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Assembly Bill 2684 Provides Additional Guidance and Clarity to the California Nurse Practitioner Scope of Practice

As part of advancing the independent scope of practice for nurse practitioners, California has revised its statutory scheme to further refine practice expectations.

California Governor Gavin Newsom has signed Assembly Bill 2684 (AB 2684), which, among other revisions to the California Business and Professions Code, refines some of the changes Assembly Bill 890 (AB 890) made to the nurse practitioner (NP) scope of practice in 2020 (discussed in our 2020 Alert). Signed days after the California Board of Registered Nursing (BRN) issued proposed regulations to implement the 2020 statutes (discussed in our recent Alert), AB 2684’s changes will become effective on January 1, 2023, and are designed to provide additional guidance and clarity to the new independent NP scope of practice. 

Clarification of the Requirements for Prescribing and Furnishing Drugs

Newly added Section 2837.103.5 details the minimum requirements an NP practicing pursuant to Section 2837.103 must meet in order to have the authority to prescribe, administer, dispense, and furnish pharmacological agents: they must have a BRN furnishing number; hold DEA registration if prescribing administering, dispensing, or furnishing controlled substances; and have completed additional training if prescribing administering, dispensing, or furnishing Schedule II controlled substances. These requirements are similar to those that NPs currently must meet in order to prescribe, administer, dispense, and furnish drugs pursuant to a standardized procedure and under physician supervision. The new statute, however, specifies that NPs practicing under the authority of Business and Professions Code 2837.103 and 2837.104 must meet these requirements, but do not have to prescribe, administer, dispense, or furnish drugs pursuant to a standardized procedure or under physician supervision.

Clarification of the Consultation and Collaboration Requirements

Section 2837.104 already requires NPs practicing pursuant to that provision to collaborate and consult with physicians under certain circumstances, as well as to have a plan to refer complex medical cases and emergencies to a physician or other appropriate practitioner. The amendments clarify the circumstances requiring consultation and referral. They also make clear that an NP’s consultation with a physician does not by itself create a physician-patient relationship, specifying that the NP is solely responsible for the services they provide. 

Additional Revisions Include Independent Nurse Practitioners in Multiple Statutes

Additionally, AB 2684 modifies several other statutes to add independent NPs to existing lists of independent practitioners who treat patients. For example, certain laboratory and pharmacy laws will now include NPs practicing pursuant to Sections 2837.103 and 2837.104 among the existing list of professionals who have authority to order medical services or prescribe drugs.  

Primary Takeaways 

AB 2684’s statutory refinements and the BRN’s recent proposed regulations bring NPs closer to the independent scope of practice the Legislature set forth in 2020. 

© 2023 ArentFox Schiff LLPNational Law Review, Volume XII, Number 284

About this Author

Sarah G. Benator Healthcare Attorney ArentFoxSchiff

Sarah advises a broad range of health care clients, including medical staffs, hospitals, health systems, long-term care facilities, medical groups, and laboratories in regulatory, operational, and medico-legal matters. Her exclusive focus on the health care industry has given her the depth to understand the needs of her health care clients.

Client Work

Sarah’s expertise includes medical staff bylaws, peer review matters, practitioner credentialing, disciplinary hearings, state licensing, Medicare certification, Joint...

Fernanda Sanchez Jara Associate ArentFox Schiff LLP

Fernanda represents small and large companies as well as individuals in various business and commercial matters. She defends employers in a range of industries.

Prior to joining ArentFox Schiff, Fernanda was a Law Clerk at the Los Angeles Center for Law and Justice, where she assisted survivors of domestic violence and other crimes. Fernanda was also a Student Volunteer at the Self-Help desk of the U.S. Bankruptcy Court for the Central District of California.