PRINTER'S NO. 456
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No. 507
Session of
2025
INTRODUCED BY BROWN, J. WARD, COMITTA, BAKER, SCHWANK,
PENNYCUICK, FONTANA, COSTA, CAPPELLETTI, HAYWOOD, SAVAL AND
VOGEL, MARCH 21, 2025
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE,
MARCH 21, 2025
AN ACT
1 Amending the act of December 20, 1985 (P.L.457, No.112),
2 entitled "An act relating to the right to practice medicine
3 and surgery and the right to practice medically related acts;
4 reestablishing the State Board of Medical Education and
5 Licensure as the State Board of Medicine and providing for
6 its composition, powers and duties; providing for the
7 issuance of licenses and certificates and the suspension and
8 revocation of licenses and certificates; provided penalties;
9 and making repeals," further providing for definitions, for
10 midwifery and for nurse-midwife license; and providing for
11 certified midwife license.
12 The General Assembly of the Commonwealth of Pennsylvania
13 hereby enacts as follows:
14 Section 1. The definitions of "medical training facility"
15 and "midwife or nurse-midwife" in section 2 of the act of
16 December 20, 1985 (P.L.457, No.112), known as the Medical
17 Practice Act of 1985, are amended to read:
18 Section 2. Definitions.
19 The following words and phrases when used in this act shall
20 have the meanings given to them in this section unless the
21 context clearly indicates otherwise:
 1 * * *
2 "Medical training facility." A medical college, hospital or
3 other institution which provides courses in the art and science
4 of medicine and surgery and related subjects for the purpose of
5 enabling a matriculant to qualify for a license to practice
6 medicine and surgery, graduate medical training, [midwife]
7 nurse-midwife certificate or physician assistant license.
8 * * *
9 "Midwife [or nurse-midwife]." An individual who is licensed
10 as a [midwife] nurse-midwife under section 35 or a certified
11 midwife under section 35.1 by the board.
12 * * *
13 Section 2. Section 12(b) of the act is amended to read:
14 Section 12. Midwifery.
15 * * *
16 (b) Use of title.--A [midwife may ] nurse-midwife and a
17 certified midwife may also use the title midwife[, nurse-
18 midwife] or an appropriate abbreviation of [those titles] the
19 title.
20 * * *
21 Section 3. Section 35(c) and (d) of the act are amended and
22 the section is amended by adding subsections to read:
23 Section 35. Nurse-midwife license.
24 * * *
25 (c) Authorization.--
26 (1) A nurse-midwife is authorized to practice midwifery
27 [pursuant to a collaborative agreement with a physician and
28 regulations promulgated by the board.] under the following
29 conditions:
30 (i) A nurse-midwife who is not an employee of a
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 1 public or private health system, hospital, licensed birth
2 center or part of an interdisciplinary group practice in
3 which at least one physician practices in the specialty
4 area of the care provided by the nurse-midwife shall
5 practice under a collaborative agreement with a physician
6 or physician interdisciplinary group practice in
7 accordance with the regulations promulgated by the board.
8 (ii) A nurse-midwife who is an employee of a public
9 or private health system, hospital or licensed birth
10 center or part of an interdisciplinary group practice in
11 which at least one physician practices in the specialty
12 area of the care provided by the nurse-midwife shall
13 obtain and maintain clinical staff privileges at the
14 public or private health system, hospital or licensed
15 birth center and shall adhere to the established internal
16 mechanisms at the facility of the public or private
17 health system, hospital or licensed birth center for
18 quality improvement, consultation, collaboration or
19 referral in accordance with the nurse-midwife's clinical
20 practice privileges and the facility's policies and
21 procedures as approved by the Department of Health.
22 (2) A nurse-midwife who possesses a master's degree or
23 its substantial equivalent and national certification may
24 prescribe, dispense, order and administer drugs, including
25 legend drugs and Schedule II through Schedule V controlled
26 substances, as defined in the act of April 14, 1972 (P.L.233,
27 No.64), known as The Controlled Substance, Drug, Device and
28 Cosmetic Act, provided that the nurse-midwife demonstrates to
29 the board that:
30 (i) The nurse-midwife has successfully completed at
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 1 least 45 hours of coursework specific to advanced
2 pharmacology at a level above that required by a
3 professional nursing education program.
