Read the full stored bill text
H. B. No. 311 *HR26/R1101* ~ OFFICIAL ~ G1/2
26/HR26/R1101
PAGE 1 (RF\KW)
To: Public Health and Human
Services
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026
By: Representative Creekmore IV
HOUSE BILL NO. 311
AN ACT TO AMEND SECTION 73-15-20, MISSISSIPPI CODE OF 1972, 1
TO PROVIDE THAT A COLLABORATIVE/CONSULTATIVE RELATIONSHIP BETWEEN 2
AN ADVANCED PRACTICE REGISTERED NURSE AND A PHYSICIAN OR DENTIST 3
SHALL NOT REQUIRE THAT THE CARE OF A PATIENT BY THE ADVANCED 4
PRACTICE REGISTERED NURSE BE DIRECTED BY THE DENTIST OR PHYSICIAN 5
WHO IS IN THE COLLABORATIVE/CONSULTATIVE RELATIONSHIP WITH THE 6
ADVANCED PRACTICE REGISTERED NURSE; TO PROVIDE THAT CERTIFIED 7
REGISTERED NURSE ANESTHETISTS SHALL NOT BE REQUIRED TO 8
COLLABORATE/CONSULT WITH A PHYSICIAN ANESTHESIOLOGIST DURING ALL 9
PHASES OF THE ANESTHETIC PERIOD; TO PROVIDE THAT A PHYSICIAN OR 10
DENTIST IN A COLLABORATIVE/CONSULTATIVE RELATIONSHIP WITH A 11
CERTIFIED REGISTERED NURSE ANESTHETIST SHALL NOT BE REQUIRED TO BE 12
IN A COLLABORATIVE/CONSULTATIVE RELATIONSHIP WITH A PHYSICIAN 13
ANESTHESIOLOGIST; AND FOR RELATED PURPOSES. 14
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 15
SECTION 1. Section 73-15-20, Mississippi Code of 1972, is 16
amended as follows: 17
73-15-20. (1) Advanced practice registered nurses. Any 18
nurse desiring to be certified as an advanced practice registered 19
nurse shall apply to the board and submit proof that he or she 20
holds a current license to practice professional nursing and that 21
he or she meets one or more of the following requirements: 22
(a) Satisfactory completion of a formal post-basic 23
educational program of at least one (1) academic year, the primary 24
H. B. No. 311 *HR26/R1101* ~ OFFICIAL ~
26/HR26/R1101
PAGE 2 (RF\KW)
purpose of which is to prepare nurses for advanced or specialized 25
practice. 26
(b) Certification by a board-approved certifying body. 27
Such certification shall be required for initial state 28
certification and any recertification as a registered nurse 29
anesthetist, nurse practitioner or nurse midwife. The board may 30
by rule provide for provisional or temporary state certification 31
of graduate nurse practitioners for a period of time determined to 32
be appropriate for preparing and passing the National 33
Certification Examination. Those with provisional or temporary 34
certifications must practice under the direct supervision of a 35
licensed physician or a certified nurse practitioner or certified 36
nurse midwife with at least five (5) years of experience. 37
(c) Graduation from a program leading to a master's or 38
post-master's degree in a nursing clinical specialty area with 39
preparation in specialized practitioner skills. 40
(2) Rulemaking. The board shall provide by rule the 41
appropriate requirements for advanced practice registered nurses 42
in the categories of certified registered nurse anesthetist, 43
certified nurse midwife and advanced practice registered nurse. 44
(3) Collaboration. An advanced practice registered nurse 45
shall perform those functions authorized in this section within a 46
collaborative/consultative relationship with a dentist or 47
physician with an unrestricted license to practice dentistry or 48
medicine in this state and within an established protocol or 49
H. B. No. 311 *HR26/R1101* ~ OFFICIAL ~
26/HR26/R1101
PAGE 3 (RF\KW)
practice guidelines, as appropriate, that is filed with the board 50
upon license application, license renewal, after entering into a 51
new collaborative/consultative relationship or making changes to 52
the protocol or practice guidelines or practice site. The board 53
shall review and approve the protocol to ensure compliance with 54
applicable regulatory standards. The advanced practice registered 55
nurse may not practice as an APRN if there is no 56
collaborative/consultative relationship with a physician or 57
dentist and a board-approved protocol or practice guidelines. A 58
collaborative/consultative relationship shall not require that the 59
care of a patient by an advanced practice registered nurse be 60
directed by the dentist or physician who is in the 61
collaborative/consultative relationship with the advanced practice 62
registered nurse. 63
(4) Renewal. The board shall renew a license for an 64
advanced practice registered nurse upon receipt of the renewal 65
application, fees and protocol or practice guidelines. The board 66
shall adopt rules establishing procedures for license renewals. 67
The board shall by rule prescribe continuing education 68
requirements for advanced practice nurses not to exceed forty (40) 69
hours biennially as a condition for renewal of a license or 70
certificate. 71
(5) Reinstatement. Advanced practice registered nurses may 72
reinstate a lapsed privilege to practice upon submitting 73
documentation of a current active license to practice professional 74
H. B. No. 311 *HR26/R1101* ~ OFFICIAL ~
26/HR26/R1101
PAGE 4 (RF\KW)
nursing, a reinstatement application and fee, a protocol or 75
