As the American Medical Association works to block state laws from broadening the scope of advanced practice registered nurses, seven states have explored expanding APRNs' roles.
Four states where legislation is being discussed or recently passed:
1. In New Jersey, a bill currently in committee seeks to increase an advanced practice nurses' scope to include writing prescriptions and practice as a physician. If the legislation is passed, APNs in New Jersey with more than 24 months or 2,400 hours of licensed, active, advanced nursing practice will be authorized; APNs without this experience will need another provider to supervise.
2. Missouri lawmakers filed a bill in January seeking to lift restrictions to allow nurse practitioners to care for patients without a physician.
3. A Louisiana bill passed in 2021 repealed collaborative practice requirements for advanced practice registered nurses. They can also prescribe medications and offer "other healthcare items and services" by themselves, according to the law. It will become effective July 1.
4. Delaware's 2021 House Bill 141, which was signed that summer, defined APRNs "as an independent licensed practitioner." It allows them to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments, including prescribing medications, according to the bill.
Three other states that recently scrapped efforts to expand the role:
1. Maine's 2021 legislative document to repeal restrictions from APRNs' practice scopes was determined "ought not to pass."
2. A Kansas bill seeking to allow APRNs to prescribe medications, order and interpret diagnostic procedures and provide referrals to providers without a supervising physician died in committee.
3. A Mississippi bill that aimed to allow APRNs' "consultative relationship" requirements to be with another APRN with at least three years of experience, or to cut the requirement altogether for APRNs with more than practice 3,600 hours, died in 2021.