Access to Care on the Line
Pennsylvania’s regulatory framework for nurse practitioners is directly influencing where health providers set up practice — and which communities gain or lose access to medical services. Supporters of reform say the state’s current rules are blocking qualified clinicians from seeing patients while neighboring states compete to attract them.
Harrisburg Rally Renews Legislative Push
On June 1, 2026, nurse practitioners converged on Harrisburg to press state lawmakers on legislation that would end the requirement tying NPs to a written physician collaboration agreement before they can practice. The effort is aimed at placing Pennsylvania alongside the majority of states that recognize what advocates term “full practice authority” for nurse practitioners.
Under current state law, Pennsylvania is classified as a “reduced practice state.” That designation means NPs — already credentialed to examine patients, render diagnoses, order and interpret diagnostic tests, build treatment plans, write prescriptions, and manage patient care coordination — must nonetheless maintain a formal written agreement with a licensed physician to do any of it.
The human cost of that requirement surfaced in testimony connected to the rally. Family Practice and Counseling Services Network, a Philadelphia-area Federally Qualified Health Center, brought on a psychiatric nurse practitioner but spent six months waiting for the provider to become eligible to see patients — time lost entirely to fulfilling the physician agreement mandate.
Justin Rohrback, an NP specializing in addiction medicine, chose to open his practice in Maryland rather than York County, Pennsylvania, citing the state’s more restrictive regulatory climate as the deciding factor.
Two Bills, No Hearings
State Sen. Camera Bartolotta (R-Washington County) has submitted legislation to expand nurse practitioner authority each year going back to at least 2018. Her current proposal, Senate Bill 25, is paired in the House with legislation sponsored by Rep. Nancy Guenst (D-Montgomery County), House Bill 739. As of the June rally, neither measure had been granted a committee hearing.
The pattern echoes prior sessions. Bartolotta’s bill has previously moved through the Senate with almost no opposition, only to stall in the House, where the legislation went without a hearing for at minimum four years during an earlier period. In 2020, then-House Minority Leader Jesse Topper (R-Bedford) advanced a pilot version of expanded NP authority in that chamber, though it did not become law.
Bartolotta was direct about her exasperation. “We hit a crisis point a long time ago,” she said. “It’s not, ‘This could be good someday.’ That day is behind us … What the heck are we waiting for?”
Guenst pointed to an existing federal precedent: “If it works for our veterans, it can work for Pennsylvanians.” The U.S. Department of Veterans Affairs already permits nurse practitioners to practice without physician oversight requirements across its health system.
By the Numbers
- 28 states and the District of Columbia currently grant nurse practitioners full practice authority
- 6 months — the wait one Philadelphia health center endured before a hired psychiatric NP could begin treating patients
- 2018 — the earliest recorded year Sen. Bartolotta introduced her NP authority legislation; her first version cited 21 states plus D.C. as having already adopted full practice authority
- 4+ years — the minimum stretch during which NP legislation received no House committee hearing in a prior session cycle
- 0 — committee hearings scheduled for either Senate Bill 25 or House Bill 739 as of June 2026
Pennsylvania Among Regional Outliers
The majority of states bordering Pennsylvania have already moved to permit NPs to work without mandatory physician collaboration agreements. Ohio stands as the notable regional exception, maintaining oversight requirements similar to Pennsylvania’s. Across the country, the trend toward full NP practice authority has built steadily over the past decade, driven in large part by primary care shortages in rural and underserved areas.
The Pennsylvania Medical Society remains opposed to broadening the NP scope of practice, asserting that physician oversight is a patient safety safeguard. That argument has been a consistent feature of the debate wherever similar legislation has been considered, and it has been the primary institutional counterweight to reform efforts in Harrisburg.
What Comes Next
Both Senate Bill 25 and House Bill 739 are pending committee review with no hearings yet calendared. Advocates are pushing legislative leaders to move the bills forward before the current session concludes. The immediate obstacle remains the same one that has blocked the effort in previous cycles: securing a House committee hearing to give the legislation a viable path toward a floor vote.