NC S537

Establishes statutory definitions for four categories of Advanced Practice Registered Nurses (APRNs): Certified Nurse Practitioners (CNP), Certified Nurse Midwives (CNM), Clinical Nurse Specialists (CNS), and Certified Registered Nurse Anesthetists (CRNA)

Removes physician supervision requirements for APRNs, allowing them to practice independently within their scope of licensure, including prescribing medications, ordering diagnostic tests, and making treatment decisions

Creates a new APRN licensure system through the NC Board of Nursing with fees up to $100 for initial application, $100 for biennial renewal, and $180 for reinstatement

Repeals G.S. 90-18.2, which currently governs nurse practitioner practice under Medical Board oversight, and eliminates the joint Medical Board-Nursing Board subcommittee that develops rules for medical acts by nurses

Requires the Governor to submit a federal "opt-out" letter within 30 days to allow hospitals maximum flexibility for Medicare reimbursement of anesthesia services provided by CRNAs