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.
HB508, 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 pathway for certain APRNs to practice without a standard care arrangement after completing 5,000 hours of clinical practice and collaboration, and it updates multiple statutes to reflect that change. It also revises definitions, licensure, renewal, disciplinary, and prescribing provisions in the nursing code, while preserving existing limits on scope of practice and requiring compliance with board rules.
The bill also updates several health-care-related statutes outside the nursing chapter to recognize APRNs in settings such as hospitals, hospice, respiratory care, school athletics, youth sports, insurance reimbursement, Medicaid, and end-of-life care. Among other things, it allows APRNs to direct certain follow-up care, participate in hospital admissions under specified conditions, pronounce death in some circumstances, and be recognized for reimbursement and authorization purposes in insurance and public benefit programs. It also revises concussion clearance rules to account for APRNs who may practice without a standard care arrangement under the new section 4723.439.
A major policy theme of the bill is expanding access to care by reducing physician-collaboration requirements for experienced APRNs while keeping regulatory oversight through licensure, board rules, and practice limits. The bill retains restrictions on prescribing, including limits on schedule II controlled substances and prohibitions on abortion-related drugs or devices, and it continues to require education, certification, and continuing education for APRNs. It also makes conforming changes to the Board of Nursing’s authority and to physician and podiatrist collaboration provisions so the new APRN practice model fits within existing law.
Because the bill was only introduced and had no recorded votes or committee testimony in the provided materials, there is no formal legislative record of support or opposition yet. The bill’s title and structure suggest a generally pro-expansion, access-to-care orientation, but the text also shows that lawmakers anticipated concerns about patient safety, prescribing authority, and the role of collaborating physicians. Those concerns are reflected in the bill’s detailed conditions, limits, and retained oversight mechanisms rather than in any recorded debate.
The most notable point of contention is likely the reduction of mandatory physician collaboration for certain APRNs, especially in light of the bill’s changes to standard care arrangements and the ability of APRNs to practice independently after meeting experience thresholds. Related issues include whether the 5,000-hour requirement is sufficient, how much authority APRNs should have to prescribe controlled substances, and whether the bill appropriately balances access to care with supervision and accountability. The bill also touches sensitive areas such as abortion-related prescribing restrictions and insurance/Medicaid reimbursement rules, which could draw additional scrutiny.
HB508 would substantially revise Ohio’s nursing statutes by creating section 4723.439, which allows certain APRNs to practice without a standard care arrangement after meeting specified experience and documentation requirements. It also amends numerous sections of the Revised Code to conform other laws to that new model, including provisions on hospital admission authority, death pronouncement, insurance reimbursement, Medicaid coverage, school athletics concussion clearance, youth sports, and respiratory care orders. The bill would repeal existing sections 4723.45 and 5164.73 and replace or update references throughout the code to reflect the new APRN framework.
The available record shows no committee testimony or votes, so there is no documented public sentiment from legislative proceedings in the materials provided. Based on the bill text, the measure is framed as an access-to-care expansion and appears designed to be supportive of APRN practice authority, while also preserving regulatory safeguards. The overall tone is reform-oriented and pro-expansion, with careful statutory limits intended to address safety and scope-of-practice concerns.
The main likely point of contention is the bill’s move to let experienced APRNs practice without a standard care arrangement, which reduces physician oversight and may be opposed by groups favoring traditional collaboration requirements. Secondary areas of dispute include APRN prescribing authority, especially for controlled substances, the bill’s restrictions on abortion-related prescribing, and whether the new rules for hospital admissions, death pronouncement, and insurance/Medicaid reimbursement go too far or not far enough. Supporters would likely emphasize access, especially in underserved areas, while opponents would likely focus on supervision, patient safety, and scope-of-practice boundaries.