NC H514

Defines in statute four categories of Advanced Practice Registered Nurses (APRNs): Certified Nurse Practitioners (CNP), Certified Nurse Midwives (CNM), Certified Registered Nurse Anesthetists (CRNA), and Clinical Nurse Specialists (CNS)

Removes physician supervision requirements for APRNs, allowing them to practice independently to the full extent of their education and training, including prescribing medications and ordering diagnostic tests

Establishes a new APRN licensure system under the North Carolina Board of Nursing with fees up to $100 for initial application and $100 for two-year renewals

Repeals G.S. 90-18.2, the existing statute governing nurse practitioner practice agreements with physicians, and repeals Article 10A (Midwifery Practice Act)

Requires the Governor to submit a Medicare "opt-out" letter within 30 days to allow hospitals maximum flexibility for anesthesia services reimbursement; act becomes effective 90 days after becoming law