Bill Name: House Bill 449 (HB 449) House Bill 508 (HB 508)

Primary Sponsor: HB 449: Rep. Tim Barhorst, Rep. Riordan T. McClain | HB 508: Rep. Jennifer Gross, Rep. Rachel B. Baker

Status: HB 449: 10/01/2025 referred to Committee on Health|  HB 508: 10/15/2025 referred to Committee on Medicaid

AmSpa’s Take:    Allowing nurse practitioners and other APRNs to practice to the level of their education and skill, without the need to maintain cumbersome chart review and meeting requirements, frees up time and resources that can be better spent seeing patients, improving their skills and developing their practices. Independence also allows these practitioners to innovate in new practice areas through owning their own practices. 

Analysis: Currently, Ohio advanced practice registered nurses (APRNs)—including nurse practitioners (NP), clinical nurse specialists (CNS) and certified nurse midwives (CNM)—require practicing in collaboration with a physician or podiatrist under a standard care arrangement. A collaborative relationship must be maintained throughout their career. Under HB 449 and HB 508, APRNs would no longer need to practice under a standard care arrangement once they met certain requirements. While these bills are similar, they contain different provisions for independence. 

Under HB 449, an NP, CNS, or CNM who completes 2,000 hours of practice in a clinical setting under a standard care arrangement with a collaborating practitioner may then apply to the board to practice independently. In this case, a collaborating practitioner may be a 1) physician, 2) podiatrist, or 3) an NP, CNS, or CNM who practices independently. Standard care arrangements are written formal guides for treating patients with oversight provided by the collaborating practitioner. APRNs can choose to continue to practice under a standard care arrangement even after they qualify for independent practice..

Under HB 508, APRNs would need to complete 5,000 hours of practice under a standard care arrangement before applying for independence. The language otherwise broadly mirrors the provisions of HB 449.

While these bills are very similar, they have been assigned to different committees, which may mean that they could end up being amended in very different ways. Potentially, both may separately advance through the legislative process. However, it is likely that one version will receive more support and become the dominant version of the bill.

The majority of states allow nurse practitioners to practice independently. Most states have begun to provide reduced oversight or increase flexibility while still retaining the physician oversight. HB 449 and HB 508 would solidly go along with this trend in providing a path to independence for NPs, CNSs, and CNMs. If you would like additional information, to read the language of the bills or to contact the sponsors or committee, you can find the information you need through these links: HB 449 and HB 508.