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NC Legislators Introduce Bipartisan SAVE Act to Increase Access to Quality Healthcare

February 26, 2019

RALEIGH – For more than 40 years, the laws regulating some of the most highly-trained healthcare providers in North Carolina have remained unchanged. With today’s introduction of the SAVE Act, legislators hope to modernize healthcare by removing outdated and unnecessary restrictions on Advanced Practice Registered Nurses (APRNs).

Primary sponsors of the bipartisan SAVE Act (SB 143/HB 185) include Sen. Ralph Hise, Rep. Josh Dobson, Rep. Donny Lambeth, Rep. Sarah Stevens, and Rep. Gale Adcock. The full title of the bill is An Act to Deliver Safe, Accessible, Value Directed and Excellent Health Care throughout North Carolina by Modernizing Nursing Regulations.

“Everyone in the country is looking at ways to bring down the cost of healthcare while maintaining a high standard of care. The SAVE Act does just that with a small change that can deliver a big impact. This is the low-hanging fruit,” said Sen. Hise. “Allowing these nurses to practice to the top of their training will give thousands of North Carolinians faster access to healthcare and drive down costs to the tune of half a billion dollars per year or more.”

The SAVE Act cuts red tape by removing so-called “physician supervision” requirements for Nurse Practitioners and Clinical Nurse Midwives. This antiquated rule forces APRNs to enter into a business contract with a physician in the same field before they can treat patients.

“We all know someone who has struggled to see a healthcare provider in a timely manner, and it is a problem that has not been trending in the right direction for a long time. That is exactly why I am proud to introduce the SAVE Act,” said Rep. Dobson. “Increasing access to quality healthcare is vital for patients across the state and in my home district. Advanced Practice Registered Nurses have proven that they deliver quality healthcare and our constituents deserve more choices in who they can see in a provider.”

Dozens of studies over the last four decades have shown time and again that APRNs care for patients as well as – and often better than – physicians when their scopes of practice overlap. Nearly ten years ago, the Institute of Medicine offered a full-throated endorsement of Full Practice Authority with its “Future of Nursing” report.1 Since then, studies published everywhere from the Federal Trade Commission2 to the Journal of the American Medical Association3 have continued to support these changes.

At the same time, research specific to North Carolina shows that the SAVE Act would be a major economic windfall for the state. According to a 2015 study by Dr. Chris Conover from the Duke University Center for Health Policy and Inequalities Research, this type of legislation will save North Carolina between $433 million and $4.3 billion per year and create more than 3,800 jobs.4

“Over 4 million North Carolinians live in the state’s 80 rural counties where primary care physicians are in short supply. In these rural and underserved communities, older adults frequently lack the ability and resources to get to their appointments because of mobility issues, long travel distances to a provider and wait times for appointments. This puts their health at risk and adds stress to family caregivers,” said Charmaine Fuller Cooper, Associate State Director of AARP North Carolina. “AARP is working to eliminate outdated barriers that prevent people from fully accessing the clinical skills that advanced practice registered nurses provide.”

We already know how the opponents to this legislation will respond: physicians groups will say patient safety will suffer due to this legislation. Unfortunately, it is not an argument based on facts.

“Scary anecdotes and hypotheticals may make for good political theater, but they are a terrible way to shape healthcare policy. Quality healthcare depends on evidence-based practice and the evidence overwhelmingly supports this legislation,” said NCNA President Elaine Scherer, MAEd, BSN, RN. “These updates are long overdue for the patients of North Carolina, and we look forward to moving this legislation quickly.”

APRNs are some of the most highly-trained nurses in the profession and require masters-level education or higher. The four types of APRNs include Nurse Practitioners, Certified Nurse-Midwives, Certified Registered Nurse Anesthetists, and Clinical Nurse Specialists.


For more information, please contact Chris Cowperthwaite, Manager of Communications and Outreach, at or 919.821.4250.


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  1. “The Future of Nursing: Leading Change, Advancing Health.” National Academy of Sciences. 2010.
  2. “Policy Perspectives: Competition and the Regulation of Advanced Practice Nurses.” Federal Trade Commission. 2014.
  3. “Primary Care Nurse Practitioners and Physicians in Low-Income and Rural Areas, 2010-2016.” Journal of the American Medical Association. 2018.
  4. “Economic Benefits of Less Restrictive Regulation of Advanced Practice Registered Nurses in North Carolina.” Center for Health Policy & Inequalities Research at Duke University. 2015.