New law eliminates direct physician supervision requirement for some NPs, allowing for full practice authority

In April 2018, Governor Ralph Northam signed House Bill 793, which will allow Virginia Nurse Practitioners (NPs) with the equivalent of five years of full-time practice with a collaborating physician to be certified to practice independently.  What does this mean for NPs in Virginia? Practically speaking, if a nurse practitioner meets the qualifications and makes the appropriate filings with the Board of Nursing, he or she can open up an independent practice to provide care in their community. This change aligns Virginia law with more than twenty other states across the country in adopting full practice authority and is expected to expand access to affordable primary care to thousands of Virginians. 

When does the new law go into effect?

The Committee of the Joint Boards of Nursing and Medicine met on May 17, 2018 to draft emergency regulations that will go into effect no later than 280 days after the bill was signed into law (January 9, 2019). Once those regulations go into effect, NPs will be able to apply for full practice authority through the process to be outlined in the emergency regulations.  If the draft regulations are adopted by the Board of Nursing on July 17th and the Board of Medicine on August 3rd, it is anticipated that the Boards will begin receiving applications in December. You can follow the draft regulations process HERE.  The current comment period on the proposed regulations runs through June 21, 2018. 

I’m an NP. Am I qualified for independent practice certification?

In order to qualify for certification by the Board of Nursing, the law required the following elements be met:

1.    NP must have the equivalent of five (5) years of full-time clinical experience.

2.    The NP has to file an attestation from his or her patient care team physician with the Board of Nursing that states: 

a.    The physician served on a patient care team with the NP pursuant to a practice agreement;

b.    The physician routinely practiced with a patient population and in a practice area for which the NP was certified and licensed; 

c.    The time period that the physician practiced with the NP under the practice agreement.

What are the practice restrictions for certified NPs?

Once certified, an NP may only practice within the scope of his or her clinical and professional training, knowledge and experience, consistent with the applicable standards of care. In addition, the NP must consult and collaborate with other health care providers based on the clinical conditions of the patient and establish a plan for referring complex medical cases and emergencies to physicians or other appropriate healthcare providers.  

What are the practice restrictions for certified NPs.jpg


Nixon Law Group loves Nurses! If you are a qualified nurse practitioner and have questions or require assistance in setting up an autonomous practice in Virginia, please Contact Us. Also, make sure to sign up for NLG e-mail updates for the latest summaries and other healthcare happenings.