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House adopts compromise substitute to Nurse Practice Act requiring consultation for solo APRNs and pain‑clinic practitioners
Summary
Lawmakers passed a substitute to HB 336 that narrows which advanced practice registered nurses must maintain consultation/referral agreements: new solo practitioners and those operating in pain clinics will need agreements with a physician or an APRN with three years’ experience; the substitute passed the House and will go to the Senate.
The Utah House adopted a substitute version of House Bill 336 on Feb. 26 that modifies consultation and referral requirements under the Nurse Practice Act for advanced practice registered nurses (APRNs).
Representative Dunnigan, sponsor of the substitute, described the text as a compromise between nurse‑practitioner interests and physician stakeholders, saying the substitute was intended to be a middle ground. Under the substitute, APRNs who open in solo practice or who run pain clinics must maintain a consultation and referral agreement either with a physician or with an experienced APRN (an APRN with at least three years’ experience). The substitute relieves APRNs working in group settings with available colleagues from that specific consultation requirement, and it clarifies that newly licensed APRNs in solo practice would still be subject to consult requirements.
Floor discussion included questions about which categories of APRNs would be covered by the substitute; Representative Thurston asked for clarification and the sponsor explained the distinction between solo practice and group practice. Representatives on both sides of the issue characterized the substitute as a practical compromise: it preserves oversight where the sponsor and several members said it is needed while reducing burdens on APRNs working in collaborative group settings.
A technical amendment to insert the word "solo" after the word "independent" was adopted on the floor to clarify the intent of the language. After waiver of summation, the House adopted the substitute and passed the bill by recorded vote, 68–2. The measure was transmitted to the Senate for further consideration.
What’s next: The Senate will take up the substitute; implementation details (such as enforcement and administrative guidance) will depend on the final enacted language and any rulemaking required after passage.
