NC H277

Modernizes North Carolina nursing regulations by establishing licensure for Advanced Practice Registered Nurses (APRNs) with four designated roles: Nurse Practitioner (NP), Certified Nurse Midwife (CNM), Clinical Nurse Specialist (CNS), and Certified Registered Nurse Anesthetist (CRNA).

Grants APRNs independent prescribing, ordering, dispensing, and furnishing authority, removing the requirement for joint oversight with the Medical Board and replacing it with Board of Nursing authority under G.S. 90-171.20.

Repeals G.S. 90-18.2 (the prior nurse practitioner supervision statute) and establishes new APRN licensure provisions including grandfathering exceptions for individuals recognized as APRNs by December 31, 2021, with automatic license renewal requirements.

Clarifies the scope of practice for each APRN role, defining specific components including advanced assessment, ordering diagnostic studies, prescribing therapies, and consulting with other healthcare providers as warranted by patient needs.

Requires the Governor to submit a Medicare "opt-out" letter to the Centers for Medicare and Medicaid Services within 30 days to allow maximum flexibility for hospitals and surgical centers regarding anesthesia services reimbursement; becomes effective October 1, 2021.