Bill
HB 5681
The bill would let qualified APRNs (CNPs/CNMs) prescribe and dispense drugs without a collaborating physician, with education and oversight safeguards.
HB 5681 (West Virginia, 2026) – Summary
Purpose
- The bill aims to empower qualified certified nurse practitioners (CNPs) and certified nurse midwives (CNMs) to prescribe, administer, and dispense prescription drugs without a collaborating physician, expanding their prescriptive authority beyond current requirements.
Key Definitions and framework
- Advanced Practice Registered Nurse (APRN): Includes certified nurse practitioners and certified nurse midwives, defined as RNs with board-approved graduate education and national certification.
- Collaborative Relationship: A written agreement with a physician that currently governs prescriptive authority under existing law.
- The bill modifies and aligns definitions and regulatory language under WV’s Article 7 (Registered Professional Nurses), setting the stage for broader prescriptive authority for APRNs.
Core Provisions
- Prescriptive Authority without Collaboration: The bill states that qualified CNPs and CNMs may prescribe, administer, and dispense prescription drugs without a collaborating physician, subject to prerequisites and board rules.
- Eligibility and prerequisites for prescriptive authority (new/clarifying requirements under §30-7-15b):
- APRN must be licensed (or apply for licensure) as an APRN in WV and be at least 18.
- Must complete 45 contact hours of pharmacology and clinical management education, with at least 15 hours completed within the two years preceding licensure/renewal.
- Must demonstrate good moral character and absence of certain disciplinary actions or addictions.
- Must submit a completed application and pay the prescribed fee.
- The board may allow prescriptive authority without a collaborative relationship if the APRN meets additional prerequisites (see below).
- Optional collaborative pathway remains: APRNs may still establish a collaborative relationship with a licensed physician, with a written agreement detailing protocols, responsibilities, and joint evaluation.
- Automatic authorization without collaboration after certain conditions: If an APRN has practiced at least three years in a documented collaborative relationship with prescriptive authority, remains licensed in good standing, and submits the required application and fee, the board may authorize prescriptive authority without a continuing collaborative agreement. The board may still require collaboration if public protection or rehabilitation of a license is needed.
- Collaborative agreements (if used): Must include written guidelines/protocols, roles/responsibilities, periodic evaluation, and joint review/update of guidelines.
Regulatory and Administrative Provisions
- The WV Board of Examiners for Registered Professional Nurses retains authority over licensure, scope of practice, education requirements, and prescriptive regulation, including fee setting and rulemaking.
- The bill preserves the board’s ability to regulate and enforce nursing practice, investigate violations, issue disciplinary actions, and maintain a registry of licensed APRNs.
- Note on compliance: The board cannot implement policies prohibiting APRNs from practicing without physician supervision, per subsection (c) of §30-7-4.
Impact and Implications
- Access to care: Potentially expands patient access to timely prescriptive care, particularly in underserved or rural areas where physician supply is limited.
- Professional practice: Provides a path for experienced APRNs to obtain prescriptive independence, with safeguards (education, character, ongoing oversight if needed).
- Oversight: Maintains regulatory checks through the nurse board and possible continued collaboration requirements when appropriate for public safety.
Timeline and status
- Introduced February 17, 2026; referred to Health and Human Resources; markup discussions noted (February 23, 2026).
- As of the current text, the bill is in the committee process and has not become law.
Compiled from official sources — confirm details with the bill’s official record.
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