HB 1253 is a smaller bill that came to fruition following a move by the legislature to break up HB 700, which was introduced in March in the Pennsylvania General Assembly. HB 700 encompasses all aspects of Pennsylvania Gov. Edward Rendell's healthcare reform plan known as “Prescription for Pennsylvania.”

HB 1253 is considered an important victory for the state's nurse practitioners as it updates “outdated regulations that unnecessarily restrict certified registered nurse practitioners' scope of practice,” according to the CCA. Under the new bill, they can carry out the following functions: Order home health and hospice care Order durable medical equipment Issue oral orders inside healthcare facilities (provided that the orders issued are in accordance with the rules, regulations and administrative procedures enforced by the healthcare facility) Perform workers' compensation physicals Issue physical therapy and dietician referrals Order respiratory and occupation therapy Perform disability assessments for the Temporary Assistance to Needy Families program Perform and sign methadone treatment evaluations (provided that any methadone is ordered by a physician) Issue home schooling certifications According to the CCA, the only limitations placed on these functions are that the Department of Health may regulate the scope of practice, supervision and oversight requirements for nurse practitioners practicing in healthcare facilities, such as hospitals. In addition, the Departments of Health and Public Welfare may regulate the types of healthcare professionals who are eligible for medical staff membership.

In addition, the bill requires all nurse practitioners practicing in the commonwealth to maintain a level of professional liability coverage that is comparable to the level of coverage a physician is legally required to maintain when providing similar healthcare services. It also states that nurse practitioners are not eligible to participate in the Medical Care Availability and Reduction of Error fund.

The original version of the bill contained a provision eliminating the regulation stating that a physician may only collaborate with four nurse practitioners at any given time. But because the nursing community and Medical Society were unable to reach a compromise on the issue, the provision was not included in the final version of the bill. While the 4-to-1-ratio requirement remains in effect under Board of Nursing regulations, the board is expected to boost the ratio within a year, according to the CCA.

Furthermore, the Pennsylvania Coalition of Nurse Practitioners and the Pennsylvania Medical Society have agreed to a three and a half year moratorium of the nurse practitioner scope of practice legislation in the state. Since its introduction, HB 700 has been stalled in the House Committee on Insurance. In order to increase the likelihood that the Prescription for Pennsylvania will be enacted, the legislature has decided to break up HB 700 into several smaller bills that cover specific aspects of the plans. Enter HB 1253, a smaller bill that covers the changes to nurse practitioners scope of practice proposed in HB 700.

Since May, members of the nursing community, primarily represented by the state's Coalition of Nurse Practitioners, have been negotiating with the state Medical Society to reach a compromise that would help the bill move out of committee. Negotiations have ended with the introduction of an amended version of HB 1253, which both the nursing community and the Medical Society have agreed to support. The amended version of the bill is expected to soon come up for vote before the House, according to the CCA.