For nurse practitioners · Every jurisdiction

The Watch

Every change to nurse-practitioner practice authority we can pin to a primary source — what is pending and what has recently taken effect — by jurisdiction, with the date we last read each source.

The loop ran on 9 November 2026: 33 of the 49 watch items were re-read against their primary sources, and 54 of the 76 guidance entries were checked for supersession. Every item below links the source it was read from and carries the date we read it; where a jurisdiction has nothing pending, it is named at the foot of this page rather than left out.

This is the whole record — 16 of the 36 jurisdictions we track carry something pending today, and 15 more carry a change that has already taken effect. Each item has its own anchor, so a single row can be linked on its own.

Alaska

Enacted, not yet effective

HB 195 (ch. 24 SLA 26): APRNs must offer an opioid overdose drug prescription with certain opioid prescriptions from January 1, 2027

Expected — The APRN overdose-drug offer requirement (new AS 08.68.705(e)) takes effect January 1, 2027.

CSHB 195(FIN) passed the House May 15 and the Senate May 20, 2026. The governor vetoed it June 18, 2026; the legislature overrode the veto 43-17 in joint session on June 19, 2026, and it was assigned Chapter 24 SLA 26. Section 26 adds AS 08.68.705(e): an APRN who prescribes an opioid must offer the patient a prescription for an opioid overdose drug when the supply exceeds three days, the total daily dose is 50 MME or more, a benzodiazepine is co-prescribed, or the patient has a history of overdose or substance use disorder. Section 87 makes section 26 effective January 1, 2027. The act also renames physician assistants as physician associates and changes pharmacist collaborative-practice and prescribing rules.

Alaska State Legislature, Enrolled HB 195 (34th Legislature); bill history at https://www.akleg.gov/basis/Bill/Detail/34?Root=hb+195 →

first recorded 2026-10-10 · last read 2026-10-10

Arizona

Already in force (2)

Recently effective

Five-business-day provisional licensure for out-of-state APRNs/RNs — effective September 26, 2025

HB 2133 (Laws 2025, Chapter 223, signed June 25, 2025; effective September 26, 2025 with the session's general effective date) added A.R.S. § 32-1635.02: the Board of Nursing must issue a provisional license to a qualifying out-of-state APRN, RN, or LPN within 5 business days of a complete application, convertible to a regular license after 6 months. For an NP relocating to or picking up work in Arizona, the licensure wait drops from months to days.

Arizona Legislature, Laws 2025, Chapter 223 (HB 2133) →

first recorded 2026-08-11 · last read 2026-11-09

Recently effective

HB 2050 (Laws 2026, ch. 37): registered nurse practitioners may use diagnostic x-ray without another state license

HB 2050, a radiologic-technologist bill, was approved by the governor April 13, 2026 as Chapter 37. It adds registered nurse practitioners to A.R.S. 30-672(G), the list of licensees the department may not require to obtain any other license to use a diagnostic x-ray machine; they are governed by their own licensing acts. A legislative-intent section says the change is meant to prompt a Board of Nursing advisory opinion on radiation-safety training and operator certification. The act has no effective-date clause, so it took effect on the session's general effective date, September 12, 2026.

Arizona Legislature, Laws 2026, Chapter 37 (HB 2050), with general effective date from https://www.azleg.gov/SessionLaws/ →

first recorded 2026-10-10 · last read 2026-11-09

California

Rulemaking in progress

BRN rulemaking to conform 103/104 NP regulations to SB 1451 — comment period closed August 25, 2026, adoption pending

The BRN proposes amending 16 CCR 1481, 1482, 1482.3, 1482.4 and 1487 to implement AB 890 (Ch. 265, Stats. 2020) and SB 1451 (Ch. 481, Stats. 2024). The changes recognize pre-2017 retired population-focus exams for 103/104 NPs, clarify that 104 NPs may perform both BPC 2837.104(b) and (c) functions, remove the Method 3 equivalency option, and update consumer-notice rules. The written comment period closed August 25, 2026 with no hearing scheduled. As of October 2026 the package is still listed under Proposed Regulations with no modified text posted, and it is not on the Approved Regulations list. The September 24-25, 2026 board agenda carried no adoption item. The next full board meeting, December 16-17, 2026, is the earliest posted chance for adoption, but no agenda is out. For a Gale NP, this text will govern 103/104 certification mechanics once the board adopts it and OAL approves it.

CA Board of Registered Nursing, Notice of Proposed Action (16 CCR 1481–1487), 7/2/2026 →

first recorded 2026-08-11 · last read 2026-11-09

Enacted, not yet effective

SB 1302 (Ch. 429, Stats. 2026): out-of-state transition to practice counts toward 103 NP status; BRN extended to 2031

Expected — January 1, 2027 — statute takes effect (majority-vote, non-urgency bill); BRN must publish its list of qualifying states on or before January 1, 2028

SB 1302 (Wahab) was approved by the Governor and filed with the Secretary of State on September 20, 2026 as Chapter 429, Statutes of 2026. It amends BPC 2837.103 so the transition to practice of at least three full-time-equivalent years or 4,600 hours may be completed in California or in another state the board identifies. On or before January 1, 2028, the board must identify states where practice experience would meet or exceed California's requirements, keep the list on its website, set up a process for tracking changes in those states' laws, and review the list periodically. The bill also extends the Board of Registered Nursing, its executive officer, and its meeting requirements until January 1, 2031. It lets the board issue NP furnishing numbers on renewal applications and removes the penalty fee for late furnishing-number renewal. It also adds administering medications ordered by an NP or CNM to the definition of nursing practice. The digest shows a majority vote and the text has no urgency clause, so the bill takes effect on California's default date of January 1, 2027.

California Legislative Information — SB 1302 chaptered text (Ch. 429, Stats. 2026) →

first recorded 2026-10-10 · last read 2026-10-10

Enacted, not yet effective

AB 1973 (Ch. 487, Stats. 2026): first-trimester limit removed for NP- and CNM-performed abortion; written transfer procedures required past the first trimester

Expected — January 1, 2027 — statute takes effect (majority-vote, non-urgency bill)

AB 1973 (Aguiar-Curry) was approved by the Governor and filed on September 27, 2026 as Chapter 487, Statutes of 2026. It amends BPC 2253, 2725.4 and 3502.4. It deletes the rule that abortions by non-physician licensees authorized under the Nursing Practice Act and related acts be performed only in the first trimester, and it changes 2725.4 from 'aspiration techniques' to 'procedural abortion.' An NP or CNM performing a procedural abortion beyond the first trimester must establish, maintain, and follow written procedures for consultation, collaboration, referral, and transfer of care to a physician when care goes beyond their education, training, and experience. Some provisions carry over from current 2725.4 (SB 1375, 2022): a trained NP functioning under 2837.103 or 2837.104 still needs no physician supervision, and exclusively online or simulation-based training without direct-patient-care clinical hours still does not count. The bill passed by majority vote with no urgency clause, so it takes effect January 1, 2027.

California Legislative Information — AB 1973 chaptered text (Ch. 487, Stats. 2026) →

first recorded 2026-10-10 · last read 2026-10-10

Rulemaking in progress

BRN rulemaking: probation supervision condition for APRNs practicing without standardized procedures (16 CCR 1444.5), modified text approved, OAL step pending

The BRN noticed amendments to 16 CCR 1444.5 on January 30, 2026, updating Standard Probation Condition 8 in its incorporated Recommended Guidelines for Disciplinary Orders and Conditions of Probation. The update covers APRNs whose scope lets them practice without standardized procedures in an independent setting, which the notice ties to 103/104 NPs and to nurse-midwives under SB 1237. The Board approved modified text at its March 26, 2026 meeting, and comments on the modifications closed April 23, 2026. Under the modified condition, the probationer must propose a supervisor and a supervision plan within 60 days and may not practice until the Board approves them in writing. The supervisor must have no discipline in the last 5 years and no current or prior financial, personal, business, or professional relationship with the probationer. Supervision is either direct or general with quarterly monitoring visits, and the probationer bears all supervision costs. The guidelines let the Board deviate when the facts of a case warrant it. The BRN's 2026 rulemaking calendar projected OAL submission in April 2026, but as of October 2026 the package still appears under Proposed Regulations.

