S.B. No. 1859 seeks to improve the licensing and regulation of advanced practice registered nurses (APRNs) in Texas, while also establishing their reimbursement structure within certain government employee health plans. The bill defines "advanced practice registered nurse" to include nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists, and introduces new terms related to nursing practice. It outlines the responsibilities and scope of practice for APRNs, granting them the authority to independently prescribe medications and perform diagnostic tests, contingent upon meeting specific educational and training requirements. The bill also mandates that health plans reimburse services provided by independent APRNs at rates comparable to those for physicians, unless a supervising physician has made a treatment decision on the same day.

Additionally, the bill amends various sections of the Insurance Code, Education Code, and Health and Safety Code to enhance the roles of APRNs and physician assistants (PAs) in the healthcare system. It requires that administrators of basic and primary care coverage plans reimburse independent APRNs at applicable rates and mandates physicians to certify claims for reimbursement when they do not make a decision on the same day an APRN provides care. The bill also allows APRNs to be designated as primary care providers for medical assistance recipients and to prescribe durable medical equipment. Furthermore, it expands the definition of "practitioner" to include APRNs authorized to prescribe and order drugs and devices, and it mandates the Texas Board of Nursing to adopt necessary rules by February 1, 2026, to implement these changes. The effective date for the bill is set for September 1, 2025.

Statutes affected:
Introduced: Occupations Code 301.002, Occupations Code 301.005, Occupations Code 301.152, Occupations Code 301.303, Education Code 38.151, Education Code 38.211, Education Code 38.225, Education Code 61.601, Estates Code 502.002, Government Code 671.001, Health and Safety Code 47.011, Health and Safety Code 301.152, Health and Safety Code 401.504, Health and Safety Code 481.002, Health and Safety Code 157.0511, Health and Safety Code 481.076, Health and Safety Code 481.0767, Health and Safety Code 483.001, Health and Safety Code 483.022, Health and Safety Code 301.358, Health and Safety Code 773.0145, Human Resources Code 32.024, Human Resources Code 32.03141, Human Resources Code 42.067, Insurance Code 843.312, Insurance Code 1452.051, Labor Code 408.025, Occupations Code 157.051, Occupations Code 203.002, Occupations Code 551.003, Occupations Code 157.0511, Occupations Code 563.053, Occupations Code 605.002, Occupations Code 605.2515, Occupations Code 1701.703 (Health and Safety Code 301, Estates Code 502, Human Resources Code 32, Health and Safety Code 773, Occupations Code 551, Human Resources Code 42, Occupations Code 203, Insurance Code 843, Health and Safety Code 401, Education Code 38, Occupations Code 605, Education Code 61, Occupations Code 301, Health and Safety Code 481, Insurance Code 1452, Occupations Code 563, Government Code 671, Occupations Code 157, Occupations Code 1701, Health and Safety Code 157, Labor Code 408, Health and Safety Code 483, Health and Safety Code 47)