Pennsylvania House Bill HB1490

Pennsylvania 2025-2026 Regular Session

• Introduced: 5/21/25
• Refer: 5/21/25

Caption

Providing for Certified Registered Nurse Practitioner Pilot Program.

Summary

HB1490 would amend Pennsylvania’s Professional Nursing Law to create a Certified Registered Nurse Practitioner Pilot Program. The program would allow eligible certified registered nurse practitioners (CRNPs) to obtain an additional certification to practice independently in designated health professional shortage areas, but only within primary care settings. Eligible CRNPs must hold a current Pennsylvania license, have no recent disciplinary history, and have at least three years and 3,600 hours of collaborative practice with a physician in primary care within the prior five years. Applicants would apply to the State Board of Nursing, pay a board-set fee, and provide documentation of their qualifying experience. Once certified, participating CRNPs could practice without a collaborative agreement and prescribe therapeutic or corrective measures without one while working in a shortage area. The bill limits the pilot to primary care specialties such as family practice, internal medicine, gynecology, and pediatrics, and requires patients to be informed that the practitioner is not a physician. Participants must renew every two years, complete additional continuing education in patient safety and risk management, and notify the board if they move outside the approved practice setting. The program would sunset after six years, with a required legislative study after five years to evaluate access, outcomes, referrals, complaints, and other measures.

Impact

The bill would modify the Professional Nursing Law by adding a new section authorizing a temporary independent-practice pathway for qualified CRNPs in health professional shortage areas. It would also interact with the Medical Care Availability and Reduction of Error (Mcare) Act by treating participating CRNPs as participating health care providers for liability and assessment purposes, while clarifying that a physician who separately collaborates with a CRNP outside the program has no legal responsibility for acts or omissions performed under the program. The State Board of Nursing would gain new administrative authority, including certification, renewal, tracking, revocation, and temporary rulemaking, and the Joint State Government Commission would be tasked with a formal evaluation of the pilot.

Sentiment

Based on the bill text, the overall sentiment appears supportive of expanding access to care in underserved areas while preserving oversight and guardrails. The measure is framed as a pilot, includes eligibility requirements, limits practice to primary care in shortage areas, and requires reporting, continuing education, and a later study to assess results. The absence of recorded votes or committee testimony means there is no documented public debate in the provided materials, but the sponsor list suggests a coalition of members interested in nursing scope-of-practice and rural or underserved health access.

Contention

The main policy tension is between expanding CRNP autonomy and maintaining physician oversight. Supporters are likely to emphasize improved access to primary care in health professional shortage areas and reduced barriers for experienced nurse practitioners, while opponents may be concerned about patient safety, diagnostic complexity, and the adequacy of training without a collaborative agreement. The bill addresses some of those concerns by limiting the pilot to primary care, requiring prior collaborative experience, mandating patient disclosure, and imposing board oversight and a post-implementation study. Another possible point of contention is liability and professional responsibility, since the bill expressly limits a collaborating physician’s legal exposure for work done under the program.