California Board of Registered Nursing — Proposed Regulations (notice, modified text, and notice of modified text for 16 CCR 1444.5) →

first recorded 2026-10-10 · last read 2026-11-09

Already in force (2)

Recently effective

The 104 NP pathway runs in two stages: about 4,600 hours to qualify as a 103 NP, then three more full-time-equivalent years as a 103 NP

The Board of Registered Nursing's AB 890 page sets out the 104 pathway in two sequential stages. First, certification as a 103 NP, which requires a transition to practice defined as 4,600 hours or three full-time-equivalent years of clinical practice experience and mentorship, completed within five years prior to the date the applicant applies as a 103 NP, completed after certification by the Board as an NP, and completed in direct patient care. Second, and separately, a 103 NP must practise in good standing for at least three full-time-equivalent years or 4,600 hours in direct patient care before becoming a 104 NP. These two 4,600-hour blocks are sequential rather than the same requirement, so transition-to-practice hours do not count toward the 104 clock. 'In good standing' means practice under a current, active and unrestricted licence where the applicant was not subject to a disciplinary action by the Board, including probation, suspension, or public reproval. A 104 NP can practise without standardized procedures outside of a group setting, and may work independently within the population focus of their national certification. Certain provisions of AB 890 were later amended by SB 1451 (Chapter 481, Statutes of 2024). On availability, the page states that the Board is only able to certify 103 NPs at this time and will not be able to certify 104 NPs until 2026, and it carries no last-updated date, so it neither confirms nor denies that 104 applications are open; an NP who has met the requirements should ask the Board directly.

CA Board of Registered Nursing, Assembly Bill 890 page →

first recorded 2026-08-11 · last read 2026-11-09

Recently effective

AB 583 (Ch. 271, Stats. 2025): NPs may complete and attest to death certificates, operative July 1, 2026

AB 583 (Pellerin) was approved by the Governor on October 3, 2025 as Chapter 271, Statutes of 2025. It amends the Health and Safety Code so that, starting July 1, 2026, the medical and health section data and the time of death on a death certificate may be completed and attested to by the nurse practitioner last in attendance. The attending physician or NP must complete that section within 15 hours after the death. Also from July 1, 2026, NPs join the individuals who must notify the coroner of deaths under specified circumstances, which extends an existing crime to NPs. NPs are added to the provisions on fetal death certificates, including stating required information and depositing or delivering the certificate within 15 hours. NPs may also file declarations, under penalty of perjury, to amend records of death, fetal death, or live birth.

California Legislative Information, AB 583 chaptered text (Ch. 271, Stats. 2025) →

first recorded 2026-10-10 · last read 2026-10-10

Colorado

Sunset ahead

Nurse Practice Act repeals September 1, 2027 — COPRRR's 2026 sunset review of the Nursing Board is underway

Expected — COPRRR sunset report due by October 15, 2026; Act repeals September 1, 2027 unless the 2027 General Assembly continues it

HB 20-1216 continued the Nurse Practice Act only through September 1, 2027, and COPRRR's official schedule lists the Nursing Board (plus Nurse Aides Certification and the Nurse-Physician Advisory Task Force) among '2026 Sunset Reviews in Progress,' with reports released each October 15. The 2027 continuation bill is where APRN provisions could be reopened — including SB 23-167's regime (effective May 25, 2023) whose 750-hour prescribing mentorship rules are now fully in effect in 3 CCR 716-1 ch. 1.15 with no open Board of Nursing rulemaking found. For an NP, Colorado's current provisional-to-full prescriptive authority path is stable today but goes on the table in the 2027 session.

Colorado DORA, Office of Policy, Research & Regulatory Reform — Review Schedule →

first recorded 2026-08-11 · last read 2026-10-10

Already in force (1)

Recently effective

HB26-1296 (signed May 5, 2026; effective August 12, 2026) moves an APRN's late death-certificate certification from Medical Board unprofessional conduct to Board of Nursing discipline

HB26-1296 does two things in one move. Section 1 strikes 'or advanced practice registered nurse's' from C.R.S. 25-2-110(4)(b)(I), so an APRN's failure is no longer unprofessional conduct under the Medical Practice Act, and adds 25-2-110(4)(b)(II) making it grounds for discipline under the Nurse and Nurse Aide Practice Act instead. Section 2 adds that ground at 12-255-120(1)(ii): repeatedly or willfully failing, without reasonable cause, to comply with the requirements of completing a medical certification for a certificate of death in accordance with any applicable deadline set in section 25-2-110. The underlying duty predates this act and is unchanged: 25-2-110(4)(a) requires the physician, physician assistant or APRN in charge of the patient's care to complete the certification within seventy-two hours of the electronic death registration request. So no new duty is imposed; the disciplining body moves from the Colorado Medical Board to the Board of Nursing, and the ground applies on and after the effective date only. The act was approved May 5, 2026, enacted as Chapter 122, and took effect ninety days after final adjournment as an act subject to referendum petition rather than under a safety clause.

Colorado General Assembly, HB26-1296 (2026 Session Laws ch. 122) →

first recorded 2026-11-05 · last read 2026-11-09

Connecticut

Already in force (1)

Recently effective

Nurse Licensure Compact implemented October 1, 2025 — it covers RN and LPN licences only; an NP needs a separate APRN licence in each state

The Connecticut Department of Public Health states that effective October 1, 2025 the state implemented its participation in the Nurse Licensure Compact, and that eligible registered nurses and licensed practical nurses with Connecticut as their primary state of residence may apply from that date. Conversion runs through elicense.ct.gov under Nurse Compact, with no fee and no need to wait for a renewal period, but it is not automatic: the page requires documentary proof of Connecticut primary residence, NCLEX-RN, NCLEX-PN or SBTPE completion, graduation from an approved programme, no encumbrance on any state licence, a valid Social Security number, no enrolment in an alternative-to-discipline programme, no felony or nursing-related misdemeanour, and a state and federal fingerprint criminal background check. A multistate licence is recognized only in the states and territories that belong to the compact. What it does not give a nurse practitioner: the compact's own FAQ at nursecompact.com states that the NLC pertains to RN and LPN/VN licenses only, and that an APRN must hold an individual APRN license in each state of APRN practice. So a Connecticut multistate licence lets an NP work as an RN in other compact states and does nothing for her APRN scope; APRN multistate licensure sits in a separate APRN Compact, whose status should be checked on its own. The Connecticut page itself never uses the words APRN, advanced practice or nurse practitioner.

Connecticut Department of Public Health, Nurse Licensure Compact →

first recorded 2026-08-11 · last read 2026-11-09

Delaware

Enacted, not yet effective

SS 1 for SB 334 (85 Del. Laws c. 487): uniform payer credentialing application, 15+30-day response clock and provisional credentials, effective January 1, 2028

Expected — Takes effect January 1, 2028. From then on, carriers that require credentialing must accept only the uniform (CAQH or Pharmacy Profiles) credentialing application.

Signed September 8, 2026 (85 Del. Laws c. 487), the Health Care Professional Access Act adds Chapter 33B to Title 18. It applies to carriers that require credentialing, including insurers, HMOs, TPAs, PBMs, workers' compensation carriers, the state employee plan and, as far as federal law allows, Medicaid MCOs. Within 15 days of receiving a uniform application, a carrier must confirm that it is clean or flag it as incomplete; silence deems it complete. Within 30 days after confirming a clean application, the carrier must accept it, deny it, or send a delay notice with reasons and an estimated time. Provisional credentials are required from the clean-application notice when the professional works mainly in a HRSA shortage area or an FQHC, is already credentialed by the carrier at another Delaware site or in a reciprocal state, or the carrier misses its decision deadline. The deadline trigger cites '§ 6207(b) of this title', apparently a cross-reference error. Applicants who disclosed malpractice settlements within 5 years or board discipline are excluded. Damages are capped at $500 per day of delay and $5,000 per incident. The act covers any licensed 'health care professional'; APRNs are included but not named.

