- On March 14, 2023, Utah granted full-practice authority to nurse practitioners (NPs), ending the state-mandated physician contract required for licensure.
- Senate Bill 36 also lifted the limits on NP prescriptive authority, so NPs are no longer restricted in any of the four elements of advanced practice in Utah.
- Evidence shows NP care matches physician care, costs less, and leads to fewer hospitalizations and emergency visits.
What full-practice authority changes for Utah NPs
Senate Bill 36 modernizes Utah's licensure law and rewrites the scope of practice for NPs. American Association of Nurse Practitioners (AANP) President April Kapu, DNP, APRN, said the change would help Utah attract and retain nurse practitioners and improve patient access to care.
States authorize NPs under one of three models: full practice, reduced practice, and restricted practice. Before Senate Bill 36, Utah NPs worked under reduced practice, which meant they were limited in their prescriptive authority, including for controlled substances under Utah Code 58-31b-803, and required a state-mandated physician contract as a condition of licensure.
Under full-practice authority, that physician contract is gone, and NPs are no longer limited in any of the four elements of APRN practice:
- Evaluating
- Diagnosing
- Ordering and interpreting diagnostic tests
- Initiating and managing treatments, including prescription medications and controlled substances
Full-practice authority gives APRNs more autonomy and helps Utah attract and keep nurse practitioners, which widens access to care. It also opens more roles across hospitals, clinics, and offices, plus independent paths like clinic owner, health coach, or mobile testing.
What it means for patient care
Several studies compare NP and physician care. A 2020 study in Health Services Research examined utilization, costs, and outcomes between NPs and physicians in a Veterans Administration database and found patients assigned to an NP used fewer primary care and specialty services and had fewer total hospitalizations. A 2019 study in Health Affairs found that when NPs and physician assistants handled primary care for complex patients with diabetes, they used less acute care and incurred lower total costs than physicians. NP-led medical emergency teams have also been linked to lower hospital mortality and a higher likelihood of discharge home.
The pattern holds across outcomes, satisfaction, and cost. NPs expand access, especially in primary care, which matters for the tens of millions of people HRSA reports living in federally designated primary care Health Professional Shortage Areas. Limited access drives reduced life expectancy, heavier emergency department use, and worse health, and it stems from a mix of factors: lack of insurance, high costs, too few providers, and language barriers. An NP's focus on managing health and preventing disease addresses many of those gaps directly.
What it means for nurses
Nurse practitioners are in demand across the country, and full-practice authority makes Utah an attractive place to advance. Scope-of-practice laws still vary by state, so know the rules wherever you plan to work before you commit.
Frequently Asked Questions
When did Utah grant nurse practitioners full-practice authority?
Governor Spencer Cox signed Senate Bill 36 into law on March 14, 2023, making Utah the 27th state to grant nurse practitioners full-practice authority.
What changed for Utah NPs under Senate Bill 36?
The state-mandated physician contract required for licensure is gone, and NPs are no longer limited in the four elements of advanced practice: evaluating, diagnosing, ordering and interpreting diagnostic tests, and initiating and managing treatments, including prescription medications and controlled substances.
What are the three NP practice models?
States authorize NPs under one of three models. Full practice lets NPs evaluate, diagnose, and prescribe independently. Reduced practice limits at least one element and usually requires a collaborative agreement. Restricted practice limits at least one element and requires career-long physician oversight.
Does NP-led care produce good outcomes?
Research supports it. A 2020 Health Services Research study found patients assigned to an NP used fewer primary care and specialty services and had fewer total hospitalizations, and a 2019 Health Affairs study found NPs and physician assistants managing complex diabetes patients used less acute care at lower total cost than physicians.
Why does full-practice authority matter for patients?
It gives patients direct access to NP care, which expands access in primary care and underserved areas, where HRSA reports tens of millions of people live in federally designated shortage areas.