4 (ii) As a condition of biennial license renewal by
5 the board, a nurse-midwife shall complete the continuing
6 education requirement as required by the act of May 22,
7 1951 (P.L.317, No.69), known as The Professional Nursing
8 Law. In case of a nurse-midwife who has prescriptive
9 authority under this act, the continuing education
10 required by The Professional Nursing Law shall include at
11 least 16 hours in pharmacology in that two-year period.
12 [(iii) The nurse-midwife acts in accordance with a
13 collaborative agreement with a physician which shall at a
14 minimum identify the categories of drugs from which the
15 nurse-midwife may prescribe or dispense and the drugs
16 which require referral, consultation or comanagement.]
17 (iv) The nurse-midwife acts in accordance with the
18 following restrictions:
19 (A) A nurse-midwife shall not prescribe,
20 dispense, order or administer a controlled substance
21 except for a woman's acute pain[.], for a woman's
22 medication-assisted treatment for opioid use disorder
23 or for primary gynecologic health conditions.
24 (B) In the case of a Schedule II controlled
25 substance for acute pain, the dose shall be limited
26 to 72 hours and shall not be extended except with the
27 approval of [the] a collaborating physician.
28 (C) In the case of a Schedule III or IV
29 controlled substance, the prescription shall be
30 limited to 30 days and shall only be refilled with
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 1 the approval of [the] a collaborating physician.
2 [(B) A nurse-midwife shall prescribe, dispense,
3 order or administer psychotropic drugs only after
4 consulting with the collaborating physician.]
5 (D) A nurse-midwife when working with a
6 physician or physician group prescribing medication
7 treatment for opioid use disorder may prescribe,
8 dispense, order and administer United States Food and
9 Drug Administration-approved prescription drugs,
10 including buprenorphine, methadone and naltrexone,
11 for medication-assisted treatment for opioid use
12 disorders consistent with Federal laws and
13 regulations.
14 (3) A nurse-midwife may, [in accordance with a
15 collaborative agreement with a physician and] consistent with
16 the nurse-midwife's academic educational preparation and
17 national certification, prescribe, dispense, order and
18 administer:
19 (i) Medical devices.
20 (ii) Immunizing agents.
21 (iii) Laboratory tests.
22 (iv) Therapeutic, diagnostic and preventative
23 measures.
24 [(d) Collaborative agreements.--The physician with whom a
25 nurse-midwife has a collaborative agreement shall have hospital
26 clinical privileges in the specialty area of the care for which
27 the physician is providing collaborative services.]
28 (e) Consultation, collaboration or referral.--
29 (1) A nurse-midwife who is an employee of a public or
30 private health system, hospital or licensed birth center or
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 1 part of an interdisciplinary group practice in which at least
2 one physician practices in the specialty area of the care
3 provided by the nurse-midwife shall identify deviations from
4 normal and appropriate interventions, including the
5 management of complications and emergencies utilizing
6 consultation, collaboration or referral to or with a
7 physician as indicated by the health status of a patient. A
8 consultation between a nurse-midwife and a physician shall
9 not alone establish a physician-patient relationship or any
10 other legal relationship with the physician. A nurse-midwife
11 shall be solely responsible for the services the nurse-
12 midwife provides to a patient.
13 (2) In order to maintain safe midwifery practice during
14 a collaboration with a physician, a nurse-midwife shall, at a
15 minimum, take all of the following actions:
16 (i) Maintain a medical record for each patient.
17 (ii) In the case of a transfer of care to another
18 health care provider or facility, transfer a patient's
19 medical records to the health care provider or facility.
20 (f) Disclosures.--A nurse-midwife who is not an employee of
21 a public or private health system, hospital or licensed birth
22 center or part of an interdisciplinary group practice in which
23 at least one physician practices in the specialty area of the
24 care provided by the midwife shall disclose, verbally and in
25 written form, the information specified in paragraphs (1) and
26 (2) to a prospective patient at the beginning of the
27 professional relationship between nurse-midwife and the patient.
28 The discussion must be documented by the use of a disclosure
29 form. The patient shall sign and date the disclosure under this
30 subsection at the same time the nurse-midwife and patient enter
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 1 into an agreement for services. The nurse-midwife shall file the
2 disclosure under this subsection in the patient's medical
3 record. The disclosure shall include all the following
4 information:
5 (1) The nurse-midwife's name.
6 (2) The patient's name, contact information and the name
7 of the patient's primary care provider, if applicable.