Delaware General Assembly, SS 1 for SB 334 bill detail and engrossed text (https://legis.delaware.gov/json/BillDetail/GenerateHtmlDocumentEngrossment?engrossmentId=38229&docTypeId=6) →

first recorded 2026-10-10 · last read 2026-11-09

Already in force (1)

Recently effective

End of Life Options Act in effect by January 1, 2026 — APRNs may act as attending or consulting provider, subject to the Act's conditions

HB 140, the End of Life Options Act, was signed May 20, 2025. The bill page's synopsis says the act takes effect when the final regulations it requires have been promulgated or on January 1, 2026, whichever occurs earlier, while the page's own Effective Date field reads 5/20/25. The synopsis names the attending physician or attending advanced practice registered nurse (APRN) and a consulting physician or consulting APRN, so an APRN may act in either role — but the role is heavily conditioned, and a physician or APRN may also refuse to prescribe under the Act. As the synopsis describes it: the patient must be a terminally ill adult resident of Delaware with a prognosis of six months or less; the attending and the consulting provider must both confirm the terminal illness, the patient's decision-making capacity, and that the decision is informed and voluntary; a psychiatrist or psychologist must evaluate the patient if either provider is concerned about capacity; mental illness is not a qualifying condition; the patient must self-administer the medication and no one may request it on another's behalf; age or disability alone cannot establish eligibility; all end-of-life options including comfort, palliative and hospice care and pain control must be disclosed; a witnessed written request is required; two waiting periods must elapse and the patient must be offered a chance to rescind before a prescription is written; and a health-care institution may prohibit the practice on its premises. Immunity runs only to good-faith conduct within accepted standards. These conditions come from the Assembly's bill synopsis; an APRN considering participation should read the enacted text and her employer's policy.

Delaware General Assembly, HB 140 (153rd General Assembly) →

first recorded 2026-08-11 · last read 2026-11-09

Guam

Rulemaking in progress

Guam Board of Nurse Examiners completed draft revisions to its nursing rules, including APRN provisions, for submission to the Legislature

Minutes of the Board’s regular meeting of July 9, 2026, reconvened July 16, 2026, and certified by the chairperson 08/13/2026, say the draft revisions to the rules and regulations “had been completed and would be submitted for one final review and approval before being forwarded to Senator S. Salas-Matanane.” The draft incorporates input from APRN member G. Woodard on APRN provisions, “language necessary for participation in the NLC” with the applicable NLC rules to be attached after coordination with Mr. Jim Puente, updates recognizing ADN and LPN programs, and “proposed fee increases of approximately 10% to 20%,” with final amounts to follow. The Board was advised that “the immediate priority was to finalize and submit the proposed rules and regulations to the Legislature.” The packet was transmitted to the Governor and Speaker on August 13, 2026 under 5 GCA § 8113.1, and the August 13, 2026 agenda carries “Rules and Regulations (Proposed)” under Committee Reports. Nothing in the packet shows a submission, a bill, an adoption or an effective date, and its newest date is August 14, 2026, the Legislature’s receipt. This replaces the retired item guam-nursing-rules-legislative-adoption, whose only source was the board’s July 2025 packet.

Guam Legislature Messages and Communications Doc. No. 38GL-26-2741 (Guam Board of Nurse Examiners meeting packet, August 13, 2026, with the July 9, 2026 minutes) →

first recorded 2026-11-09 · last read 2026-11-09

Idaho

Rulemaking in progress

Board of Nursing rules rewrite headed to the 2027 Legislature; a pending-vote recording is dated October 22, 2026 (Docket 24-3401-2601)

Expected — Submission to the 2027 Idaho Legislative Session, per DOPL's rulemaking page; neither the vote outcome nor an effective date is posted

Idaho DOPL and the Board of Nursing are revising IDAPA 24.34.01 under Docket 24-3401-2601. The rulemaking page states that it describes 2026 rulemaking activity for submission before the 2027 Legislative Session, which is the timing anchor for when any of this lands. It lists a notice of intent dated May 6, 2026, draft chapters dated May 28 and July 23, 2026, a negotiated-rulemaking summary dated June 1, 2026, a proposed rule published in the Idaho Administrative Bulletin on September 2, 2026, a public hearing recording dated September 14, 2026, a link labelled 'Pending Vote Recording' dated 10/22/26, and a record of public comments dated 10/28/26. The page does not state that a vote occurred or its outcome, and the same recording is also listed under the Midwifery docket, so it does not tie that session to this docket. DOPL summarizes the docket as moving licence renewals to biennial birthdate renewals and advancing the licensure exception from nurse apprenticeship to nurse internship; the draft chapters were not reviewed here for NP-specific provisions. The page is stamped last updated September 3, 2026, which predates the October items it lists.

Idaho DOPL, Board of Nursing statutes, rules and rulemaking (IDAPA 24.34.01) →

first recorded 2026-08-11 · last read 2026-11-09

Illinois

Sunset ahead

Nurse Practice Act scheduled for repeal January 1, 2028 — reenactment or extension needed before then

Expected — January 1, 2028 — statutory repeal of 225 ILCS 65 unless reenacted/extended

The Act's text on ILGA carries '(Article scheduled to be repealed on January 1, 2028)' throughout 225 ILCS 65, so the General Assembly must extend or reenact it before that date. Any reenactment bill would reopen the APRN practice provisions. Today an Illinois NP needs a written collaborative agreement unless granted full practice authority after attesting to 4,000 clinical hours plus 250 hours of continuing education. Even with full practice authority, controlled-substance prescribing carries limits, such as physician consultation for benzodiazepines beyond a 120-day supply. NPs considering Illinois should watch the reenactment bill ahead of the January 1, 2028 repeal date.

Illinois General Assembly, 225 ILCS 65 (Nurse Practice Act) →

first recorded 2026-08-11 · last read 2026-10-10

Already in force (1)

Recently effective

PA 104-0244 (HB 2688) effective January 1, 2026 — CNM/APRN collaboration and birth-center practice without a collaborative agreement

Signed August 15, 2025 after passing the House 114-0 (4/9/2025) and Senate 57-1 (5/22/2025), the act amends the Nurse Practice Act to allow written collaborative agreements between full-practice-authority certified nurse midwives and APRNs, and lets a CNM granted clinical privileges by a licensed birth center's clinical director provide out-of-hospital birth services without a written collaborative agreement. It is a narrow but real loosening of Illinois's physician-anchored collaboration model — a signal for where the 2027 rewrite may go.

Illinois General Assembly, HB 2688 Bill Status / Public Act 104-0244 →

first recorded 2026-08-11 · last read 2026-10-10

Iowa

Already in force (1)

Recently effective

ARNP rules chapter rescinded and rewritten — effective June 4, 2025

Expected — June 4, 2030 — automatic rescission date for the rewritten chapter under Iowa Code 17A.7 unless readopted

Under Iowa's Executive Order 10 red-tape review, the Board of Nursing replaced the ARNP chapter wholesale (655—Ch. 7, ARC 9164C, IAB 4/30/25, effective 6/4/25): streamlined licensure/renewal tied to the RN license expiration, an $81 fee, telehealth and cross-coverage definitions, and a grandfathering exception for ARNPs certified before accredited-program requirements. Full independent practice and prescribing are unchanged, but the entire chapter now carries a built-in rescission date of 6/4/30, so it must be readopted before then.

Iowa Administrative Code, Nursing Board [655] Chapter 7 (ARC 9164C) →

first recorded 2026-08-11 · last read 2026-11-09

Kansas

Already in force (3)

Recently effective

HB 2528 (2026 Kan. Sess. Laws ch. 73) — signed April 7, 2026, effective April 16, 2026 on publication in the Kansas Register

Expected — The first day of the 2027 regular legislative session — appointees the governor names begin serving while awaiting Senate confirmation; the interim board serves until then. The act gives no calendar date for that day.

