To amend sections 1751.67, 2133.211, 3313.539, 3707.511, 3727.06, 3923.233, 3923.301, 3923.63, 3923.64, 4723.01, 4723.02, 4723.06, 4723.07, 4723.24, 4723.28, 4723.36, 4723.41, 4723.42, 4723.43, 4723.431, 4723.44, 4723.46, 4723.481, 4723.482, 4723.483, 4723.493, 4723.50, 4731.27, 4761.17, and 5164.07; to enact section 4723.439; and to repeal sections 4723.45 and 5164.73 of the Revised Code to modify the laws governing the practice of advanced practice registered nurses and to name this act the Better Access to Health Care Act.
HB449, titled the Better Access to Health Care Act, makes broad changes to Ohio law governing advanced practice registered nurses (APRNs), especially clinical nurse specialists, certified nurse-midwives, and certified nurse practitioners. The bill creates a new pathway for those APRNs to practice without a standard care arrangement after they have completed 2,000 hours of clinical practice and collaborated under such an arrangement, and it directs the Board of Nursing to accept documentation showing those requirements are met. It also revises multiple sections of law to align other statutes with that new authority, including provisions on prescribing, hospital admission, death pronouncement, emergency epinephrine furnishing, respiratory care orders, and insurance reimbursement.
The bill would significantly alter Chapter 4723 of the Revised Code by establishing section 4723.439 and repealing section 4723.45, thereby removing the standard care arrangement requirement for qualifying APRNs. It also updates related statutes so that insurers, public employee benefit plans, Medicaid, hospitals, schools, youth sports organizations, and other health care-related entities recognize APRN authority in areas such as maternity care, follow-up care, hospital admission, concussion clearance, and certain prescribing and ordering functions. In practical terms, the bill expands independent practice authority for some APRNs while preserving limits on scope, prescribing, and collaboration requirements in specified settings.
Because the bill was only introduced and has no recorded committee testimony or votes in the provided materials, there is no formal legislative record of support or opposition. The bill’s title and structure indicate a pro-expansion, access-to-care framing, and its sponsors appear to be advancing it as a health care access measure. Based on the text alone, the overall tone is favorable toward APRN practice expansion and increased flexibility in care delivery.
The main policy tension in the bill is the reduction of physician or podiatrist collaboration requirements for certain APRNs, which may draw concern from medical groups or others who favor continued supervision or standard care arrangements. The bill still preserves collaboration for some functions and keeps limits on prescribing, but it shifts authority toward APRN autonomy, which is likely the central point of debate. Another possible area of contention is the bill’s broad conforming amendments across insurance, Medicaid, hospital, school athletics, and youth sports statutes, because those changes extend the effects of APRN practice expansion well beyond the nursing chapter itself.