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View NCGA Bill Details2021
House Bill 277 (Public) Filed Thursday, March 11, 2021
Intro. by White, Adcock, Cunningham, Wheatley.

Status: Re-ref Com On Rules, Calendar, and Operations of the House (House action) (Jun 29 2022)
H 277

Bill Summaries:

  • Summary date: Mar 11 2021 - View Summary

    Identical to S 249, filed 3/11/21.

    Enacts new GS 90-171.36B to prohibit an advanced practice registered nurse (APRN) from practicing as such without a license. Defines advanced practice registered nurse or APRN as an individual licensed by the The North Carolina Board of Nursing (Board) as an advanced practice registered nurse within one of the following four roles: (1) nurse practitioner or NP, (2) certified nurse midwife or CNM, (3) clinical nurse specialist or CNS, or (4) certified registered nurse anesthetist or CRNA. Enacts GS 90-171.36C to require the Board to issue an APRN license to any person recognized by the Board as an APRN or approved to practice as an APRN in the state on December 31, 2021. Enacts GS 90-171.36D, which specifies the process for APRN license renewal and reinstatement. Makes conforming changes to GS 90-171.43, GS 90-171.43A, and GS 90-171.44.

    Amends the definitions of terms used in the Nursing Practice Act. Adds definitions for advanced assessment, advanced practice registered nurse, population focus, practice of nursing as an advanced practice registered nurse or APRN, practice of nursing as a certified nurse midwife or CNM, practice of nursing as a certified registered nurse anesthetist or CRNA, practice of nursing as a clinical nurse specialist or CNS, and practice of nursing as a nurse practitioner or NP. Amends the components listed that define the practice of nursing by a registered nurse to include collaborating with other health care providers in determining the appropriate health care for a patient (previously, limited to not prescribing a medical treatment regimen or making a medical diagnosis, except under the supervision of a licensed physician). Makes clarifying, organizational, and technical changes.

    Amends GS 90-18(c) to establish that the practice of nursing by an APRN does not constitute practicing medicine or surgery.

    Repeals GS 90-18.2, which places limitations on nurse practitioners. Makes conforming changes to GS 90-2, GS 90-18.3, GS 90-85.24, and GS 90-85.34A.

    Amends GS 90-29(b) to establish that a certified registered anesthetist administering anesthetic does not constitute practicing dentistry.

    Amends the powers of the Board in GS 90-171.23 by empowering the Board to grant prescribing, ordering, dispensing, and furnishing authority to holders of the advanced practice registered nurses license (deletes the power of the Board to appoint and maintain a subcommittee to work with the NC Medical Board to develop rules and regulations to govern the performance of medical acts by registered nurses and to determine related application fees).

    Amends GS 90-171.27 to set out fees for application for licensure, license renewal, and reinstatement of lapsed licenses for APRNs.

    Repeals GS 90-171.37(b) regarding the Board's disciplinary authority over registered nurses. 

    Repeals Article 10A of GS Chapter 90, Nurses Registered Under Previous Law, Practice of Midwifery. Makes conforming changes to GS 90-18 and GS 90-21.11.

    Effective October 1, 2021.

    Requires the Governor to submit an opt-out letter to the Centers for Medicare and Medicaid Services within 30 days of the date the section becomes law, requesting an exemption that allows hospitals, ambulatory surgical centers, critical access hospitals, and rural hospitals in the state the maximum flexibility to obtain Medicare reimbursement for anesthesia services in a manner that best serves each facility and its patients and community. 

    Directs the Board, the NC Medical Board, and the State Board of Dental Examiners to adopt implementing rules.