HB 2528 was signed by the Governor on April 7, 2026, enacted as chapter 73 of the 2026 Session Laws of Kansas, and took effect on April 16, 2026, the date of its publication in the Kansas Register. It adds a late-renewal path for professional, practical and advanced practice registered nurse licences. The board may grant a one-time temporary permit to practise as an APRN for not more than 180 days pending completion of the application for a licence: the permit is discretionary, available only while a licence application is pending, cannot be repeated, and carries its own application fee. The act also limits 'unprofessional conduct' to acts related to the licensee's practice of nursing, voids certain earlier board actions based on nonpractice violations, requires refunds of overpaid or duplicate payments on request, and bars board retaliation with a private cause of action. Terms of members serving on the board on July 1, 2026 expired that day, and the governor appoints interim members who serve between July 1, 2026 and the first day of the 2027 regular legislative session.

Kansas Legislature, 2026 HB 2528 →

first recorded 2026-08-11 · last read 2026-11-09

Recently effective

HB 2509 (2026 Kan. Sess. Laws ch. 124, signed April 9, 2026, effective July 1, 2026): Kansas APRNs become Health Care Stabilization Fund providers from January 1, 2028

Expected — APRN obligations under the Health Care Provider Insurance Availability Act commence January 1, 2028, with six months to comply with membership requirements.

HB 2509 was signed April 9, 2026, enacted as chapter 124 of the 2026 Session Laws of Kansas, and took effect July 1, 2026; the APRN obligation it creates is future-dated. Commencing on and after January 1, 2028, the act adds any APRN licensed or granted a temporary authorization by the Board of Nursing to the definition of 'health care provider' under the Health Care Provider Insurance Availability Act, and grants each such APRN six months to comply with membership requirements. Section 3 of the act amends K.S.A. 40-3402 itself, and the amended text requires coverage of not less than $500,000 per claim subject to not less than a $1,500,000 annual aggregate, maintained by each resident health care provider as a condition of active licensure, unless the provider is a self-insurer. There are further off-ramps: an APRN is not subject to that requirement if the initial surcharge to participate in the fund exceeds 15%, and the fund's board of governors keeps authority to grant temporary exemptions to providers with exceptional circumstances. An APRN will also owe the fund surcharge under K.S.A. 40-3404, which is what the 15% test measures. The act adds an APRN seat to the board of governors, which grows from 11 to 12 members; before this act the definition listed only nurse-midwife APRNs and registered nurse anesthetists.

Kansas Legislature, HB 2509 bill page and enrolled text (https://www.kslegislature.gov/li/b2025_26/measures/documents/hb2509_enrolled.pdf) →

first recorded 2026-10-10 · last read 2026-11-05

Recently effective

HB 2478 (2026 Session Laws ch. 20) brings APRN and nurse anesthetist applicants within the Board of Nursing's fingerprint and criminal-history-check authority

HB 2478 amends K.S.A. 2025 Supp. 74-1112 so that 'applicant' means a person who has applied for licensure as a professional nurse, an advanced practice registered nurse, a registered nurse anesthetist, a practical nurse or a mental health technician. For those applicants the board of nursing may require fingerprinting and a state and national criminal history record check; the authority is discretionary, not automatic. Subsection (b) requires the board to fix a fingerprinting fee in an amount necessary to reimburse its cost, so an applicant who is asked to be printed pays for it. The Governor approved the bill on March 20, 2026 and it was enacted as Chapter 20 of the 2026 Session Laws of Kansas, taking effect on publication in the statute book on July 1, 2026. When read on 2026-11-05 the Revisor of Statutes' online text of 74-1112 had not yet been updated to the 2026 supplement.

Kansas Legislature, HB 2478 enrolled text (2026 Session Laws ch. 20) →

first recorded 2026-11-05 · last read 2026-11-05

Maine

Rulemaking in progress

Board of Nursing reissued its Chapter 8 APRN rule as a second amended proposal; comments due November 7, 2026

Expected — November 7, 2026 — comment deadline on the second amended 02-380 C.M.R. Ch. 8 proposal; final adoption would follow

Public Law Chapter 540, enacted February 17, 2026, authorizes the Board of Nursing to replace the fixed supervised-practice requirement with board-set practice standards, including mentorship by a supervising nurse practitioner. The first Ch. 8 proposal (2026-P157, comments closed 2026-07-25) was not adopted as filed. On September 2-3, 2026 the Board reviewed the comments and added an exception allowing supervisory mentorship by a physician, aligning that exception with the 1-year clinical practice requirement in Section 2(2)(A). The Board posted the second amended proposal 2026-10-07 with comments due November 7, 2026 at 4:30pm, and no public hearing is planned. The old supervision framework governs until Ch. 8 is finally adopted.

Maine State Board of Nursing, Additional Proposed Amendments to Chapter 8 (posted 10/07/2026), with 2nd Amended Rule Proposal PDF →

first recorded 2026-08-11 · last read 2026-10-10

Maryland

Rulemaking in progress

Maryland proposes moving the HIV/AIDS case-reporting duty from physicians to health care providers, including certified registered nurse practitioners (COMAR 10.18.02)

Expected — Public comments are accepted through November 30, 2026.

Notice [26-187-P], at 53:22 Md. R. 1114 (October 30, 2026), proposes to amend Regulations .01—.06, .08 and .09 under COMAR 10.18.02, HIV and CD4+ Investigations and Case Reporting. A new definition added at Regulation .03B(11) provides that “‘Health care provider’ means a physician, registered nurse, certified registered nurse practitioner, certified nurse midwife, licensed certified midwife, licensed direct-entry midwife, or designees of a health care facility”; the chapter in force contains no definition of “health care provider” and does not mention certified registered nurse practitioners. The proposal then substitutes “health care provider” for “physician” through the chapter, retitling Regulation .04 from “Physician Responsibility” to “Health Care Provider Responsibility” and changing its lead-in from “A physician shall” to “a health care provider shall.” For a Maryland nurse practitioner the effect, if adopted, is a reporting duty of her own rather than one she carries as a physician’s designee: reporting an individual diagnosed with HIV or AIDS under her care to the health officer within 48 hours, and reporting newborn HIV exposure and a pregnancy in a woman with HIV to the Secretary. Comments are accepted through November 30, 2026, and the notice states that no public hearing has been scheduled.

Maryland Register, Vol. 53, Issue 22 (Oct. 30, 2026), Notice of Proposed Action [26-187-P] at 53:22 Md. R. 1114 →

first recorded 2026-11-09 · last read 2026-11-09

Rulemaking in progress

Maryland proposes a continuing education chapter covering every health occupations board, including Nursing (COMAR 10.31.03)

Expected — Public comments are accepted through November 30, 2026.

Notice [26-189-P], at 53:22 Md. R. 1119 (October 30, 2026), proposes new Regulations .01—.06 under a new chapter, COMAR 10.31.03, General Continuing Education Requirements. Regulation .01 applies the chapter to all health occupations boards within the Maryland Department of Health and to their licensees, certificate holders, permit holders and registrants seeking renewal; the Board of Nursing is among the boards the notice lists as having considered it at a public meeting, on July 29, 2026. Regulation .03 states the chapter’s requirements are in addition to each board’s existing continuing education regulations, and leaves credit approval and the renewal cycle with each board. Regulation .04 requires licensees to complete implicit bias and structural racism training under Health Occupations Article § 1-225, tied to a licensee’s first renewal after April 1, 2026. Regulation .05 requires boards to allow a renewing applicant at least 1 hour of continuing education credit for a Department-approved human trafficking awareness program, and Regulation .06 requires boards whose licensees’ scope covers menopause or perinatal care, and that require continuing education for renewal, to grant at least 2 hours of credit for each hour of Department-approved training, with a board-set maximum permitted. The chapter does not itself create the underlying training mandates, which come from HB 783, HB 771, HB 1365 and HB 1118, and Regulations .05 and .06 operate only once the Department has approved a program. Comments are accepted through November 30, 2026.

