Bill > S345

This bill makes significant changes to the regulation of physician assistants (PAs), nurse practitioners (NPs), and nurse midwives in North Carolina. The bill introduces a new concept of "team-based practice" for physician assistants, which allows PAs with extensive clinical experience (over 4,000 hours total and 1,000 hours in a specific medical specialty) to practice with greater autonomy. In team-based settings, such as medical practices where physicians collectively own the practice and actively participate in patient care, PAs can now perform medical acts with reduced direct physician supervision. The bill also transfers regulatory authority for nurse practitioners and nurse midwives exclusively to the North Carolina Board of Nursing, removing the previous joint oversight with the Medical Board. This change gives the Board of Nursing sole responsibility for creating and enforcing rules governing the practice of NPs and nurse midwives. Additionally, the bill modifies various licensing and practice requirements for PAs, NPs, and nurse midwives, such as allowing PAs to authenticate documents, clarifying prescribing authorities, and establishing new guidelines for independent practice. The legislation aims to expand healthcare professionals' scope of practice while maintaining patient safety through experience-based practice standards and collaborative healthcare team approaches.

Government Affairs, Health and Social Services

https://www.ncleg.gov/BillLookUp/2025/S345