S 163: An act relating to the role of advanced practice providers in hospital care - Vermont

As EnactedOpens in a new window → As Passed by Both House and Senate (OfficialOpens in a new window) · 7 edits

MODERATE

The diff compares the enacted version of Vermont S.163 to the version as passed by both chambers. The enacted version expanded scope to include physician assistants alongside physicians and APRNs, while the passed version limited coordinating providers to physicians and APRNs only. Additionally, the passed version added a requirement that physician consultation and support be available to an attending APRN at all times, a provision absent from the enacted version.

SCOPE

The title changed from 'advanced practice providers' (enacted) to 'advanced practice registered nurses' (passed), narrowing the bill's stated scope in the passed version.

DEFINITION

The enacted version includes a definition of 'Physician assistant' in Section 1851; the passed version omits this definition entirely.

ELIGIBILITY

In the Patient Bill of Rights (Section 1852(a)(2)), the passed version limits care coordination to a physician or APRN and adds a new requirement that 'Physician consultation and support shall be available to an attending APRN at all times in accordance with applicable standards of practice and regulatory requirements.' The enacted version instead allows a physician, physician assistant, or APRN to coordinate care, with no explicit physician backup requirement for APRNs.

Throughout the Patient Bill of Rights (items 3, 4, 9, and 11), the passed version removes 'physician assistant' from lists of providers who may coordinate care, provide information, or inform patients of continuing needs after discharge. The enacted version retains physician assistants in all these roles.

ENFORCEMENT

Section 1852(b) on disciplinary action: the passed version limits complaints to physicians and APRNs; the enacted version adds physician assistants under 26 V.S.A. chapter 31 as a subject of potential disciplinary action.

REQUIREMENT

Section 1905(5) on hospital license requirements: the passed version requires patients be under the care of a physician or APRN; the enacted version adds physician assistants licensed under chapter 31 as an acceptable category.

Section 1905(8) on professional case records: the passed version requires records be signed by the attending physician or APRN; the enacted version adds physician assistant as an acceptable signer.

As Passed By the Senate (OfficialOpens in a new window) → As EnactedOpens in a new window · 7 edits

MODERATE

The enacted version (Act No. 92) broadens the bill from covering only advanced practice registered nurses (APRNs) to also including physician assistants as providers who can serve as the primary coordinator of hospital patient care. This change appears throughout the definitions, patient rights, enforcement provisions, and hospital licensing requirements. Additionally, a Senate provision requiring that physician consultation and support be available to an attending APRN at all times was removed in the enacted version.

SCOPE

The bill title changed from 'advanced practice registered nurses' to 'advanced practice providers,' reflecting the expanded scope to include physician assistants alongside APRNs.

DEFINITION

A new definition for 'Physician assistant' was added, meaning an individual licensed under 26 V.S.A. chapter 31.

ELIGIBILITY

The patient's right to have a primary care coordinator in the hospital now includes physician assistants as an option alongside physicians and APRNs (previously only physicians or APRNs).

REQUIREMENT

The Senate version required that 'Physician consultation and support shall be available to an attending APRN at all times in accordance with applicable standards of practice and regulatory requirements.' This requirement was removed in the enacted version.

Hospital licensing standards (Section 3(5)) now permit physician assistants licensed under chapter 31 as acceptable providers for admitted patients, in addition to physicians and APRNs.

Professional case records (Section 3(8)) may now be signed by a physician assistant in addition to a physician or APRN.

ENFORCEMENT

Disciplinary action provisions now explicitly include physician assistants under 26 V.S.A. chapter 31, not just physicians and APRNs.

As Passed by Both House and Senate (OfficialOpens in a new window) → As Passed by Both House and Senate (UnofficialOpens in a new window) · 5 edits

MODERATE

The unofficial version of S.163 explicitly adds physician assistants (PAs) alongside physicians and APRNs as providers who may be responsible for coordinating hospital patient care, and removes a prior requirement that physician consultation be available to an attending APRN at all times. A new definition of 'physician assistant' is added, and disciplinary action provisions are expanded to cover PAs. The bill title is broadened from 'advanced practice registered nurses' to 'advanced practice providers.'

Scope change

The bill's scope expands from covering only physicians and APRNs as potential attending providers to also include physician assistants, making it applicable to a wider range of advanced practice providers in Vermont hospitals.

SCOPE

Physician assistants are now explicitly included as a category of provider who can serve as the attending provider responsible for coordinating a hospital patient's care, in the Patients' Bill of Rights, hospital license requirements, and medical record signing provisions.

The bill title changes from 'the role of advanced practice registered nurses in hospital care' to 'the role of advanced practice providers in hospital care,' reflecting the broader inclusion of PAs.

DEFINITION

A new definition is added: 'Physician assistant' means an individual licensed under 26 V.S.A. chapter 31.

REQUIREMENT

The requirement that 'Physician consultation and support shall be available to an attending APRN at all times in accordance with applicable standards of practice and regulatory requirements' is removed from the Patients' Bill of Rights.

ENFORCEMENT

The disciplinary action provision now explicitly includes physician assistants under 26 V.S.A. chapter 31 as a category subject to discipline for failure to comply with the bill's provisions.

As Passed By the Senate (UnofficialOpens in a new window) → As Passed By the Senate (OfficialOpens in a new window) · 2 edits · Apr 22, 2026

MINOR

The official version of S.163 adds a new requirement that physician consultation and support must be available to an attending APRN at all times, in accordance with applicable standards of practice and regulatory requirements. This clarifies the level of physician oversight expected when an APRN serves as the primary coordinating provider for a hospital patient. The remaining changes are formatting and header updates (page count, sponsor information, committee referral, and statement of purpose).

REQUIREMENT

A new sentence was added to Section 2(a)(2) requiring that 'Physician consultation and support shall be available to an attending APRN at all times in accordance with applicable standards of practice and regulatory requirements.' This establishes a mandatory physician backup obligation whenever an APRN is the attending provider for a hospital patient.

TECHNICAL

Header and formatting changes: page count updated from 5 to 6 pages, addition of sponsor (Senator White), committee referral (Health and Welfare), introduction date (January 6, 2026), subject line, and statement of purpose block. No substantive policy impact.

As IntroducedOpens in a new window → As Passed By the Senate (UnofficialOpens in a new window) · 2 edits · Apr 22, 2026

MINOR

The Senate removed a requirement that physician consultation and support be available to an attending APRN at all times when coordinating patient care. The introduced version mandated this as part of the hospital patient bill of rights, but the Senate-passed version deleted that sentence, leaving only the general requirement that patients have an attending physician or APRN responsible for coordinating their care. All other substantive provisions remain unchanged.

REQUIREMENT

Removed the requirement that 'Physician consultation and support shall be available to an attending APRN at all times in accordance with applicable standards of practice and regulatory requirements.' This eliminated a specific operational obligation on hospitals to ensure physician backup is always accessible when an APRN serves as the coordinating provider for a patient.

TECHNICAL

Removed the introductory section containing the sponsor name, committee referral line, date field, subject heading, and statement of purpose. This is standard legislative formatting that drops out when a bill passes a chamber.

An act relating to the role of advanced practice providers in hospital care

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