Maryland Register, Vol. 53, Issue 22 (Oct. 30, 2026), Notice of Proposed Action [26-189-P] at 53:22 Md. R. 1119 →

first recorded 2026-11-09 · last read 2026-11-09

Massachusetts

Enacted, not yet effective

Nurse Licensure Compact enacted November 20, 2024; Board of Registration in Nursing targets implementation for May 2027

Expected — May 2027 — Board's targeted NLC implementation date (a target, not a fixed effective date)

NP practice authority itself is unchanged (full practice authority since 2021). The Acts of 2024, c.238 (approved in part 2024-11-20) inserted G.L. c.112A, the Nurse Licensure Compact, and directs the Board of Registration in Nursing to adopt implementing regulations. The Board says the compact is not in effect until implementation is complete. It received conditional FBI approval for federal background checks in May 2026, proposed amendments to three regulations between April and June 2026, and is targeting implementation for May 2027. Multistate applications are not yet available, so NPs relocating to or from Massachusetts still need a standalone MA RN license plus APRN authorization.

Mass. Board of Registration in Nursing, The Nurse Licensure Compact (NLC) page; MA Acts of 2024, Chapter 238 →

first recorded 2026-08-11 · last read 2026-10-10

Minnesota

Already in force (1)

Recently effective

Setting restriction on the 2,080-hour transition period removed for primary care and mental health NPs — effective August 1, 2026

2026 Session Laws ch. 115 (HF 3825, signed 2026-05-27), art. 11 amends 148.211 subd. 1c: the 2,080-hour postgraduate collaborative-agreement requirement stays, but the mandate that it occur in a hospital or integrated clinical setting is struck, and qualifying collaborators now include APRNs with 3+ years of practice; new subd. 1d keeps the integrated-setting requirement only for NPs outside primary care and mental health. With no special effective-date clause, it took effect 2026-08-01 under Minnesota's default rule — a new primary-care or behavioral-health NP can now complete transition hours in an independent practice with a remote-eligible collaborator. Full repeal of subd. 1c (HF 1794) passed the House 119-12 on 2026-04-27 but died in Senate committee.

MN Revisor of Statutes, 2026 Session Laws ch. 115 (HF 3825), art. 11 →

first recorded 2026-08-11 · last read 2026-11-09

Montana

Already in force (1)

Recently effective

Noncompete shield covering APRNs in force, with a sale-of-practice exception (MCA 28-2-724, amended three times in 2025)

MCA 28-2-724, enacted in 2023 (Ch. 479) and amended in 2025 by Ch. 104, Ch. 131 and Ch. 698, provides that a contract creating or establishing the terms of employment, a partnership, or any other form of professional relationship may not restrict a covered provider, after the relationship ends, from practising in any geographic area and for any period, or from treating, advising, consulting with or soliciting a current patient of the employer or partnership. The providers covered include an advanced practice registered nurse licensed under Title 37, chapter 8. The section's own catchline names exceptions, and there are two. It does not apply to a contract in connection with the sale and purchase of a practice, so a noncompete tied to buying into or selling a practice can still bind an NP. It also does not apply to a provision for repayment of money paid or advanced to a physician licensed under Title 37, chapter 3 — a bona fide loan, relocation cost, signing bonus, or education or tuition expense — where the amount owed decreases over time; that carve-out is written for physicians, and the statute does not say how an APRN's own repayment clause is treated.

Montana Code Annotated 2025, 28-2-724 →

first recorded 2026-08-11 · last read 2026-11-09

Nebraska

Already in force (2)

Recently effective

LB 912 adds fluoroscopy to NP scope — operative three calendar months after the 2026 session adjourned sine die on April 17, despite the act's emergency clause

LB 912 was approved by the Governor April 14, 2026 and amends Neb. Rev. Stat. 38-2315 so a nurse practitioner may perform and utilize fluoroscopy for procedural guidance and for the performance of authorized duties on successful completion of appropriate education and training approved jointly by the department and the board. That training must also be in accordance with rules and regulations adopted under section 71-3508, so there are two gates, not one. The act carries an emergency clause and takes effect when passed and approved, but Section 34 makes the fluoroscopy section operative three calendar months after the adjournment of the 2026 legislative session. The Legislature's Journal for the Sixtieth Day records adjournment sine die on April 17, 2026, which puts the operative date in mid-July 2026; Nebraska's own 2026 statute compilation gives July 18, 2026 as the default operative date for this session's non-emergency changes. Nothing read for this entry shows that a jointly approved training standard yet exists, so the authority is operative but not yet exercisable. An NP may also direct fluoroscopy in collaboration with a medical radiographer licensed by the department on the board's recommendation; that radiographer may not perform interpretative fluoroscopic procedures, and the radiographer half of the scheme carries the same operative date.

Nebraska Legislature, LB 912 slip law (109th Leg., 2nd Sess.) →

first recorded 2026-08-11 · last read 2026-11-05

Recently effective

Board of Advanced Practice Registered Nurses dissolved and NP oversight moved to the Board of Nursing on July 1, 2026 (LB 346)

LB 346 (approved by the Governor May 30, 2025) ended the Board of Advanced Practice Registered Nurses on July 1, 2026. From that date, 'board' in the Nurse Practitioner Practice Act means the Board of Nursing. The Board of Nursing grows to ten RN members, four of them APRNs (preferably one each CRNA, NP, CNS, and CNM), and takes on monitoring APRN scope of practice and recommending APRN discipline. The 2,000-hour transition-to-practice requirement itself is unchanged by this bill.

Nebraska Legislature, LB 346 (2025) slip law →

first recorded 2026-10-10 · last read 2026-11-05

Nevada

Already in force (1)

Recently effective

R087-25 medical-assistant delegation regulation approved and filed April 29, 2026

Board of Nursing regulation R087-25, filed April 29, 2026, adds sections to NAC chapter 632 under NRS 632.120 as amended by AB 319 (ch. 246, Statutes of Nevada 2025). The regulation specifies no later date, and under NRS 233B.070(1) a permanent regulation becomes effective when filed with the Secretary of State, so it took effect that day. It defines a 'delegating practitioner' as a registered nurse, including an advanced practice registered nurse, and authorizes delegation of a clinical task to a medical assistant only if four conditions hold: the practitioner knows the assistant possesses the knowledge, skill and training to perform the task safely and properly; the task is not one the assistant is required to be certified or licensed to perform; the assistant is employed by the practitioner or by the same employer; and the employer has documented in the assistant's employment record that the assistant has been appropriately trained and is competent for that task. The delegating practitioner must be immediately available to exercise oversight in person during an invasive procedure, retains responsibility for the safety and performance of each delegated task, and may not delegate outside her own authority, training, expertise or normal scope of practice, may not let the assistant sub-delegate, and may not let the assistant administer an anesthetic agent that renders a patient unconscious or semiconscious. A medical assistant may not make a diagnosis, initiate any treatment or prescribe any drug.

Nevada Legislature, Approved Regulation of the State Board of Nursing, LCB File R087-25 (filed April 29, 2026) →

first recorded 2026-08-11 · last read 2026-11-09

New Hampshire

Rulemaking in progress

Nur 400 'Continued Status' rules overhaul underway — Notice 2026-68, hearing held April 23, 2026

The Board of Nursing (c/o OPLC) filed Notice 2026-68 to readopt and amend Nur 400, which governs renewal, reinstatement/re-entry, continuing competency, disciplinary sanctions, and delegation for all nurse licensees including APRNs — replacing rules that expired in April 2024. The proposal moves renewal to OPLC's universal renewal application, requires proof of BLS/ACLS/CPR at renewal (a new burden flagged in public comment), and retains the APRN survey/opt-out requirement; the hearing was April 23, 2026 and written comments closed April 30, 2026, with adoption not yet appearing in the state's Nur filing history as of August 2026.

