Vital Sounds 2026, Quarter 2
Vital Sounds 2026, Quarter 2
Legislative Update: APRNs (and more) to Join the Fund—A Foundational Principle Reaffirmed
May 7, 2026
Legislative Update: APRNs (and more) to Join the Fund—A Foundational Principle Reaffirmed
May 7, 2026
By Tucker Poling, JD, CPCU
Executive Vice President and General Counsel
The 2026 Kansas legislative session produced three significant updates to the Kansas Health Care Stabilization Fund (the “Fund”). The headline change is HB 2509, which brings Advanced Practice Registered Nurses (APRNs) into the Fund beginning January 1, 2028. This closes what had become the most notable gap in Fund participation.
Additionally, two scope-of-practice bills, HB 2223 (optometry) and HB 2068 (pharmacy), include important provisions that condition certain newly authorized practice authority on participation in the Fund.
Taken together, these updates to Kansas law reaffirm a principle at the heart of the legislative structure that has helped stabilize the Kansas healthcare environment and protect Kansans’ access to care for more than 40 years: healthcare professionals who independently render any aspect of medical care to Kansas patients should participate in the Fund.
A Brief Refresher on the Fund and Its Purpose
As discussed in the Q1 2025 Vital Sounds article, “How the Fund Safeguards Kansas Healthcare,” the Fund was created by the Kansas Legislature during the medical malpractice crisis of the late 1970s and early 1980s as part of the Kansas Health Care Provider Insurance Availability Act. The Fund is an independent professional liability coverage fund, governed by a statutorily appointed Board of Governors, and wholly financed by participating healthcare providers (not Kansas tax dollars).
The Fund’s original legislative purpose was twofold: (1) to ensure that healthcare professionals have reasonable access to adequate liability insurance so that patients have access to care; and (2) to guarantee a source of recovery for patients injured as a result of malpractice.
Those purposes depend on a simple structural premise: that all healthcare professionals who independently diagnose, treat, prescribe, and perform procedures on Kansas patients participate in the Fund. Mandatory participation is what makes the Fund’s layered liability coverage, guaranteed access to primary insurance through the Kansas Health Care Provider Insurance Availability Plan, statutory vicarious liability protections, and automatic tail coverage function as a coherent system for both healthcare professionals and their patients. When a category of healthcare professionals who independently render such patient care sits outside the Fund, it creates a gap in that system.
HB 2509: APRNs Join the Fund
Signed into law on April 9, 2026, HB 2509 updates the Health Care Provider Insurance Availability Act to bring APRNs into the statutory definition of “healthcare provider.”
The bill takes effect January 1, 2028, and APRNs will have six months from that date to come into compliance.
Why This Update Was Needed
APRNs had become the most notable group of healthcare professionals who independently render patient care and yet remained excluded from the Fund. This gap came into sharper focus after the 2022 amendments to the Kansas Nurse Practice Act, which broadened the APRN scope of practice and required APRNs to carry malpractice insurance, but did not update the Fund statute to extend Fund coverage to APRNs.
The result was a category of roughly 8,500 licensed Kansas APRNs who were increasingly practicing independently but did not qualify for the legal protections and coverage benefits that physicians, physician assistants, nurse anesthetists, nurse midwives, and other Fund-qualified healthcare professionals have long relied on.
What HB 2509 Does
Beginning January 1, 2028, APRNs will qualify for the same layered professional liability coverage structure, legal protections, and coverage benefits as other Fund-qualified healthcare professionals. Among the features most directly relevant to APRNs and their employers:
- A statutory layer of Fund coverage (typically $500,000) on top of the required basic professional liability insurance coverage.
- Statutory protection from liability for injuries arising out of professional services rendered by other Fund-qualified healthcare professionals, under K.S.A. 40-3403(h).
- Guaranteed access to primary professional liability insurance through the Kansas Health Care Provider Insurance Availability Plan.
