SB 406

83(R) - 2013

Vote Recommendation

Vote Yes; Amend
  • Positive
  • Neutral
  • Neutral
  • Positive
  • Neutral


Jane Nelson

Bill Caption

Relating to the delegation and supervision of prescriptive authority by physicians to certain advanced practice registered nurses and physician assistants.

Fiscal Notes

No significant fiscal implication to the State is anticipated.

Bill Analysis

Summary: SB 406 would give physicians more flexibility and freedom to delegate responsibility to registered nurses and physician assistants. For instance, SB 406 would allow physicians to enter into prescriptive authority agreements with registered nurses or physician assistants to prescribe or order drugs and devices. SB 406 also requires Medicaid Managed Care Organizations and other state operated care providers to use advanced practice registered nurses and physician assistants essentially as primary care providers to increase access to care. SB 406 limits physician liability for mistakes made by registered nurses or physician assistants unless they delegated to providers they had reason to believe lacked  competency to perform the delegated act. Finally, SB 406 requires several agencies to share information to combat delegation abuse and gives these agencies power to investigate providers who come under investigation.

Analysis: SB 406 would reduce regulation in health care for registered nurses and physicians assistants. This reduction in regulation would increase access to care, meaning SB 406 promotes free markets and limits government. We support SB 406.

Recommendation: This legislation is a step in the right direction, however there are many other regulations on advance practice nurses that should also be removed. Experience in other states has demonstrated that there is no need for the level of supervision required in Texas. This legislation could be strengthened by further reducing unnecessary regulations.