The expansion of scope of practice for certified registered nurse practitioners (CRNPs) is a controversial topic. Proponents of independent scope of practice for CRNPs argue that enacting such legislation would make healthcare more accessible and affordable, especially in rural areas where there is a clear shortage of primary care providers. Opponents argue that CRNP training is not standardized and far less than the clinical training of physicians who therefore practice independently, that there is little support of either CRNPs moving to or filling gaps in care in rural areas in states that have allowed independent CRNP scope of practice, and that the evidence on comparable clinical outcomes or cost savings with independent CRNP scope of practice is quite weak or non-existent.
 
After more than a decade of this debate in our General Assembly, it is time to find a middle ground between these competing positions. We will be introducing legislation that would create a Certified Registered Nurse Practitioner Pilot Program to allow CRNPs to practice as independent practitioners in health professional shortage areas only. To qualify, CRNPs would be required to have no less than 3,600 hours of primary care experience within the prior five years under a licensed supervising physician. Additionally, this pilot program would limit CRNP independent scope of practice to family medicine, gynecology, primary care internal medicine, and primary care pediatrics. The pilot program would mandate that CRNPs practicing independently participate in the MCare Act related to malpractice coverage as physicians do. Finally, the pilot program would evaluate outcomes related to cost, accessibility, and outcomes over five years at which point the program would sunset for consideration by the legislature of further actions.
 
This pilot program passed the House unanimously during the 2019-2020 session, but unfortunately was not enacted into law. It is time for us to take action and use this opportunity to collect the necessary data to determine whether independent scope of practice for CRNPs can fulfill the claims of its proponents and answer the concerns of its opponents in the high-need areas where it is assumed that the benefit would be apparent in Pennsylvania. We ask for your co-sponsorship of this important legislation so that we can move forward with truly addressing the primary care access crisis we have in many parts of our state.

Statutes/Laws affected:
Printer's No. 1744 (May 21, 2025): P.L.317, No.69