S.B. No. 1859 seeks to enhance the licensing and regulation of advanced practice registered nurses (APRNs) in Texas, establishing their independent practice and payment structures within government employee health plans. The bill defines "advanced practice registered nurse" to include roles such as nurse practitioners and nurse anesthetists, and introduces new sections to the Occupations Code, specifically Sections 301.357 and 301.358, which outline the scope of practice for APRNs, including their ability to order diagnostic tests, prescribe medications, and serve as primary care providers. Additionally, the bill mandates that health care services provided by independent APRNs be reimbursed at applicable rates unless a supervising physician has made a care decision on the same day.

The legislation also amends various sections of the Insurance Code and Education Code, clarifying the authority of APRNs to prescribe medications and order medical devices. It requires a report on cost savings from these changes to be submitted by December 1, 2026, and specifies that the new provisions will apply to healthcare services provided on or after January 1, 2026. Furthermore, the bill expands the definition of "practitioner" to include APRNs authorized to prescribe and order drugs and devices, and it mandates that the Texas Board of Nursing adopt necessary rules by February 1, 2026, to implement these changes. The bill is set to take effect on September 1, 2025, aiming to streamline healthcare delivery and improve access to care by recognizing the essential roles of APRNs in the medical field.

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 481, Occupations Code 301, Health and Safety Code 47, Health and Safety Code 773, Health and Safety Code 401, Occupations Code 1701, Occupations Code 203, Estates Code 502, Labor Code 408, Insurance Code 843, Insurance Code 1452, Occupations Code 551, Occupations Code 605, Health and Safety Code 483, Education Code 38, Human Resources Code 32, Education Code 61, Occupations Code 157, Human Resources Code 42, Health and Safety Code 157, Government Code 671, Occupations Code 563, Health and Safety Code 301)