A BILL to amend and reenact § 54.1-2957 of the Code of Virginia, relating to advanced practice registered nurses; authorization to practice without a practice agreement; service in military or employment with Department of Veterans Affairs.
HB622 amends Virginia’s law governing advanced practice registered nurses (APRNs), primarily by expanding and clarifying when certain APRNs may practice without a written or electronic practice agreement with a physician. The bill updates § 54.1-2957 to allow nurse practitioners, certified nurse midwives, and some clinical nurse specialists to practice independently once they meet specified experience thresholds and documentation requirements, while preserving consultation, collaboration, referral, and scope-of-practice obligations. It also creates special recognition for APRNs who have practiced autonomously for at least three years in active-duty military service or as employees of the U.S. Department of Veterans Affairs, deeming them to have satisfied the experience requirement for independent practice.
The bill also revises the rules for practice agreements, endorsements, temporary licensure, and continuity of care when a collaborating physician dies, retires, becomes disabled, or otherwise leaves practice. It sets out procedures for APRNs to continue practicing temporarily, requires evidence of efforts to secure a new physician collaborator, and allows some APRNs to transition to leadership by an experienced nurse practitioner. Certified nurse midwives and clinical nurse specialists receive separate pathways to independent practice, with additional conditions for those who prescribe controlled substances or have fewer than 1,000 hours of practice.
In practical terms, HB622 would reduce physician-supervision requirements for qualified APRNs and make it easier for experienced APRNs, including those with military or VA service, to continue practicing in Virginia. It would affect the Boards of Medicine and Nursing, which would continue to regulate licensure and would be responsible for verifying experience, issuing endorsements, and adopting implementing regulations. Patients and health care employers, especially in rural or underserved areas, could see expanded access to APRN-provided care.
The general sentiment reflected by the bill’s structure is supportive of broader APRN autonomy and workforce flexibility, particularly for experienced practitioners and those with public-service backgrounds. However, the bill was left in the House Committee on Health Professions, indicating it did not advance, and no recorded votes or committee transcript are available to show direct debate. The main point of contention is likely the long-running policy issue of whether APRNs should be allowed to practice independently without physician practice agreements, balancing access to care and professional autonomy against concerns about oversight, collaboration, and patient safety.
HB622 would amend § 54.1-2957 of the Code of Virginia to expand independent practice authority for advanced practice registered nurses, including nurse practitioners, certified nurse midwives, and certain clinical nurse specialists. It would modify the statutory requirements for practice agreements, create experience-based pathways to practice without physician agreements, and add special provisions for APRNs with qualifying military or Department of Veterans Affairs service. The bill would also affect the regulatory responsibilities of the Boards of Medicine and Nursing and the documentation, endorsement, and continuity-of-care rules governing APRN practice.
The bill appears generally favorable toward APRN autonomy, experience-based licensure, and improved workforce flexibility, especially for practitioners with military or VA service. Because there were no recorded votes or committee transcripts, there is no direct evidence of floor or committee debate, but the bill’s referral and ultimate leaving in committee suggest it did not secure enough support to advance. The overall policy direction is pro-expansion of APRN practice authority, though the absence of movement indicates unresolved concerns or insufficient consensus.
The central contention is the extent to which APRNs should be permitted to practice without a physician practice agreement. Supporters would likely emphasize access to care, especially in underserved areas, and recognition of experienced APRNs, including veterans and VA employees. Opponents or skeptics would likely focus on maintaining physician oversight, ensuring patient safety, and preserving collaborative practice structures. Additional potential points of debate include whether the experience thresholds are sufficient, how the Boards would verify qualifications, and whether the bill’s independent-practice provisions should apply equally across APRN categories.