Darby Files Legislation to Remove Red Tape on Nurse Practitioners, Expand Health Care Options 

AUSTIN, TX — Representative Drew Darby (R-San Angelo) filed House Bill 3794, what he called a transformative piece of legislation, designed to improve healthcare access and increase patient choice across Texas. Senator Mayes Middleton (R-Galveston) has filed the companion bill in the Texas Senate – Senate Bill 1859. 

“Texans deserve access to high-quality healthcare close to home, and this legislation will improve care while empowering both patients and providers,” said Representative Drew Darby. 

“By introducing stronger price transparency measures, we can ensure Texans have access to high-quality, affordable care. This legislation is a common-sense approach to healthcare that will lead to better outcomes for everyone.”

Currently, Texas law requires licensed Advanced Practice Registered Nurses (APRNs), like Nurse Practitioners, to find and enter into a contract with a physician in order to provide care to patients. The law does not require the contracting physician to see the patients, consult on the care, or even work in the same city or county.

“This is a common sense bill that increases access and lowers the cost of healthcare in Texas,” said Senator Mayes Middleton. 

“Advanced Practice Registered Nurses have long filled a vital role in healthcare. This bill will not only remove costly and unnecessary government red tape, but the bill will also improve accessibility to care in low income and rural communities that need it the most. We need to expand access to quality healthcare to as many Texans as we can, and this bill accomplishes exactly that.”

HB 3794 and SB 1859 will maximize flexibility for healthcare providers while expanding patient access to care by giving providers the ability to opt in or out of the mandatory delegation framework required for APRNs – removing unnecessary administrative barriers and fostering a more efficient healthcare system. Providers who prefer the existing delegation rules can continue to adhere to them, ensuring a seamless transition while creating a more competitive and patient-centered model. 

Additionally, the bill introduces groundbreaking price transparency measures that will directly impact state-funded programs like Medicaid, the Employees Retirement System (ERS), and the Teacher Retirement System (TRS). Under these provisions, physicians will no longer be allowed to bill at a higher rate for an APRN's patient visit unless they personally see and make a decision regarding the patient's care on that same day. By limiting this abusive billing practice, HB 3794 and SB 1859 will drive down healthcare costs, ensuring significant savings for taxpayers and patients alike.

Texas is experiencing rapid population growth, yet the state ranks last in healthcare access and affordability. With 87% of counties classified as primary care shortage areas and 46.5% designated as maternity care deserts, many Texans struggle to find adequate care. Restrictive licensing laws for APRNs compound the issue by preventing qualified providers from practicing independently despite their training, certification, and experience.

HB 3794 and SB 1859 remove these barriers, aligning Texas with 27 other states and federal healthcare systems that have already eliminated similar restrictions without adverse effects. By allowing APRNs to practice to the full extent of their licensure, the bill will improve healthcare access, particularly in rural and underserved communities, while introducing cost-saving measures for state-funded programs. As Texas continues to navigate the complexities of healthcare access, cost management, and quality care, HB 3794 and SB 1859 stand as a pivotal step forward. 

Darby said the bill has broad support from over 40 Texas organizations advocating for increased access to healthcare, including the Texas Conservative Coalition Research Institute, Texas 2036, Texas Organization of Rural and Community Hospitals, AARP Texas, NAMI-Texas, Texas Association of Business, and Americans for Prosperity-Texas. In 2024, the Texas Republican and Democratic party platforms endorsed this policy, reflecting strong bipartisan backing.

Representative Darby serves House District 72, which includes Coke, Coleman, Concho, Glasscock, Howard, Irion, Reagan, Runnels, Sterling, and Tom Green counties.