NH Office of Legislative Services / OPLC, Rulemaking Notice 2026-68 (Nur 400) →

first recorded 2026-08-11 · last read 2026-11-05

Already in force (1)

Recently effective

SB 453 (Chapter 253, 2026) lets APRNs sign medical immunization exemptions and disability vehicle-waiver certifications

SB 453 (Chapter 253, Laws of 2026), approved July 2, 2026 and effective August 31, 2026, adds APRNs licensed under RSA 326-B, and physician associates, to RSA 141-C:20-c, I. An APRN can now certify that a required childhood immunization may be detrimental to a child's health. It also amends RSA 266:61-a, VII so that an APRN can document a lasting medical necessity, which lets a disability vehicle-equipment waiver run up to 4 years instead of up to 2.

New Hampshire General Court, SB 453 final version (Chapter 253, 2026 Session) →

first recorded 2026-10-10 · last read 2026-11-09

New Jersey

Already in force (1)

Recently effective

P.L.2026 c.6 (approved March 30, 2026): an NJ APN past 5,000 hours in an approved population focus may practise without a joint protocol, subject to insurance, CE and notice conditions

P.L.2026, c.6, approved March 30, 2026, exempts an advanced practice nurse from the joint-protocol requirement only where the APN is authorized within a population focus the act enumerates (family or individual across the lifespan, adult gerontology, pediatrics, women's health, behavioral health) and has more than 5,000 hours of licensed, active, advanced nursing practice in a role with the applicable population focus. The APN must be providing primary health care or behavioral health care, must not be providing services in the area of general obstetrics, and must not be providing elective aesthetic or cosmetic services. Where the care is behavioral health, the APN must take appropriate action to facilitate the timely referral, transfer, or admission to a higher level of care, on a documented clinical assessment. The act also attaches conditions to practising under the exemption: prescriptions on a New Jersey Prescription Blank; 14 contact hours of continuing professional education in pharmacology and 10 contact hours each biennial period; malpractice liability insurance, or a letter of credit, for at least the minimum amount applicable to a licensed physician, with written notice of the carrier to the Board of Nursing; immediate notice to the Board on incapacity, indictment, discipline or a lapsed certification; and the same standard of care as other independent health care practitioners. For an APN already practising without a joint protocol under Executive Order No. 13 (2026), the act sets two tracks: one who would reach 5,000 hours within 12 months of the effective date may continue without a joint protocol, and one who would have less than 5,000 hours within 12 months may continue for six months after the effective date, after which a joint protocol with a collaborating physician is required. Hours practised without a joint protocol during the transition count toward the required hours. The act carries no sunset and directs the Board of Nursing and the Commissioner of Health to adopt regulations effective immediately upon filing with the Office of Administrative Law, including how the Board verifies hours, for a period not to exceed 18 months from filing. The act sets no calendar date for the six-month window; six months from an immediate effective date on a March 30, 2026 approval would have closed in late September 2026, but that is a calculation rather than the act's text, and an APN relying on a transition track should confirm it with the Board.

New Jersey Legislature, P.L.2026, c.6 (S2996/A4052), enacted text →

first recorded 2026-08-11 · last read 2026-11-09

New Mexico

Already in force (1)

Recently effective

Nursing Practice Act rewrite covering CNPs, licensure and anesthesia (HB 178, Laws 2025, Ch. 101) signed April 8, 2025

HB 178 passed the House 56-3 and the Senate 41-0 and was signed April 8, 2025 as Laws 2025, Chapter 101. Section 8 amends 61-3-23.2 and provides that certified nurse practitioners may practice independently and make decisions regarding the health care needs of the individual, family or community and carry out health regimens, including the prescription and distribution of dangerous drugs and controlled substances in Schedules II through V, and may serve as a primary, acute, chronic, long-term and end-of-life health care provider. Section 4 adds board duties: the board shall provide a nurse applying for a first-time license, or upon renewal, the option for a single or multistate license, which may incur an additional fee, and shall promulgate rules establishing standards for the use of artificial intelligence in nursing. Section 6(D) sets initial APRN licensure at a fee not to exceed two hundred dollars, in addition to the registered nurse fee. On anesthesia, a currently licensed certified registered nurse anesthetist may administer general anesthesia to any person, while a registered nurse may, on successful completion of required training programs, administer anesthetics as ordered by a licensed physician or independent provider or per employing organization protocol, up to and including moderate sedation. The act defines 'anesthetics' to exclude general anesthesia and defines four graded levels of sedation. For the amount of any multistate licence fee, check the Board of Nursing directly; the act states only that one may be charged.

NM Legislature, HB 178 (2025), Ch. 101; NM Board of Nursing →

first recorded 2026-08-11 · last read 2026-11-09

New York

Sunset ahead

NP independent-practice provisions extended to July 1, 2030 (A10007-C / Chapter 57, signed May 28, 2026)

Expected — July 1, 2030 — new sunset of the Education Law § 6902(3) independent-practice provisions

The FY2027 health budget bill (A10007-C, passed both chambers May 27, 2026, signed as Chapter 57 on May 28, 2026) replaced the July 1, 2026 sunset: the current statute now carries a version of § 6902(3) 'effective until July 1, 2030,' so NPs with 3,600+ practice hours continue practicing on attested collaborative relationships with no written practice agreement. Permanence bills have not moved: S2360 was re-referred to Senate Higher Education on January 7, 2026 and remains in committee (A1220 likewise), so the 2030 cliff is the next real date.

NY Senate Open Legislation, Education Law § 6902 (rev. 2026-05-29); A10007-C/Ch. 57 of 2026 →

first recorded 2026-08-11 · last read 2026-11-09

North Dakota

Already in force (1)

Recently effective

Board credential verification required for nursing PLLC registration (NDBON notice dated September 21, 2026)

Per the Board of Nursing's notice dated September 21, 2026, a nursing professional organization (e.g., an NP's PLLC) must clear NDBON credential verification before the ND Secretary of State completes its registration, and again for each annual report. Required items are Certificate of Professional License form SFN 13610, a CV for each partner or member, a description of services, and an attestation of compliance with N.D.C.C. ch. 43-12.1 (Nurse Practices Act), N.D.A.C. Title 54, and NDBON practice guidance. There is also a $20 administrative fee, and the requirement rests on N.D.C.C. ch. 10-31 (Professional Organizations Act). Applications are filed through the ND Nurse Portal under Other Application, and NDBON allows 2 to 3 business days for review. An NP forming an independent practice in ND should build this board sign-off into the entity-formation timeline.

ND Board of Nursing, PLLC credential verification notice (dated September 21, 2026) →

first recorded 2026-08-11 · last read 2026-11-09

Oregon

Rulemaking in progress

HB 3044 (2025) Nurse Practice Act modernization — Phase 2 rules adopted August 20, 2026

HB 3044 (2025 session) authorized the Oregon State Board of Nursing to modernize its rules. Phase 1, effective Jan 1, 2026, repealed the separate APRN licensure division (Div. 53) and consolidated all nurse licensure into Division 31. Division 21 changes adopted April 16, 2026 permit Oregon institutions to develop master's, post-master's certificate, or post-doctoral certificate APRN programs. Phase 2 amendments to Divisions 31 and 62, which the board says further clarify, refine, and operationalize board processes, ran public comment June 30 to July 21, 2026 with a hearing July 21, 2026. The board adopted them at its August 20, 2026 meeting, and the OSBN page does not state an effective date. An Oregon NP should re-check licensure and renewal citations, since APRN licensure rules have moved from Division 53 to Division 31.