practice guidelines, documentation of current certification as an 76
advanced practice nurse in a designated area of practice by a 77
national certification organization recognized by the board and 78
documentation of at least forty (40) hours of continuing education 79
related to the advanced clinical practice of the nurse 80
practitioner within the previous two-year period. The board shall 81
adopt rules establishing the procedure for reinstatement. 82
(6) Changes in status. The advanced practice registered 83
nurse shall notify the board immediately regarding changes in the 84
collaborative/consultative relationship with a licensed physician 85
or dentist. If changes leave the advanced practice registered 86
nurse without a board-approved collaborative/consultative 87
relationship with a physician or dentist, the advanced practice 88
nurse may not practice as an advanced practice registered nurse. 89
(7) Practice requirements. The advanced practice registered 90
nurse shall practice: 91
(a) According to standards and guidelines of the 92
National Certification Organization. 93
(b) In a collaborative/consultative relationship with a 94
licensed physician whose practice is compatible with that of the 95
nurse practitioner. Certified registered nurse anesthetists may 96
collaborate/consult with licensed dentists. Certified registered 97
nurse anesthetists shall not be required to collaborate/consult 98
with a physician anesthesiologist during all phases of the 99
H. B. No. 311 *HR26/R1101* ~ OFFICIAL ~
26/HR26/R1101
PAGE 5 (RF\KW)
anesthetic period. A physician or dentist in a 100
collaborative/consultative relationship with a certified 101
registered nurse anesthetist shall not be required to be in a 102
collaborative/consultative relationship with a physician 103
anesthesiologist. The advanced practice nurse must be able to 104
communicate reliably with a collaborating/consulting physician or 105
dentist while practicing. 106
(c) According to a board-approved protocol or practice 107
guidelines. 108
(d) Advanced practice registered nurses practicing as 109
nurse anesthetists must practice according to board-approved 110
practice guidelines that address pre-anesthesia preparation and 111
evaluation; anesthesia induction, maintenance, and emergence; 112
post-anesthesia care; peri-anesthetic and clinical support 113
functions. 114
(e) Advanced practice registered nurses practicing in 115
other specialty areas must practice according to a board-approved 116
protocol that has been mutually agreed upon by the nurse 117
practitioner and a Mississippi licensed physician or dentist whose 118
practice or prescriptive authority is not limited as a result of 119
voluntary surrender or legal/regulatory order. 120
(f) Each collaborative/consultative relationship shall 121
include and implement a formal quality assurance/quality 122
improvement program which shall be maintained on site and shall be 123
available for inspection by representatives of the board. This 124
H. B. No. 311 *HR26/R1101* ~ OFFICIAL ~
26/HR26/R1101
PAGE 6 (RF\KW)
quality assurance/quality improvement program must be sufficient 125
to provide a valid evaluation of the practice and be a valid basis 126
for change, if any. 127
(g) Nurse practitioners may not write prescriptions 128
for, dispense or order the use of or administration of any 129
schedule of controlled substances except as contained in this 130
chapter. 131
(8) Prescribing controlled substances and medications. 132
Certified nurse midwives and certified nurse practitioners may 133
apply for controlled substance prescriptive authority after 134
completing a board-approved educational program. Certified nurse 135
midwives and certified nurse practitioners who have completed the 136
program and received prescription authority from the board may 137
prescribe Schedules II-V. The words "administer," "controlled 138
substances" and "ultimate user," shall have the same meaning as 139
set forth in Section 41-29-105, unless the context otherwise 140
requires. The board shall promulgate rules governing prescribing 141
of controlled substances, including distribution, record keeping, 142
drug maintenance, labeling and distribution requirements and 143
prescription guidelines for controlled substances and all 144
medications. Prescribing any controlled substance in violation of 145
the rules promulgated by the board shall constitute a violation of 146
Section 73-15-29(1)(f), (k) and (l) and shall be grounds for 147
disciplinary action. The prescribing, administering or 148
distributing of any legend drug or other medication in violation 149
H. B. No. 311 *HR26/R1101* ~ OFFICIAL ~
26/HR26/R1101
PAGE 7 (RF\KW)
ST: CRNAs; not required to collaborate/consult
with anesthesiologist during all phase of the
anesthetic period.
of the rules promulgated by the board shall constitute a violation 150
of Section 73-15-29(1)(f), (k) and (l) and shall be grounds for 151
disciplinary action. 152
SECTION 2. This act shall take effect and be in force from 153
and after its passage. 154