working with a
 6                   physician or physician group prescribing medication
 7                   treatment for opioid use disorder may prescribe,
 8                   dispense, order and administer United States Food and
 9                   Drug Administration-approved prescription drugs,
10                   including buprenorphine, methadone and naltrexone,
11                   for medication-assisted treatment for opioid use
12                   disorders consistent with Federal laws and
13                   regulations.
14             (3)   A nurse-midwife may, [in accordance with a
15      collaborative agreement with a physician and] consistent with
16      the nurse-midwife's academic educational preparation and
17      national certification, prescribe, dispense, order and
18      administer:
19                   (i)    Medical devices.
20                   (ii)    Immunizing agents.
21                   (iii)    Laboratory tests.
22                   (iv)    Therapeutic, diagnostic and preventative
23             measures.
24      [(d)    Collaborative agreements.--The physician with whom a
25   nurse-midwife has a collaborative agreement shall have hospital
26   clinical privileges in the specialty area of the care for which
27   the physician is providing collaborative services.]
28      (e)    Consultation, collaboration or referral.--
29             (1)   A nurse-midwife who is an employee of a public or
30      private health system, hospital or licensed birth center or

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 1      part of an interdisciplinary group practice in which at least
 2      one physician practices in the specialty area of the care
 3      provided by the nurse-midwife shall identify deviations from
 4      normal and appropriate interventions, including the
 5      management of complications and emergencies utilizing
 6      consultation, collaboration or referral to or with a
 7      physician as indicated by the health status of a patient. A
 8      consultation between a nurse-midwife and a physician shall
 9      not alone establish a physician-patient relationship or any
10      other legal relationship with the physician. A nurse-midwife
11      shall be solely responsible for the services the nurse-
12      midwife provides to a patient.
13            (2)   In order to maintain safe midwifery practice during
14      a collaboration with a physician, a nurse-midwife shall, at a
15      minimum, take all of the following actions:
16                  (i)    Maintain a medical record for each patient.
17                  (ii)    In the case of a transfer of care to another
18            health care provider or facility, transfer a patient's
19            medical records to the health care provider or facility.
20      (f)   Disclosures.--A nurse-midwife who is not an employee of
21   a public or private health system, hospital or licensed birth
22   center or part of an interdisciplinary group practice in which
23   at least one physician practices in the specialty area of the
24   care provided by the midwife shall disclose, verbally and in
25   written form, the information specified in paragraphs (1) and
26   (2) to a prospective patient at the beginning of the
27   professional relationship between nurse-midwife and the patient.
28   The discussion must be documented by the use of a disclosure
29   form. The patient shall sign and date the disclosure under this
30   subsection at the same time the nurse-midwife and patient enter

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 1   into an agreement for services. The nurse-midwife shall file the
 2   disclosure under this subsection in the patient's medical
 3   record. The disclosure shall include all the following
 4   information:
 5            (1)   The nurse-midwife's name.
 6            (2)   The patient's name, contact information and the name
 7      of the patient's primary care provider, if applicable.
 8            (3)   An individual emergency plan established between the
 9      nurse-midwife and patient. The plan shall include all of the
10      following:
11                  (i)    The patient's name, address and telephone
12            number.
13                  (ii)    The arrangements for transport from the
14            delivery site to a nearby hospital with obstetric
15            services.
16                  (iii)    The name, address and telephone number of the
17            hospital with obstetric services that will be used for an
18            emergency transfer.
19                  (iv)    The name, address and telephone number of the
20            hospital with obstetric services that will be used for a
21            nonemergency transfer.
22                  (v)    The name and telephone number of the
23            collaborating physician or another physician, group
24            practice, public or private health system or hospital
25            with which the nurse-midwife has a collaborative
26            agreement or which provides backup care or co-management
27            care to the patient.
28      Section 4.        The act is amended by adding a section to read:
29   Section 35.1.        Certified midwife license.
30      (a)   License.--A certified midwife license shall empower the

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 1   licensee to practice midwifery in this Commonwealth as provided
 2   in this act. The board shall issue rules and promulgate
 3   regulations as may be necessary for the examination, licensing
 4   and proper conduct of the practice of midwifery.
 5      (b)   Requirements.--An applicant for a certified midwife
 6   license must have completed an academic and clinical program of
 7   study in midwifery which has been approved by the board or an
 8   accrediting body recognized by the board.
 9      (c)   Authorization.--
10            (1)   A certified midwife may practice midwifery under the
11      following conditions:
12                  (i)    A certified midwife who is not an employee of a
13            public or private health system, hospital or licensed
14            birth center or part of an interdisciplinary group
15            practice in which at least one physician practices in the
16            specialty area of the care provided by the midwife shall
17            practice under a collaborative agreement with a physician
18            or physician interdisciplinary group practice in
19            accordance with the regulations promulgated by the board.
20                  (ii)   A certified midwife who is an employee of a
21            public or private health system, hospital or licensed
22            birth center or part of an interdisciplinary group
23            practice in which at least one physician practices in the
24            specialty area of the care provided by the midwife shall
25            obtain and maintain clinical staff privileges at the
26            public or private health system, hospital or licensed
27            birth center and shall adhere to the established internal
28            mechanisms at the facility of the public or private
29            health system, hospital or licensed birth center for
30            quality improvement, consultation, collaboration or