- Automatic tail coverage at no additional cost after an APRN leaves active practice.
- Consistent liability coverage that follows Kansas APRNs across practice locations.
The bill also adds a seat to the Fund’s Board of Governors for a licensed APRN, ensuring that APRNs have representation in the Fund’s governance. HB 2509 further includes a cost guardrail that limits APRNs’ initial surcharge (the amount paid for Fund participation) to no more than fifteen percent of the underlying primary insurance premium, a threshold that reflects the Fund’s long-standing approach to balancing participation with reasonable cost.
HB 2223 and HB 2068: Fund Participation Attached to Scope Expansions
HB 2223 and HB 2068 are scope-of-practice bills that each require Fund participation as a condition to exercise newly authorized practice authority. In both cases, physician stakeholders raised concerns about the underlying scope expansion based on patient safety and successfully convinced legislators to narrow the scope expansions and add Fund participation requirements for the healthcare professionals granted these expansions.
HB 2223: Optometry
HB 2223 amends the Kansas Optometry Practice Act to expand the procedures optometrists may perform—most notably, two laser procedures (laser capsulotomy and laser trabeculoplasty) that credentialed optometrists may perform independently.
The final bill includes two provisions that physician stakeholders identified as critical improvements. First, a restructured Interprofessional Advisory Committee (IPAC), with equal representation of optometrists and ophthalmologists, must make a positive recommendation before the Board of Examiners in Optometry may approve any new procedure or technology for optometrists. Second, optometrists credentialed to perform the newly authorized procedures must carry the same minimum liability insurance as physicians and participate in the Fund. The Fund’s Board of Governors is also expanded to include an optometrist.
The Fund participation requirement takes effect on January 1, 2028.
HB 2068: Pharmacists Initiating Therapy
HB 2068 authorizes pharmacists to initiate therapy (essentially to prescribe) for conditions that do not require a new diagnosis, are minor and generally self-limiting, or constitute a patient emergency if a prescription is not immediately dispensed. It also authorizes pharmacists to initiate therapy in accordance with statewide protocols for influenza, streptococcal pharyngitis, and urinary tract infection.
Again, although physician stakeholders opposed the underlying scope expansion, several narrowing amendments were ultimately included in the final bill, including a 90-day supply limit on pharmacist-initiated prescriptions, a prohibition on prescribing controlled substances (other than medication used in medication-assisted treatment for opioid use disorder), and, relevant here, a requirement that pharmacists who independently initiate therapy carry the same minimum liability insurance as physicians and participate in the Fund.
That requirement takes effect January 1, 2028.
Reaffirming a Foundational Principle of the Fund: Fund Participation is a Part of Providing Independent Medical Care
The APRN update in HB 2509, the optometry provision in HB 2223, and the pharmacist provision in HB 2068 are different in scale and scope. However, they each reaffirm the foundational principle that healthcare professionals who independently render any aspect of medical care to Kansas patients must participate in the Fund.
Honoring that principle matters. It preserves the consistent liability coverage framework across healthcare professionals who independently render any aspect of medical care. This avoids creating a patchwork of different scopes of medical professional liability coverage across the state, which can leave both healthcare professionals and patients in unexpected liability coverage gaps. It protects patients by ensuring a reliable source of recovery when medical care is negligent, regardless of which type of licensee provided it. And it protects practitioners and their employers by extending the Fund’s statutory legal protections and guaranteed access to primary coverage to the full range of healthcare professionals the system was designed to support. Taken together, these benefits help attract and retain healthcare professionals in Kansas and promote Kansans’ access to care.
Future scope-of-practice discussions in Kansas should proceed from the same foundational principle the Legislature reaffirmed in HB 2509, HB 2223, and HB 2068. Maintaining the alignment between scope and Fund participation is how Kansas continues to honor the Fund’s original purpose—and how we keep one of the most successful state liability stabilization systems in the country working as it was designed, for both Kansas patients and the healthcare professionals who serve them.