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Ohio has been facing a growing healthcare challenge for years: not enough providers to meet the needs of our communities, especially in rural and underserved areas. Two new bills, Ohio Senate Bill 258 and Ohio House Bill 508, offer a potential solution by modernizing how certain Advanced Practice Registered Nurses (“APRNs”), such as nurse practitioners, certified nurse midwives, and clinical nurse specialists, are allowed to practice in our state.

These bills, known collectively as the Better Access to Health Care Act, would eliminate the outdated requirement that APRNs enter into a written contract called a “Standard Care Arrangement” (SCA) with a collaborating physician in order to provide care. This bureaucratic hurdle doesn’t reflect the training and expertise that APRNs possess, and it limits patient access to timely, affordable, high-quality care. For the many APRN-owned practices that exist in Ohio, the SCA requirement also creates a regulatory barrier that increases the cost of owning a business in Ohio.

Why This Matters:

• More Providers = Better Access
  Lifting the SCA requirement would allow APRNs to practice with fewer barriers, meaning more clinics in rural areas, shorter wait times, and faster treatment for patients who need it most. In certain areas of Ohio, an APRN is the only available healthcare provider for the entire area.
  
  
• APRNs Are Highly Trained
  APRNs are advanced-degree nurses who undergo rigorous clinical and academic training. In over half of the states, APRNs already practice without any regulatorily prescribed relationship with a physician, and studies show that care APRNs provide is safe, effective, and well-received by patients.
  
  
• Reducing Costs Without Sacrificing Quality
  Allowing APRNs to practice to the full extent of their training helps reduce health care costs while maintaining high standards of care. More access to primary care means fewer ER visits and lower costs for the health system overall. Recent studies also show that retiring the mandated SCA has not resulted in any adverse impact on the quality of patient care in other states.[1]
  
  
• Federal Trade Commission (“FTC”) Support
  Since 2014, the FTC has continually issued guidance stating that regulations that mandate contracts such as the SCA are a restraint of trade.[2]  The FTC has advised, including in prior commentary specific to Ohio, that APRNs should be free to practice without any mandated contract with a physician.[3] 
  
  
• Bipartisan Support
  Both bills are backed by legislators in the Ohio House and Senate from both parties, showing that this is not a partisan issue; it’s a common-sense policy change supported by health care experts and patient advocates alike.

Passing SB 258 and HB 508 won’t just support nurses; it will support patients, families, businesses, and communities across Ohio. These bills are a long-overdue step toward a more flexible, efficient, and patient-centered health care system.

Let’s give APRNs the tools they need to serve Ohioans, and let’s make sure every patient has access to the care they deserve.

To learn more about Ohio SB 258 and Ohio HB 508 or the Ohio laws and regulations that govern APRN practice, please contact BMD Member Jeana Singleton at jmsingleton@bmdllc.com.

[1] Markowitz et al., “Nurse Practitioner Scope of Practice and Patient Harm,” NBER Working Paper No. 31109 (2023); Journal of Policy Analysis and Management (2023).  See “A Comparative Analysis of NP, PA, and Physician Malpractice Risk,” Journal of the American Association of Nurse Practitioners, Vol. 37, Issue 6 (2025). See also, Myers et al., Advanced Practice Provider Malpractice Claims, Journal of Healthcare Risk Management (2021).

[2] Federal Trade Commission, Policy Perspectives: Competition and the Regulation of Advanced Practice Nurses, March 2014, https://www.ftc.gov/system/files/documents/reports/policy-perspectives-competition-regulation-advanced-practice-nurses/140307aprnpolicypaper.pdf (last accessed 10/22/2025). 

[3] Federal Trade Commission, Letter to Ohio House of Representatives re: Ohio HB 177, January 2020, https://www.ftc.gov/system/files/documents/advocacy_documents/ftc-staff-comment-ohio-house-representatives-concerning-ohio-house-bill-177/v200005ohiohb177aprnscomment.pdf (last accessed 10/22/2025).