Oregon State Board of Nursing rulemaking page (HB 3044 implementation) →

first recorded 2026-08-11 · last read 2026-11-09

Already in force (1)

Recently effective

HB 4040 (Or. Laws 2026, ch. 109) makes Oregon NPs attending physicians in workers' compensation, ending the 180-day cap

HB 4040, a 2026 health omnibus, passed the House March 3, 2026 and the Senate March 5, 2026. It was approved by the Governor and filed with the Secretary of State on April 7, 2026, published as Oregon Laws 2026 chapter 109, with an effective date of April 7, 2026 under the emergency clause in Section 61. It amends ORS 656.005 so that, except as otherwise provided for workers subject to a managed care contract, 'attending physician' includes a nurse practitioner licensed under ORS 678.375 to 678.390. It also deletes the language capping an NP's compensable services at 180 days from the first visit on the initial claim. The managed-care exception is the live limit: under ORS 656.245(5)(a), an NP who is not a member of the worker's managed care organization may provide the same level of services as a primary care physician only if she maintains the worker's medical records, has a documented history of treating the worker, agrees to refer the worker to the organization for any specialized treatment including physical therapy, and agrees to comply with the organization's rules, terms and conditions. ORS 656.245(2)(b)(C) also still limits impairment findings to a qualified provider serving as the attending physician at the time of claim closure, a category NPs now fall within. One point is unresolved: the act amends ORS 656.005 in two sections, one of them the version as amended by chapter 78, Oregon Laws 2025, and it carries later operative dates for other units, so which text governs on which date was not established here.

Oregon Legislature, Enrolled House Bill 4040 (2026 Regular Session); OLIS measure overview (Chapter 109) →

first recorded 2026-10-10 · last read 2026-11-09

Rhode Island

Already in force (1)

Recently effective

APRNs added to the Mental Health Law's immunity provision, subject to a fraud and gross-negligence exception (S 2978, enacted June 19, 2026 as P.L. 2026 ch. 229)

S 2978, introduced March 4, 2026, was enacted June 19, 2026 as P.L. 2026, ch. 229; its House companion H 7634 was enacted the same day as ch. 228. The act amends R.I. Gen. Laws 40.1-5-41, whose heading changes from 'Immunity of physicians and surgeons from liability' to 'Immunity from liability', and takes effect upon passage. It has two limbs. An advanced practice registered nurse licensed in this state, having met the requirements either of the statute or of the chapter, may not be made to answer in any court for participation in any proceeding under the Mental Health Law except upon a showing of actual fraud or gross, willful or wanton negligence. Separately, the APRN may not be made to answer for damage or injury arising out of a patient's exercise of rights protected by the chapter, including discharge, where that exercise contravenes the clinician's written orders, prescription or advice. The gross, willful or wanton negligence exception is new: the prior physician-only text fell only to a showing of actual fraud, so this is not identical to the immunity physicians previously held. The published public-law page has lost its strike and insert markup, so whether 'physician or surgeon' was retained alongside the APRN reference or replaced by it cannot be settled from it. This chiefly matters for psychiatric NPs doing certification and commitment work.

Rhode Island General Assembly, P.L. 2026, ch. 229 (S 2978), enacted text →

first recorded 2026-08-11 · last read 2026-11-09

Utah

Already in force (1)

Recently effective

SB 31 scope expansion effective May 6, 2026 — APRN minor-surgery authority sunsets July 1, 2028

Expected — July 1, 2028 — APRN (and PA) minor surgical procedures authority repeals unless the legislature extends it

SB 31, Office of Professional Licensure Review Amendments (signed by Gov. Cox March 17, 2026; effective May 6, 2026), permits APRNs to perform minor surgical procedures, gives CRNAs prescriptive authority immediately before and after a procedure, extends the registered nurse apprentice window, and repeals-and-reenacts Nurse Practice Act sections 58-31b-102 and 58-31b-302 while amending several other 58-31b sections. The new minor-surgical-procedures authority carries an explicit repeal date of July 1, 2028, so a Utah NP adding procedural services should track whether the 2028 legislature renews it. Full practice authority (SB 36, 2023) is otherwise unchanged.

Utah Legislature, 2026 S.B. 31 (enrolled); Gov. Cox signing list, Mar 17, 2026 →

first recorded 2026-08-11 · last read 2026-11-09

Vermont

Already in force (2)

Recently effective

Act 92 (S.163): APRNs recognized as hospital attending clinicians — effective May 6, 2026

Act 92 amends hospital licensure requirements and the Bill of Rights for Hospital Patients so an APRN (or PA), not only a physician, may serve as the attending clinician responsible for coordinating a hospital patient's care and signing patient records, with Office of Professional Regulation discipline attached to non-compliance. Vermont's full-practice-authority framework is otherwise unchanged — for an NP this removes a statutory ambiguity around hospital attending status rather than altering licensure.

Vermont General Assembly, Act No. 92 (2026) official act summary →

first recorded 2026-08-11 · last read 2026-10-10

Recently effective

Vermont Act 119 drops the practice-requirement line from the APRN renewal application — the transition-to-practice requirement itself is unchanged

26 V.S.A. § 1614 now lists two items on an APRN license renewal application: documentation of a current certification by a national APRN specialty certifying organization, and a current collaborative provider agreement if required for transition to practice. Its history note reads “amended … 2025, No. 119 (Adj. Sess.), § 14, eff. June 8, 2026.” The statute page shows only today’s text, with no prior version and no diff, so the change itself is verified against the enacted act: Act 119 of 2026 (H.588), § 14, at https://legislature.vermont.gov/Documents/2026/Docs/ACTS/ACT119/ACT119%20As%20Enacted.pdf, page 17, which strikes “completion of the APRN practice requirement;” and “(2) possession of” and renumbers “(3)” to “(2)”. Act 119 § 20(a) makes §§ 13–17 effective on passage and the Governor signed the bill on June 8, 2026; other parts of the same act take effect September 1 and December 1, 2026. What this does not change: the transition-to-practice requirement and the collaborative provider agreement stand — Act 119 amends no other section of 26 V.S.A. chapter 28, and the surviving item still turns on whether an agreement is “required for transition to practice.” A Vermont nurse practitioner still completes transition to practice; the renewal application no longer asks for a separate document proving the practice requirement was met.

Vermont General Assembly, Vermont Statutes Online, 26 V.S.A. § 1614 (with Act 119 of 2026, H.588, § 14 as enacted) →

first recorded 2026-11-09 · last read 2026-11-09

Virginia

Rulemaking in progress

Boards of Nursing and Medicine propose amending APRN licensure and prescriptive-authority regulations (NOIRA approved September 13, 2026; Register publication scheduled November 30, 2026)

Expected — The notice is scheduled for publication in the Virginia Register on November 30, 2026, which opens a public comment forum through December 30, 2026.

After a 2026 periodic review, the Boards of Nursing and Medicine filed a Notice of Intended Regulatory Action (Action 7020) to amend 18VAC90-30 (APRN licensure) and 18VAC90-40 (APRN prescriptive authority). The Governor's review was completed and approved on 9/13/2026, and the stage was submitted to the Registrar on 11/5/2026. The boards will consider clarity cleanup, removing obsolete prescriptive-authority language, removing copied Code language, coordinating with legislative changes from the last ten years, and updating opioid and buprenorphine prescribing rules to match federal changes, Board of Medicine changes and a 2024 advisory panel. No draft text has been submitted. The Town Hall page says the stage is awaiting publication and will be published on 11/30/2026 (Volume 43, Issue 8), and that a public comment forum will open on 11/30/2026 and remain open through 12/30/2026.

Virginia Regulatory Town Hall, Board of Nursing, Action 7020 NOIRA stage 11191 and Agency Background Document (TH-01, prepared 6/4/2026) →

first recorded 2026-10-10 · last read 2026-11-09

Washington

Enacted, not yet effective

ARNP title becomes APRN statewide on June 30, 2027 (HB 2416, 2024)

Expected — June 30, 2027 — title change takes effect

The Board of Nursing states that the change becomes effective June 30, 2027, when all licensed ARNPs will hold the APRN title and licence, under a bill from the 2023-2024 legislative session. For official legal documents, prescriptions, and other instances where legally accurate reference to the actual licence held is needed, WABON says the term ARNP should be used until the bill takes effect. For currently licensed ARNPs it is fine to use either ARNP or APRN in ads, on business cards, signage or stationery, and WABON states it will not consider the use of the new title APRN to be misleading or inaccurate. The Board lists places that may be impacted by the change, including but not limited to business bylaws, forms, electronic health records and patient documentation, and billing documents; it sets no deadline for updating them and addresses that guidance to employers reviewing their document inventory and archives. WABON says it will offer title-change support sessions, webinars and quarterly updates through its website, GovDelivery bulletins and public meetings in the months leading up to the change.

