Lawmakers consider reciprocity to speed APRN mobility as APRN compact stalls

Delegate Tom Hutchinson and the Nurse Practitioner Association of Maryland pressed the Health and Government Operations Committee to require the Maryland Board of Nursing to explore licensure reciprocity with bordering jurisdictions (Delaware, Pennsylvania, Virginia, West Virginia and the District of Columbia) under House Bill 6-02.

Supporters said reciprocity would speed licensure portability, especially for nurses practicing near state borders or providing telehealth across state lines, and would help address workforce shortages while the APRN compact remains unadopted or disputed.

Nut graf: Testimony split along practical vs. structural lines. Supporters — including Maryland nurse practitioners, military spouse advocates and patient groups — argued reciprocity is an immediate, operational way to increase APRN workforce fluidity. Opponents and some professional groups urged caution, saying a uniform APRN compact provides stronger, centralized disciplinary authority, data-sharing and clearer controls for controlled substances.

What supporters said Nurse practitioners, midwifery groups and military spouse advocates said reciprocity would allow qualified APRNs from neighboring jurisdictions to provide care in Maryland faster than a state-by-state licensing process. The sponsor cited outreach responses from neighboring boards: Virginia allows reciprocity agreements, Pennsylvania is open if standards align, West Virginia has said it supports the compact and might consider reciprocity, and Delaware has adopted the APRN compact but has mixed views on reciprocity.

What opponents said Opponents argued reciprocity lacks the centralized disciplinary mechanisms and data-sharing the APRN compact provides. A psychiatric nurse practitioner and other witnesses warned reciprocity alone would not solve issues around uniform scope of practice, controlled substances (DEA and state controlled-substance registration remain separate), and variable supervisory requirements across states.

Next steps and committee direction Supporters asked the committee for a favorable report to require the Board of Nursing to begin bilateral discussions with neighboring jurisdictions and to report annually for four years on progress. The committee noted the APRN compact’s slow adoption (only a small number of states have enacted it so far) and agreed to continue stakeholder discussions, including the Board of Nursing, national APRN organizations and employer groups.

Ending: Committee members signaled willingness to pursue both short-term reciprocity discussions and longer-term compact considerations. No formal action or vote was taken at the hearing.