A dispute over how Georgia law should be interpreted has advanced practice registered nurses warning that patients in rural communities could lose access to medical care if the issue is not resolved.

The debate centers on a recent interpretation issued by the Georgia Composite Medical Board involving a 2006 state law governing the relationship between nurse practitioners and supervising physicians. Under Georgia law, advanced practice registered nurses, or APRNs, must have a protocol agreement with a physician in order to practice. The board’s guidance states that physicians who receive compensation from a nurse-owned clinic for providing that supervision could be considered employees of the clinic, creating legal concerns for those arrangements.

Nursing leaders told members of the Georgia House Health Committee this week that the guidance has already caused some physicians to terminate or reconsider their supervisory agreements. Without those agreements, nurse practitioners cannot legally provide care, raising concerns that some clinics—particularly those serving rural and underserved areas—could be forced to reduce services or close.

The Georgia Board of Nursing says many of the affected practices provide primary care, mental health services, and other essential medical care in communities where physician shortages already exist. Nursing advocates argue that the uncertainty created by the new interpretation could leave patients with fewer local healthcare options.

Representatives of the Medical Association of Georgia and the Georgia Composite Medical Board disagree with claims that the guidance will reduce healthcare access. They say the interpretation is intended to prevent improper “rubber-stamp” supervision arrangements and ensure physicians provide meaningful oversight rather than simply signing agreements for a fee. They also say they are working with the nursing community to clarify the guidance.

Members of the House Health Committee have encouraged both sides to continue working toward a solution without requiring legislative action. For now, the issue remains unresolved, leaving many rural healthcare providers uncertain about how the guidance will affect their practices.