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 structure within certain government employee health plans. The bill introduces new sections to the Occupations Code, specifically Sections 301.357 and 301.358, which define APRNs and outline their scope of practice, including the authority to prescribe and order drugs and devices. It also amends the Insurance Code to ensure that independent APRNs are recognized as providers under specific health plans, mandating reimbursement for their services unless a supervising physician has made a care decision on the same day.

Additionally, the bill includes provisions for network adequacy standards and requires a report on cost savings from these changes by December 1, 2026. It amends various sections of the Health and Safety Code, Occupations Code, Human Resources Code, and Insurance Code to clarify the roles of APRNs and physician assistants (PAs), allowing them to prescribe durable medical equipment and communicate prescription drug orders. The bill also expands the definition of "practitioner" to include APRNs and updates regulations related to orthotics and prosthetics. It mandates the Texas Board of Nursing to adopt necessary rules by February 1, 2026, with an effective date of September 1, 2025, aiming to improve healthcare access and efficiency in Texas.

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