Rep. Setzer files bill in North Carolina House to define advanced nursing practice

A new bill filed by State Rep. Setzer seeks to clarify the practice and licensing framework for advanced practice registered nurses in North Carolina, according to the North Carolina State House.

The bill, filed as HB 514 on March 25 during the 2025 regular session, was formally listed with the short title: ‘APRN Definitions.’

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill defines the practice of nursing for advanced practice registered nurses (APRNs) in North Carolina, covering nurse practitioners, certified nurse midwives, certified registered nurse anesthetists, and clinical nurse specialists. It clarifies the roles of APRNs, expands their scope of practice, and introduces licensing requirements. The bill establishes a framework for licensing and renewing APRNs, grants them authority to conduct certain medical acts, and requires employers to verify licensure status before hiring. It mandates the adoption of rules by the state’s nursing, medical, and dental boards to implement its provisions. The bill includes a provision for the Governor to seek Medicare reimbursement flexibility concerning anesthesia services. It is effective 90 days after becoming law, with specific sections effective immediately upon enactment.

A related bill, SB 537, was also filed in the North Carolina Senate, introduced by Sen. Ralph Hise (and two others) on March 25, 2025.

Of the four sponsors of this bill, Donny Lambeth proposed the most bills (34) during the 2025 regular session.

Bills in North Carolina follow a multi-step process before becoming law. A lawmaker starts by filing a bill, which is assigned to a committee for review. The bill must be read three times in each chamber. If one chamber changes the bill after the other passes it, both must agree on the final version. Once both chambers approve the same bill, it goes to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or let it become law without a signature.

You can read more about the bills and other measures here.

Setzer graduated from the University of North Carolina, Greensboro in 1987 with a BA.

Setzer, a Republican, was elected to the North Carolina State House in 1999 to represent the state’s 89th House district, replacing previous state representative Robert Brawley.