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HB 375 2026
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hb375-00
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to autonomous practice by a certified 2
registered nurse anesthetist; amending s. 395.0191, 3
F.S.; revising staff membership and clinical 4
privileges for certain certified registered nurse 5
anesthetists; amending s. 464.012, F.S.; authorizing 6
certain certified registered nurse anesthetists to 7
perform specified acts under certain circumstances; 8
amending s. 464.0123, F.S.; revising practice 9
requirements for autonomous advanced practice 10
registered nurses; authorizing autonomous advanced 11
practice registered nurses to perform certain acts; 12
providing an effective date. 13
14
Be It Enacted by the Legislature of the State of Florida: 15
16
Section 1. Paragraph (b) of subsection (2) of section 17
395.0191, Florida Statutes, is amended to read: 18
395.0191 Staff membership and clinical privileges.— 19
(2) 20
(b) An advanced practice registered nurse who is certified 21
as a registered nurse anesthetist licensed under part I of 22
chapter 464 shall administer anesthesia under the onsite medical 23
direction of a professional licensed under chapter 458, chapter 24
459, or chapter 466, and in accordance with an established 25
HB 375 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
protocol approved by the medical staff. The medical direction 26
shall specifically address the needs of the individual patient. 27
This paragraph does not apply to an autonomous advanced practice 28
registered nurse registered under s. 464.0123 who is certified 29
as a registered nurse anesthetist licensed under part I of 30
chapter 464; however, a facility may require a certified 31
registered nurse anesthetist who is registered and practicing 32
under s. 464.0123 to perform acts under an established protocol 33
approved by the medical staff or the governing board of the 34
facility. 35
Section 2. Paragraph (b) of subsection (4) of section 36
464.012, Florida Statutes, is amended to read: 37
464.012 Licensure of advanced practice registered nurses; 38
fees; controlled substance prescribing.— 39
(4) In addition to the general functions specified in 40
subsection (3), an advanced practice registered nurse may 41
perform the following acts within his or her specialty: 42
(b) A The certified registered nurse anesthetist may, to 43
the extent authorized by an established protocol approved by the 44
medical staff of the facility in which the anesthetic service is 45
performed, or a certified registered nurse anesthetist that is 46
registered and practicing under s. 464.0123 without an 47
established protocol, may perform any or all of the following: 48
1. Determine the health status of the patient as it 49
relates to the risk factors and to the anesthetic management of 50
HB 375 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
the patient through the performance of the general functions. 51
2. Based on history, physical assessment, and supplemental 52
laboratory results, determine, with the consent of the 53
responsible physician, the appropriate type of anesthesia under 54
within the framework of the protocol unless the certified 55
registered nurse anesthetist is registered and practicing under 56
s. 464.0123 without an established protocol. 57
3. Order under the protocol preanesthetic medication under 58
the protocol unless the certified registered nurse anesthetist 59
is registered and practicing under s. 464.0123 without an 60
established protocol. 61
4. Perform under the protocol procedures commonly used to 62
render the patient insensible to pain during the performance of 63
surgical, obstetrical, therapeutic, or diagnostic clinical 64
procedures under the protocol unless the certified registered 65
nurse anesthetist is registered and practicing under s. 464.0123 66
without an established protocol. These procedures include 67
ordering and administering regional, spinal, and general 68
anesthesia; inhalation agents and techniques; intravenous agents 69
and techniques; and techniques of hypnosis. 70
5. Order or perform monitoring procedures indicated as 71
pertinent to the anesthetic health care management of the 72
patient. 73
6. Support life functions during anesthesia health care, 74
including induction and intubation procedures, the use of 75
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
appropriate mechanical supportive devices, and the management of 76
fluid, electrolyte, and blood component balances. 77
7. Recognize and take appropriate corrective action for 78
abnormal patient responses to anesthesia, adjunctive medication, 79
or other forms of therapy. 80
8. Recognize and treat a cardiac arrhythmia while the 81
patient is under anesthetic care. 82
9. Participate in management of the patient while in the 83
postanesthesia recovery area, including ordering the 84
administration of fluids and drugs. 85
10. Place special peripheral and central venous and 86
arterial lines for blood sampling and monitoring as appropriate. 87
88
A certified registered nurse anesthetist registered and 89
practicing under s. 464.0123 without an established protocol may 90
only perform acts authorized under part I of this chapter. 91
Section 3. Paragraph (a) of subsection (3) of section 92
464.0123, Florida Statutes, is amended to read: 93
464.0123 Autonomous practice by an advanced practice 94
registered nurse.— 95
(3) PRACTICE REQUIREMENTS.— 96
(a) An advanced practice registered nurse who is 97
registered under this section may: 98
1. Engage in autonomous practice only in primary care 99
practice, including family medicine, general pediatrics, and 100
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general internal medicine, as defined by board rule. 101
2. For certified nurse midwives, engage in autonomous 102
practice in the performance of the acts listed in s. 103
464.012(4)(c). 104
3. Perform the general functions of an advanced practice 105
registered nurse under s. 464.012(3) related to primary care. 106
4. For certified registered nurse anesthetists registered 107
and practicing under this section, perform the acts listed in s. 108
464.012(4)(b). 109
5.4. For a patient who requires the services of a health 110
care facility, as defined in s. 408.032(8): 111
a. Admit the patient to the facility. 112
b. Manage the care received by the patient in the 113
facility. 114
c. Discharge the patient from the facility, unless 115
prohibited by federal law or rule. 116
6.5. Provide a signature, certification, stamp, 117
verification, affidavit, or endorsement that is otherwise 118
required by law to be provided by a physician, except an 119
advanced practice registered nurse registered under this section 120
may not issue a physician certification under s. 381.986. 121
Section 4. This act shall take effect July 1, 2026. 122