8 (3) An individual emergency plan established between the
9 nurse-midwife and patient. The plan shall include all of the
10 following:
11 (i) The patient's name, address and telephone
12 number.
13 (ii) The arrangements for transport from the
14 delivery site to a nearby hospital with obstetric
15 services.
16 (iii) The name, address and telephone number of the
17 hospital with obstetric services that will be used for an
18 emergency transfer.
19 (iv) The name, address and telephone number of the
20 hospital with obstetric services that will be used for a
21 nonemergency transfer.
22 (v) The name and telephone number of the
23 collaborating physician or another physician, group
24 practice, public or private health system or hospital
25 with which the nurse-midwife has a collaborative
26 agreement or which provides backup care or co-management
27 care to the patient.
28 Section 4. The act is amended by adding a section to read:
29 Section 35.1. Certified midwife license.
30 (a) License.--A certified midwife license shall empower the
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 1 licensee to practice midwifery in this Commonwealth as provided
2 in this act. The board shall issue rules and promulgate
3 regulations as may be necessary for the examination, licensing
4 and proper conduct of the practice of midwifery.
5 (b) Requirements.--An applicant for a certified midwife
6 license must have completed an academic and clinical program of
7 study in midwifery which has been approved by the board or an
8 accrediting body recognized by the board.
9 (c) Authorization.--
10 (1) A certified midwife may practice midwifery under the
11 following conditions:
12 (i) A certified midwife who is not an employee of a
13 public or private health system, hospital or licensed
14 birth center or part of an interdisciplinary group
15 practice in which at least one physician practices in the
16 specialty area of the care provided by the midwife shall
17 practice under a collaborative agreement with a physician
18 or physician interdisciplinary group practice in
19 accordance with the regulations promulgated by the board.
20 (ii) A certified midwife who is an employee of a
21 public or private health system, hospital or licensed
22 birth center or part of an interdisciplinary group
23 practice in which at least one physician practices in the
24 specialty area of the care provided by the midwife shall
25 obtain and maintain clinical staff privileges at the
26 public or private health system, hospital or licensed
27 birth center and shall adhere to the established internal
28 mechanisms at the facility of the public or private
29 health system, hospital or licensed birth center for
30 quality improvement, consultation, collaboration or
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 1 referral in accordance with the certified midwife's
2 clinical practice privileges and the facility's policies
3 and procedures as approved by the Department of Health.
4 (2) A certified midwife who possesses a master's degree
5 or its substantial equivalent and national certification may
6 prescribe, dispense, order and administer drugs, including
7 legend drugs and Schedule II through Schedule V controlled
8 substances, as defined in the act of April 14, 1972 (P.L.233,
9 No.64), known as The Controlled Substance, Drug, Device and
10 Cosmetic Act, if the certified midwife demonstrates to the
11 board that:
12 (i) The certified midwife has successfully completed
13 at least 45 hours of coursework specific to advanced
14 pharmacology during the individual's midwifery education.
15 (ii) As a condition of biennial license renewal by
16 the board, a certified midwife shall complete at least 16
17 hours of continuing education in pharmacology in that
18 two-year period. Beginning with the license period
19 designated by regulation, licensees shall be required to
20 attend and complete 30 hours of mandatory continuing
21 education during each two-year license period. Nationally
22 certified education courses shall be considered as
23 creditable, in addition to any other courses the board
24 deems creditable toward meeting the requirements for
25 continuing education.
26 (iii) An individual applying for the first time for
27 licensure in this Commonwealth shall be exempted from the
28 continuing education requirement for the biennial renewal
29 period following initial licensure.
30 (iv) The certified midwife acts in accordance with
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 1 the following restrictions:
2 (A) A certified midwife shall not prescribe,
3 dispense, order or administer a controlled substance
4 except for a woman's acute pain, for a woman's
5 medication assisted treatment for opioid use
6 disorder, or for primary gynecologic health
7 conditions.
8 (B) For a Schedule II controlled substance for
9 acute pain, the dose shall be limited to 72 hours and
10 shall not be extended except with the approval of a
11 collaborating physician.
12 (C) For a Schedule III or IV controlled
13 substance, the prescription shall be limited to 30
14 days and shall only be refilled with the approval of
15 a collaborating physician.
16 (D) A certified midwife, when working with a
17 physician or physician group prescribing medication
18 treatment for opioid use disorder, may prescribe,
19 dispense, order and administer United States Food and
20 Drug Administration-approved prescription drugs,
21 i