On July 20, 2007, Governor Rendell signed into law Act 48 of 2007. The law became effective on September 18,
2007. This amendment to the Professional Nursing Law sets forth specific practices for Certified Registered Nurse Practitioners.
Also included in the Law is a provision that requires the CRNP to hold malpractice insurance.
The specific practices for CRNPs, beginning on September 18, 2007, are as follows:
“(c.1) Except as limited by subsection (c.2), and in addition to existing authority, a certified registered
nurse practitioner shall have authority to do all of the following, provided that the certified nurse practitioner is acting
within the scope of the certified registered nurse practitioner’s collaborative or written agreement with a physician
and the certified registered nurse practitioner’s specialty certification:
(1) Order home health and hospice care.
(2) Order durable medical equipment.
(3) Issue oral orders to the extent permitted by the health care facilities’ by-laws, rules, regulations
or administrative policies and guidelines.
(4) Make physical therapy and dietitian referrals.
(5) Make respiratory and occupational therapy referrals.
(6) Perform disability assessments for the program providing Temporary Assistance to Needy Families (TANF).
(7) Issue home bound schooling certifications.
(8) Perform and sign the initial assessment of methadone treatment evaluations, provided that any order for
methadone treatment shall be made only by a physician.
(c.2) Nothing in this section shall be construed to:
(1) Supersede the authority of the Department of Health and the Department of Public Welfare to regulate the
types of health care professionals who are eligible for medical staff membership or clinical privileges.
(2) Restrict the authority of a health care facility to determine the scope of practice and supervision or other
oversight requirements for health care professionals practicing within the facility.”
In addition, beginning on September 18, 2007, CRNPs are required to maintain a level of professional liability
coverage for an Mcare nonparticipating health care provider. The Law provides an amendment to Section 8.7 of the Professional
Nursing Law - Professional Liability -- “A certified registered nurse practitioner practicing in this Commonwealth shall
maintain a level of professional liability coverage as required for a nonparticipating health care provider under the act
of March 20, 2002 (P.L.154, No. 13), known as the “Medical Care Availability and Reduction of Error (Mcare) Act,”
but shall not be eligible to participate in the Medical Care Availability and Reduction of Error (Mcare) Fund.”
Therefore, CRNPs must maintain professional liability coverage of at least $1 million per occurrence and $3
million in annual aggregate that is obtained from an insurer licensed or approved by the Pennsylvania Insurance Department
or from a self-insurance plan approved by the Pennsylvania Insurance Department. CRNPs should contact the professional liability
provider for their hospital or practice for further information about obtaining coverage.
