H.B. No. 3794 seeks to enhance the licensing and regulation of advanced practice registered nurses (APRNs) in Texas, particularly regarding their independent practice and prescribing authority. The bill introduces new definitions and clarifications for APRNs, including nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists. It establishes independent practice for APRNs authorized by the Texas Board of Nursing, allowing them to perform diagnostic tests, formulate diagnoses, prescribe medications, and provide primary care. The bill also mandates the board to set rules for the application process, eligibility requirements, and continuing education for APRNs seeking independent practice. Additionally, it addresses reimbursement for services provided by independent APRNs under certain government employee health plans, ensuring they are compensated fairly unless a supervising physician has made a care decision on the same day.

The bill amends various sections of the Occupations Code to expand the definition of "practitioner" to include APRNs authorized to prescribe and order drugs and devices. It clarifies that APRNs can communicate prescriptions and dispense dangerous drugs in certain rural areas, and they may maintain a supply of dangerous drugs in their offices for dispensing to patients in areas with limited pharmacy access. The bill also updates definitions related to orthotics and prosthetics to include APRNs and physician assistants under physician supervision. It mandates that the Texas Board of Nursing adopt necessary rules by February 1, 2026, to implement these changes, with the bill set to take effect on September 1, 2025. Overall, the legislation aims to streamline healthcare delivery, improve access to care, and recognize the essential roles of APRNs and physician assistants 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 773, Education Code 61, Insurance Code 1452, Occupations Code 301, Human Resources Code 32, Occupations Code 157, Education Code 38, Labor Code 408, Health and Safety Code 481, Human Resources Code 42, Health and Safety Code 401, Health and Safety Code 157, Health and Safety Code 483, Occupations Code 1701, Occupations Code 605, Government Code 671, Health and Safety Code 47, Estates Code 502, Occupations Code 551, Occupations Code 563, Insurance Code 843, Occupations Code 203, Health and Safety Code 301)