On August 11, 2025, Wisconsin enacted the APRN Modernization Act (AB 257), a big update to nursing practice and licensure requirements. The law creates a new system for licensing advanced practice registered nurses (APRNs), establishes clear pathways for independent practice, and updates prescribing and malpractice insurance rules. Here’s what you should know:
A New APRN Licensure System
Previously, Wisconsin only licensed registered nurses (RNs). AB 257 creates a separate licensure process for APRNs, administered by the Board of Nursing. To qualify for an APRN license, applicants must:
- Hold (or concurrently apply for) an RN license;
- Complete an accredited graduate or postgraduate APRN program in one of four recognized roles (nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist, or clinical nurse specialist);
- Hold a current national certification approved by the board;
Carry malpractice liability insurance; and - Pay licensing fees and meet other criteria specified by the Board.
The law also contains provisions for certain RNs who are already practicing in recognized APRN roles as of January 1, 2026. RNs who are actively practicing in one of the four recognized APRN roles (nurse practitioner, clinical nurse specialist, certified nurse-midwife, or certified registered nurse anesthetist) may be automatically granted an APRN license. To qualify, RNs must: hold a valid Wisconsin RN license; and demonstrate they have been practicing in one of the recognized APRN roles before January 1, 2026.
Transition-to-Practice Requirement
APRNs, except certified nurse-midwives, must initially practice under physician or dentist collaboration. To gain full independent authority, the APRN must complete:
- 3,840 hours of professional nursing in a clinical setting; and
- 3,840 hours of APRN clinical practice in their recognized role, in collaboration with a physician or dentist.
Certified nurse-midwives are automatically licensed under the new APRN system and, unlike other APRNs, are not subject to the 3,840-hour transition-to-practice requirement. Some collaborative APRN hours may also count toward the professional nursing requirement, providing flexibility. After completing these requirements, APRNs may practice independently, including diagnosing, treating, prescribing, and managing patient care.
Prescribing Authority
The law eliminates the prior “certificate to issue prescription orders” system. Instead, licensed APRNs are automatically authorized to prescribe, subject to Board regulations and malpractice insurance requirements.
- APRNs may prescribe medications (including controlled substances, subject to DEA and state restrictions).
- Existing RNs who were previously certified to prescribe are automatically granted APRN licenses with the proper specialty designation.
- Those without prescribing certification as of January 1, 2026, may be licensed as APRNs but cannot prescribe unless they meet updated requirements.
Malpractice Insurance
The law requires APRNs to maintain malpractice coverage equal to that required for physicians and nurse anesthetists. APRNs practicing independently outside a collaborative or employment relationship must also participate in the Injured Patients and Families Compensation Fund, which provides additional malpractice coverage.
Final Takeaways:
- Wisconsin now licenses APRNs directly, with four recognized specialty roles.
- Independent practice is available, but only after meeting dual 3,840-hour requirements.
- All APRNs must carry malpractice insurance, with additional requirements for those practicing independently.
Prescribing authority is tied directly to APRN licensure.