Maryland Nurse Practitioners now have full-practice authority. What does that mean? Madelaine Binner explains…

Maryland Nurse Practitioners now have full-practice authority. What does that mean? Madelaine Binner explains…

On May 12, 2015, Governor Larry Hogan signed into law the Certified Nurse Practitioners – Authority to Practice bill. This legislation retires the mandate that Maryland nurse practitioners (NPs) maintain attestation agreements with physicians as a pre-condition of licensure and practice. Maryland is now the 21st full-practice authority state, allowing NPs to practice to the full potential of their education and training (Institute of Medicine, 2010).

Under the leadership of Elaine Crain, CRNP, DNP and Lorraine Diana, CRNP, the Maryland Academy of Advanced Practice Clinicians helped lead the way to change in this legislation.

AAMC’s Monique Willingham, CRNP and Madelaine Binner, MBA, CRNP, DNP, participated in lobbying efforts and provided testimony to the House of Delegates and Senate. Practitioner Willingham cited the historical study, Burlington Randomized Trial of the Nurse Practitioner: Health outcomes of patients (1974), which concluded that nurse practitioner health care delivery was just as effective and safe as conventional care provided by physicians. Practitioner Binner read the actual attestation statement, emphasizing that NPs collaborate with the healthcare team because it is good practice, not because of a legal or administrative requirement.

This new legislation removes the requirement of the attestation agreement and also allows new graduate NP applicants seeking their initial certification to identify an experienced Maryland certified nurse practitioner or licensed physician to act as a mentor for the first 18 months of practice.

It also denotes that NPs are only under the authority of the Board of Nursing, can practice without the supervision of another member of the healthcare team, and do not need an official procedure stating their intention to collaborate with this team.

Congratulations to Maryland’s 4,600 NPs as they continue, in collaboration with their colleagues on the healthcare team, to offer excellent patient care.  -Madelaine Binner, MBA, CRNP, DNP


  1. Posted by Jazmin Manlapaz, at Reply

    I’m so pleased to be able to attend Nurses night in Annapolis and left our message with our senator to work on this bill !! It was worth it !!

  2. Posted by Geri, at Reply

    Best wishes to our NPs for a long deserved change in this legislation. Every day we hear about the wonderful, professional work nurse practioners do in the community.
    Special thanks to Madelaine and Monique for their articulate testimony.

  3. Posted by Kelly Swan, at Reply

    Great job Madelaine!

Post your comment