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Bipartisan SAVE Act Introduced; NC Legislators Aim to Increase Access to Quality Healthcare


For Immediate Release

February 28, 2023

RALEIGH, N.C. – A bipartisan group of legislators is seeking to increase access to quality healthcare in North Carolina with the introduction of a bill to modernize outdated and restrictive regulations on Advanced Practice Registered Nurses (APRNs). The SAVE Act (HB 218/SB 175) is designed to remove superfluous red tape and would allow APRNs to practice to the full extent of their training and education, bringing the state in line with national standards that at least 26 other states have already successfully adopted1. The North Carolina Nurses Association (NCNA) is looking forward to educating legislators on the SAVE Act and helping ensure this important legislation is signed into law.

Primary sponsors of the SAVE Act in the Senate are Sen. Joyce Krawiec, R-Forsyth, Sen. Ralph Hise, R-Mitchell, and Sen. Gale Adcock, D-Wake. A companion bill is being filed in the House; its primary sponsors are Rep. Donna White, R-Johnston, Rep. Donny Lambeth, R-Forsyth, Rep. Wayne Sasser, R-Stanly, and Rep. Carla Cunningham, D-Mecklenburg. Similar legislation passed the Senate – nearly unanimously – in 2022 as part of HB 149, which would have granted “full practice authority” to APRNs and expanded Medicaid along with several other healthcare measures.

“This is an exciting opportunity for North Carolina patients, and it is rare that this kind of impact can be achieved with no hit to the state budget. Advanced Practice Registered Nurses are still practicing under regulations that haven’t been updated in 40 years, which is hard to believe, considering how much the profession has advanced since the early 1980s,” said NCNA President Meka Ingram, DNP, MSN, RN, NE-BC. “APRNs have a phenomenal track record of providing quality care, and they deliver that care more affordably and more efficiently when given the opportunity through modernized regulation.”

The National Academy of Medicine (née Institute of Medicine) initially advocated for Full Practice Authority for APRNs across the United States as part of a landmark report in 20102; the organization reaffirmed that position with a major follow-up report in 20213. Dozens of studies over several decades have consistently demonstrated the benefits of modernizing APRN regulations while assuaging fears of patient safety that have typically been espoused by opponents.

“Every single state that has passed bills like the SAVE Act has kept those changes in place. These updates are great for patients, they make a ton of sense from a financial perspective, and the results speak for themselves,” said NCNA CEO Tina Gordon, MPA, CAE, FACHE.

The SAVE Act is supported by a diverse group of advocacy organizations that represent a wide variety of perspectives on healthcare solutions from across the political spectrum; many of these organizations may not agree on other issues – but they unanimously believe the SAVE Act is good for North Carolina patients and the state’s broader healthcare ecosystem.

Another one of NCNA’s legislative priorities, Medicaid expansion, is a major reason supporters believe passing the SAVE Act is critical this session. Should the General Assembly expand Medicaid and extend coverage to an additional 600,000 North Carolinians, the existing provider shortage would be exacerbated. Research shows that bills like the SAVE Act can significantly help prevent unnecessary visits to Emergency Departments in the wake of Medicaid expansion, which has been a common challenge in other states.4

North Carolina has wasted billions of dollars in avoidable healthcare spending by clinging to outdated regulations.5 The nursing profession, nearly two-dozen outside groups, and a large, bipartisan contingent of legislators are ready to pass the SAVE Act and allow APRNs to reach their full potential for the benefit of North Carolina patients. It’s time.



Chris Cowperthwaite, APR
Director of Communications & Outreach
(919) 821-4250 or

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