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 1        referral in accordance with the certified midwife's
 2        clinical practice privileges and the facility's policies
 3        and procedures as approved by the Department of Health.
 4        (2)   A certified midwife who possesses a master's degree
 5    or its substantial equivalent and national certification may
 6    prescribe, dispense, order and administer drugs, including
 7    legend drugs and Schedule II through Schedule V controlled
 8    substances, as defined in the act of April 14, 1972 (P.L.233,
 9    No.64), known as The Controlled Substance, Drug, Device and
10    Cosmetic Act, if the certified midwife demonstrates to the
11    board that:
12              (i)    The certified midwife has successfully completed
13        at least 45 hours of coursework specific to advanced
14        pharmacology during the individual's midwifery education.
15              (ii)    As a condition of biennial license renewal by
16        the board, a certified midwife shall complete at least 16
17        hours of continuing education in pharmacology in that
18        two-year period. Beginning with the license period
19        designated by regulation, licensees shall be required to
20        attend and complete 30 hours of mandatory continuing
21        education during each two-year license period. Nationally
22        certified education courses shall be considered as
23        creditable, in addition to any other courses the board
24        deems creditable toward meeting the requirements for
25        continuing education.
26              (iii)   An individual applying for the first time for
27        licensure in this Commonwealth shall be exempted from the
28        continuing education requirement for the biennial renewal
29        period following initial licensure.
30              (iv)    The certified midwife acts in accordance with

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 1        the following restrictions:
 2                     (A)   A certified midwife shall not prescribe,
 3              dispense, order or administer a controlled substance
 4              except for a woman's acute pain, for a woman's
 5              medication assisted treatment for opioid use
 6              disorder, or for primary gynecologic health
 7              conditions.
 8                     (B)   For a Schedule II controlled substance for
 9              acute pain, the dose shall be limited to 72 hours and
10              shall not be extended except with the approval of a
11              collaborating physician.
12                     (C)   For a Schedule III or IV controlled
13              substance, the prescription shall be limited to 30
14              days and shall only be refilled with the approval of
15              a collaborating physician.
16                     (D)   A certified midwife, when working with a
17              physician or physician group prescribing medication
18              treatment for opioid use disorder, may prescribe,
19              dispense, order and administer United States Food and
20              Drug Administration-approved prescription drugs,
21              including buprenorphine, methadone and naltrexone,
22              for medication-assisted treatment for opioid use
23              disorders consistent with Federal laws and
24              regulations.
25        (3)   A certified midwife may, consistent with the
26    certified midwife's academic educational preparation and
27    national certification, prescribe, dispense, order and
28    administer:
29              (i)    Medical devices.
30              (ii)    Immunizing agents.

20250SB0507PN0456                    - 10 -
 1                  (iii)    Laboratory tests.
 2                  (iv)    Therapeutic, diagnostic and preventative
 3            measures.
 4      (d)   Consultation, collaboration or referral.--
 5            (1)   A certified midwife who is an employee of a public
 6      or private health system, hospital or licensed birth center
 7      or part of an interdisciplinary group practice in which at
 8      least one physician practices in the specialty area of the
 9      care provided by the midwife shall identify deviations from
10      normal and appropriate interventions, including the
11      management of complications and emergencies utilizing
12      consultation, collaboration or referral to or with a
13      physician as indicated by the health status of a patient. A
14      consultation between a certified midwife and a physician
15      shall not alone establish a physician-patient relationship or
16      any other legal relationship with the physician. A certified
17      midwife shall be solely responsible for the services the
18      certified midwife provides to a patient.
19            (2)   In order to maintain safe midwifery practice during
20      a collaboration with a physician, a certified midwife shall,
21      at a minimum, take all of the following actions:
22                  (i)    Maintain a medical record for each patient.
23                  (ii)    In the case of a transfer of care to another
24            health care provider or facility, transfer a patient's
25            medical records to the health care provider or facility.
26      (e)   Disclosures.--A certified midwife who is not an employee
27   of a public or private health system, hospital or licensed birth
28   center or part of an interdisciplinary group practice in which
29   at least one physician practices in the specialty area of the
30   care provided by the midwife shall disclose, verbally and in

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 1   written form, the information specified in paragraphs (1) and
 2   (2) to a prospective patient at the beginning of the
 3   professional relationship between certified midwife and the
 4   patient. The discussion must be documented by the use of a
 5   disclosure form. The patient shall sign and date the disclosure
 6   under this subsection at the same time the nurse-midwife and
 7   patient enter into an agreement for services. The certified
 8   midwife shall file the disclosure under this subsection in the
 9   patient's medical record. The disclosure shall include all the
10   following information:
11          (1)   The certified midwife's name.
12          (2)   The patient's name, contact information and the name
13      of the patient's primary care provider, if applicable.
14          (3)   An individual emergency plan established between the
15      certified midwife and patient. The plan shall include all of
16      the following:
17                (i)    The patient's name, address and telephone
18          number.
19                (ii)    The arrangements for transport from the
20          delivery site to a nearby hospital with obstetrics
21          services.
22                (iii)    The name, address and telephone number of the
23          hospital with obstetric services that will be used for an
24          emergency transfer.
25                (iv)    The name, address and telephone number of the
26          hospital with obstetric services that will be used for a
27          nonemergency transfer.
28                (v)    The name and telephone number of the
29          collaborating physician or another physician, group
30          practice, public or private health system or hospital

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1            with which the certified midwife has a collaborative
2            agreement or which provides backup care or co-management
3            care to the patient.
4      (f)   Mcare Act.--A certified midwife licensed under this
5   section is subject to the same provisions as a certified nurse
6   midwife is under the act of March 20, 2002 (P.L.154, No.13),
7   known as the Medical Care Availability and Reduction of Error
8   (Mcare) Act.
9      Section 5.   This act shall take effect in 60 days.




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