Recently, health care professionals are asking a lot of questions about Wisconsin’s new APRN Modernization Act (2025 WI 17), and for good reason.

This legislation, which was signed into law Aug. 8, 2025, and goes into effect Sept. 1, 2026, fundamentally changes how Advanced Practice Registered Nurses (APRNs) can operate in Wisconsin. Attorneys representing health care organizations, medical practices, or handle employment law need to understand what changes are coming.

Here is the bottom line: As of Sept. 1, 2026, if specific requirements are met, APRNs will no longer need to be collaborating with a physician or dentist to practice independently.

That might sound like a simple administrative change, but it is going to ripple through employment contracts, business structures, liability arrangements, and operational protocols across Wisconsin’s health care system.

What Actually Changed

The APRN Modernization Act allows for the first time independent APRN practice in Wisconsin.^[1]

Under the new law, certified registered nurse anesthetists (CRNAs), certified nurse midwives (CNMs), clinical nurse specialists (CNSs), and nurse practitioners (NPs) that have a national certification in their recognized role can practice as APRNs within their scope of expertise without being supervised by or in collaboration with a physician or dentist. “Recognized role” means one of the following roles: CRNAs, CNMs, CNSs, and NPs.^[2]

APRNs are permitted to practice independently in a recognized role without a collaborative agreement with a physician or dentist after the following requirements are met:

• The APRN has completed3,840 clinical hours of advanced practice registered nursing practice in their Recognized Role while working with a physician or dentist who was immediately available for consultation and accepted responsibility for the APRN’s during those hours.

• At least 24 months have elapsed since the APRN first began practicing in that Recognized Role.^[3]

Regulatory Unknowns

As of now, there are a number of regulatory unknowns.

This fall, The Wisconsin Board of Nursing (Board) will commence a rule project to implement 2025 WI 17. The Wisconsin Department of Safety and Professional Services (DSPS) will also be providing additional information, including application requirements for independent practice, to credential holders and applicants.

The Board is required to promulgate rules that:

• further define the scope of practice for APRNs and when APRNs may issue prescription orders;
• determine acceptable national certification;
• establish the appropriate education, training, or experience requirements;
• specify the drugs that may not be prescribed by APRNs;
• specify the conditions for registered nurses (RNs) to:
  • administer a drug prescribed by APRNs;
  • administer a drug at the direction of APRNs; and
• establish standards of professional conduct for APRNs.^[4]

Additionally, there are a number of potential ambiguities that could be ripe for confusion, such as the definitions of “expertise,” “scope of practice,” and “delegate” within 2025 WI 17 § 116.

To Collaborate or Not to Collaborate: That is the Question

Currently, health care organizations have documented health care collaborative arrangements and employment agreements built around the existing collaborative model.^[5]

This collaborative relationship “is a process in which an advanced practice nurse prescriber is working with a physician or dentist in each other’s presence, when necessary, to deliver health care services within the scope of the practitioner’s training, education, and experience.” Additionally, “[t]he advanced practice nurse prescriber shall document this relationship.” Those documented relationships typically detail supervision requirements, liability sharing arrangements, and scope limitations.^[6]

Going forward, APRNs who meet the above referenced requirements will no longer require collaborative agreements.

However, collaborative relationships and even collaborative agreements may still make sense between APRNs and physicians. Indeed, some health care providers and practitioners may explore collaborative arrangements that, while not legally required, still provide clinical and business benefits.

Others health care providers may consider new practice models that give APRNs independence while maintaining team-based care approaches. The key is helping advise health care clients to make intentional decisions about how to structure relationships that are legally compliant, in the best interest of the patients, and make business sense.

Business Structure Questions Attorneys Should Be Asking

Will APRNs remain employees, become independent contractors, or become shareholders in service corporations? Each option has different legal and tax implications.

For medical practices and health care organizations, this may open new business models. Giving APRNs more autonomy might help attract and retain talent – especially since Wisconsin was behind the curve compared to neighboring states that already allowed independent practice.

Will new service corporations (s.c.) be established by APRNs? APRNs and Physicians? Under 2025 Wis. Act 17 § 163, the board of governors may not determine that it is not the primary purpose of a service corporation to provide the medical services of physicians or APRNs unless more than 50 percent of the shareholders of the service corporation are neither physicians nor APRNs.

Malpractice Liability Insurance Coverage

APRNs will need to maintain malpractice liability insurance coverage in the amounts specified for health care providers under Wis. Stat. § 655.23(4), according to 2025 Wis. Act 17, § 116. APRNs will also be required to submit evidence of that coverage to the Board when applying for an initial or renewal license.

Action Items for Attorneys with Health Care Clients

Attorneys representing health care organizations or practitioners should start with an audit of current APNP employment arrangements. Identify which agreements need updates and which business practices need restructuring. Talking to malpractice carriers about coverage implications is important, as is developing a timeline for implementing changes before APRNs start requesting independent practice arrangements.

Clients who are getting ahead of this are taking a comprehensive approach. They are not just anticipating updating employment agreements – they are rethinking their entire approach to APRN integration.

Understand that this affects more than just health care clients. Any business that contracts with health care providers – dental practices, medical spas, aesthetic practices – may need to reconsider their service agreements and liability arrangements.

Navigating this change will require legal infrastructure, not just a legal compliance exercise. Organizations that approach it strategically – understanding both the opportunities and the risks – will be better positioned to attract talent, expand services, and compete effectively when Wisconsin's health care market changes on Sept. 1, 2026.

This article was originally published on the State Bar of Wisconsin’s Health Law Blog. Visit the State Bar sections or the Health Law Section webpages to learn more about the benefits of section membership.

Endnotes

[1] 2025 WI 17, §§ 116, 149. ↩

[2] 2025 WI 17, §§ 96-102, 149. ↩

[3] 2025 WI 17, § 116. ↩

[4] Id. ↩

[5] Wis. Admin. Code §§ N 8.10(2), (7). ↩

[6] Wis. Admin. Code § N 8.10(7). ↩