SESSION OF 2022
SUPPLEMENTAL NOTE ON SENATE SUBSTITUTE FOR
HOUSE BILL NO. 2279
As Recommended by Senate Committee on
Public Health and Welfare

Brief*
Senate Sub. for HB 2279 would amend provisions in the
Kansas Nurse Practice Act (Act) governing the licensure of
advanced practice registered nurses (APRNs) to, among
other things, allow an APRN to prescribe drugs without a
written protocol as authorized by a responsible physician,
require an APRN to maintain malpractice insurance, and
require national certification for initial licensure as an APRN.
The bill also would modify the definition of “mid-level
practitioner” in both the Pharmacy Act of the State of Kansas
(Kansas Pharmacy Act) and the Uniform Controlled
Substances Act to conform with amendments to the written
protocol requirements within the Act.
The bill also would make technical amendments.
National Certification
The bill would require an applicant for initial licensure as
an APRN, on and after July 1, 2023, to have a current APRN
certification in such applicant’s specific role and population
focus granted by a national certifying organization recognized
by the Board of Nursing (Board) and whose certification
standards are approved by the Board as equal to or greater
than the corresponding standards established by the Board.
The bill would require an APRN whose initial licensure was
granted prior to July 1, 2023, to submit evidence of such
certification to the Board upon renewal.
____________________
*Supplemental notes are prepared by the Legislative Research
Department and do not express legislative intent. The supplemental
note and fiscal note for this bill may be accessed on the Internet at
http://www.kslegislature.org
Prescriptive Authority
The bill would remove language in the Act that currently
permits an APRN to prescribe drugs pursuant to a written
protocol as authorized by a responsible physician. The bill
would instead allow an APRN to prescribe durable medical
equipment and prescribe, procure, and administer any drug
consistent with such licensee’s specific role and population
focus. The bill would specify any drug that is a controlled
substance be prescribed, procured, or administered in
accordance with the Uniform Controlled Substances Act. The
bill would also prohibit an APRN from prescribing any drug
that is intended to cause an abortion.
The bill would require an APRN, in order to prescribe
controlled substances, to comply with federal Drug
Enforcement Administration requirements related to
controlled substances.
Malpractice Insurance
The bill would require an APRN to maintain malpractice
insurance coverage as a condition of rendering professional
clinical services as an APRN in Kansas and provide proof of
insurance at the time of licensure and renewal of license.
The bill would specify the requirements related to
malpractice insurance coverage would not apply to an APRN
who:
● Practices solely in employment for which the APRN
is covered under the Federal Tort Claims Act or the
Kansas Tort Claims Act;
● Practices solely as a charitable health care
provider under the Kansas Tort Claims Act; or
● Is serving on active duty in the U.S. Armed Forces.

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Rules and Regulations
The bill would require the Board to adopt rules and
regulations consistent with the Act applicable to APRNs.
Definitions
The bill would amend the definition of “mid-level
practitioner,” as it appears in the Kansas Pharmacy Act and
the Uniform Controlled Substances Act, to mean, among
other things, a licensed APRN who has authority to prescribe
drugs under the above-described provisions of the bill.
Other Provisions
The bill would require the Board to consider the scope
and limitations of advanced practice nursing in accordance
with state laws when defining the role of ARPNs.
The bill would clarify the provisions of the Act that the bill
amends do not supersede the requirements outlined in law
related to the operation and licensure of an abortion facility.

Background
HB 2279, as introduced, would have enacted the
Physical Therapy Licensure Compact and amended the
Physical Therapy Practice Act. On February 21, 2022, the
Senate Committee on Public Health and Welfare (Senate
Committee) inserted the provisions of SB 454, as amended
by the Senate Committee, and recommended a substitute bill.
[Note: The contents of HB 2279, as amended by the
Senate Committee, were inserted into SB 170 during the
conference committee process. The bill was passed by the
Legislature and signed into law by the Governor on May 17,
2021.]

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SB 454 (Advanced Practice Registered Nurses)
SB 454 was introduced by the Senate Committee on
Public Health and Welfare.
Senate Committee on Public Health and Welfare
The Senate Committee had not held a hearing on SB
454 at the time its contents were inserted into HB 2279.
During discussion and final action on SB 454, information
from conferees was distributed to the Committee. A
representative of the National Council of State Boards of
Nursing provided proponent testimony. The proponent stated
the bill would remove unnecessary regulation and help
increase access to primary care among certain populations.
Written-only proponent testimony was provided by the
Kansas Chamber, Kansas Justice Institute, Board of Nursing,
Kansas State Nurses Association, and Mercatus Center at
George Mason University.
A representative of the Kansas Academy of Family
Physicians, Kansas Academy of Physician Assistants,
Kansas Chapter of the American Academy of Pediatrics, and
Kansas Medical Society provided opponent testimony. The
opponent stated the bill would allow APRNs to practice
medicine without the same training and regulation required of
physicians and without limitations that would protect the
public.
Written-only opponent testimony was provided by a
representative of the Kansas Association of Osteopathic
Medicine.
No other testimony was provided.
The Senate Committee amended SB 454 to:


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 ● Require the Board to consider the scope and
limitations of advanced practice nursing in
accordance with state laws when defining the role
of APRNs;
● Prohibit an APRN from prescribing any drug that is
intended to cause an abortion;
● Clarify the provisions of the Act, which the bill
would amend, do not supersede the requirements
outlined in law related to the operation and
licensure of an abortion facility; and
● Make a technical clarification.
The Senate Committee inserted the contents of SB 454,
as amended, into HB 2279 and recommended a substitute bill
be passed.
Fiscal Information
According to the fiscal note prepared by the Division of
the Budget on SB 454, as introduced, the Board states
additional fields would have to be added to the Board’s
licensure software to enable the Board to validate national
certification and malpractice insurance. The Board also would
need to communicate with all licensed APRNs and their
employers about the change in requirements. The Board
states staff would need to research the requirements of
national certifying organizations for APRNs, prepare the
information, and present the information to the Board for
approval of certification standards. The Board estimates
enactment of the bill would increase operating expenditures
by $40,600 from the Board Nursing Fee Fund for one-time
costs. Any fiscal effect associated with the bill is not reflected
in The FY 2023 Governor’s Budget Report.
Kansas Nurse Practice Act; advanced practice registered nurse; Board of Nursing;
malpractice insurance; prescriptive authority; abortion; Uniform Controlled
Substances Act; Pharmacy Act of the State of Kansas

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Statutes affected:
As introduced: 65-2920, 65-2923
As Amended by House Committee: 65-2912, 65-2920, 65-2923
{As Amended by House Committee of the Whole}: 65-2912, 65-2920, 65-2923
As Amended by Senate Committee: 65-2912, 65-2920, 65-2923
S Sub for: 65-1626, 65-4101, 65-1130, 65-4a08