Washington State Board of Nursing, ARNP Title Change (HB 2416) →

first recorded 2026-08-11 · last read 2026-11-09

Rulemaking in progress

Board of Nursing filed its Phase 2 CR-102 on advanced practice and pain management rules October 6, 2026; hearing and intended adoption November 13, 2026

Expected — Date of intended adoption: 11/13/2026 (Note: This is NOT the effective date)

The Board of Nursing filed a CR-102 notice dated October 6, 2026 on its advanced practice and pain management rules, amending WAC 246-840-010 and 246-840-300 through 246-840-4990 as Phase 2 of four phases of its review of chapter 246-840 WAC under RCW 43.70.041. A hybrid hearing is set for 11/13/26, and the notice gives 11/13/2026 as the intended adoption date while stating that this is not the effective date. After workshops on August 7 and August 11, 2026 the Board extended the period in which an initial applicant may qualify without supervised practice from one year to two, standardized supervised advanced clinical practice into 250- and 500-hour tiers based on the length of time since graduation or advanced clinical practice, cut the maximum from 1,000 hours to 500, integrated prescriptive authority into initial ARNP licensure, and modernizes pain management standards. The proposal loosens an existing requirement rather than adding one, and these hours are a pre-licensure condition on applicants, not on licensed ARNPs, so a licensed Washington ARNP's full practice authority is unchanged. An applicant who does owe hours practises under an ARNP interim permit that expires one year after application, must use the designation interim ARNP, and needs board approval of a supervisor in the same specialty who has held an unrestricted licence for two or more years and is not immediate family or otherwise conflicted; for such an applicant the interim permit is required, and it is optional only for someone returning an expired ARNP licence to active status. Supervised hours are also required of an applicant whose programme does not meet WAC 246-840-543, regardless of elapsed time, and of applicants educated outside US jurisdictions. An applicant with an active unrestricted RN licence, current CCNS certification and Washington advanced practice is exempt on evidence of 250 hours within the last two years. Written comments are due October 23, 2026 at 11:59 p.m., three weeks before the hearing; oral comment is still taken at the November 13 hearing, for which the notice gives a Zoom registration link.

Washington State Board of Nursing, CR-102 Proposed Rule Making: advanced practice and pain management rules, October 6, 2026 →

first recorded 2026-10-10 · last read 2026-11-09

Already in force (1)

Recently effective

NCQAC eliminated proof of 250 clinical practice hours for ARNP renewal and interstate endorsement in 2020 (WAC 246-840-342, -360) — still in effect

The Board of Nursing's announcement (May 6, 2020) states the commission adopted amendments eliminating the requirement that ARNPs submit proof of 250 clinical practice hours at license renewal or initial interstate endorsement, deferring instead to maintenance of active national certification; the change was proposed as WSR 20-03-125 (CR-102 filed January 17, 2020) and has been in effect since 2020 (WAC 246-840-342's history notes WSR 20-10-015, effective April 24, 2020), and the current WAC 246-840-342 text on the legislature's site carries no such proof requirement. This lowers a documentation barrier for out-of-state NPs endorsing into Washington — already a full-practice-authority state — but it is settled 2020 policy, not a recent change. (WSR 25-20-086, filed September 30, 2025, is an unrelated CR-102 covering RN/LPN licensure rules.)

Washington State Board of Nursing (NCQAC), Adopted Amendments to ARNP Clinical Practice Hour Requirements →

first recorded 2026-08-11 · last read 2026-11-09

Wisconsin

Already in force (1)

Recently effective

APRN Modernization Act (2025 Act 17) took effect September 1, 2026; independence after 7,680 verified hours, subject to pain-management and employer exceptions

2025 Wisconsin Act 17 was enacted August 8, 2025 and published August 9, 2025. Section 173 provides that the act takes effect on the first day of the 13th month beginning after publication, which is September 1, 2026. On that day the board must grant an APRN licence to each individual who, the day before, was certified to issue prescription orders under the repealed s. 441.16. New Wis. Stat. 441.09(3m)(b) lets an APRN to whom the collaboration default applies practise in a recognized role without being supervised by or collaborating with a physician or dentist — except as provided in pars. (bg) 1. and (c) — if the board verifies, on application, 3,840 hours of professional nursing in a clinical setting and 3,840 clinical hours of APRN practice in that role while working with a physician or dentist who was immediately available for consultation and accepted responsibility for the APRN's actions during those hours, with at least 24 months elapsed for each. Two limits survive that verification. Invasive treatment of pain syndromes still requires a collaborative relationship with a physician who specialises in pain management, unless the APRN is independently qualified and practising in a hospital or hospital-associated clinic or holds hospital privileges. And an employer may impose additional requirements as a condition of employment. Separately, s. 441.09(5) requires continuous malpractice liability insurance at the s. 655.23(4) health-care-provider amounts, and s. 441.09(1)(b)4. lets the board place specific limitations on any APRN licence. Certified nurse-midwives sit outside this path, because s. 441.09(3m)(a)2. exempts them from the collaboration default. The Board's own emergency rule document records approval by the Governor on July 2, 2026 and, per Act 17, such a rule is effective for two years after promulgation or until permanent rules take effect, whichever is sooner.

Wisconsin Legislature, 2025 Wisconsin Act 17 (enacted August 8, 2025; published August 9, 2025) →

first recorded 2026-08-11 · last read 2026-11-05

Wyoming

Enacted, not yet effective

APRN Compact enacted (codified at W.S. 33-21, Art. 3) but dormant until seven states join

The Wyoming State Board of Nursing's APRN Compact page states the compact 'will be implemented when 7 states have enacted the legislation' — Wyoming has codified it (Wyoming Statutes Title 33, Ch. 21, Article 3) but no multistate APRN license exists yet, and no activation date can honestly be given. Wyoming is otherwise quiet: already full practice authority, no NP practice-authority bills emerged from the February 9 – March 11, 2026 budget session, and no open WSBN APRN rulemaking was found. For a Gale NP, Wyoming is a stable FPA state whose one datable future event is the compact's seven-state trigger.

Wyoming State Board of Nursing, APRN Compact page →

first recorded 2026-08-11 · last read 2026-11-09

Closed

No longer on the watch

These items left the dataset. They keep their place here, with the reason they closed, because deleting an anchor someone bookmarked reads as a change nobody can check.

Closed 2026-11-05

Board of Nurse Examiners' rewritten nursing rules still listed as proposed in June 2026; legislative approval required

The only source for this item is the Guam Board of Nurse Examiners' July 10, 2025 meeting packet, transmitted to the Governor and Speaker on July 17, 2025, and its text carries nothing dated after August 14, 2025 and no 2026 material at all. It cannot establish whether the board's updated rules have since been submitted or adopted, which is the whole of what a Guam NP would want to know, so it is retired rather than shipped as a sixteen-month-old snapshot. It can return on a 2026 board agenda or minutes, a Guam Legislature measure adopting the rules, or the published adopted rules.

Guam Legislature, Doc. No. 38GL-25-0906 (GBNE board packet, July 2025) →

first recorded 2026-08-11 · last read 2026-11-05

The quiet ones

Twenty of the thirty-six jurisdictions have nothing pending we can pin to a primary source. Five of those carry nothing on the watch at all: the District of Columbia, Florida, Hawaii, the Northern Mariana Islands and South Dakota. We list them by name because an omission would leave you wondering whether we looked.

Each of those jurisdictions has its own dated, sourced page: District of Columbia · Florida · Hawaii · Northern Mariana Islands · South Dakota.