NCMS Opposes Proposals on House Bill 681 That Continue to Promote NP Pathways to Independent Practice

The situation over House Bill 681 continues to evolve. The NCMS lobbying team learned on Tuesday that a third Proposed Committee Substitute (PCS) would be introduced at the Wednesday meeting of the Senate Health Care Committee.  Each version continues to put patient safety at risk and demonstrates the the proponents of this effort are more concerned with financial gain than they are about quality healthcare in North Carolina. Each version has also sought to progressively  limit and even remove physician involvement from patient care.


At their core, these changes:

  • Sever the critical role of physicians from the healthcare process, undermining the very foundation of medical care.

  • Devastate access to essential healthcare for North Carolinians residing in rural and underserved areas, leaving these communities vulnerable and neglected.

  • Jeopardize the safety of every citizen in North Carolina, creating a perilous healthcare landscape fraught with risk and uncertainty.


The changes promote pathways for Nurse Practitioners to practice independently. The second version removed the increased requirements for supervision and further restricted anesthesia care by anesthesiologists and AAs, while allowing CRNAs to work independently.  These are topics that have been debated for years.

The NCMS has been able to acquire bipartisan opposition to this effort, as demonstrated over the past two weeks, when Democrats and Republicans came together in the best interest of North Carolinians.

NCMS Members Dr. William Ferrell and Dr. Bryant Murphy worked with the NCMS team yesterday, speaking with individual members of the Senate Healthcare Committee. Our allies in the Senate continue to give us valuable guidance to refine our strategy for opposing these proposals.

NCMS VP of Advocacy John Thompson says “The NCMS maintains the stance that opposing changes to legislation which jeopardizes patient safety is crucial for upholding the integrity of a healthcare delivery system. The NCMS  firmly advocates prioritizing the welfare and safety of patients above all considerations, thereby ensuring that any legislative adjustments maintain stringent standards of care and safeguard individuals from potential harm.”


Plan now to attend the North Carolina Medical Society White Coat Advocacy Day June 12


The North Carolina Medical Society continues to monitor and work on House Bill 681.  Look for a Political Pulse on May 31 with more in-depth analysis of what is happening in Raleigh.