Are CRNAs and CNSs Eligible for the IMLC?
No. The Interstate Medical Licensure Compact (IMLC) is currently limited to physicians — specifically MDs and DOs — who meet a strict set of licensure and eligibility criteria. That means Certified Registered Nurse Anesthetists (CRNAs) and Clinical Nurse Specialists (CNSs) are not eligible to apply through the IMLC.
Why Are CRNAs and CNSs Excluded?
Because the IMLC was created by and for state medical boards, its jurisdiction only covers physician licensure. Advanced practice nurses — including CRNAs and CNSs — are regulated by state nursing boards. As a result, separate compacts or state-based licensure systems apply to those roles.
Is There an Alternative for CRNAs and CNSs?
Yes, but it's evolving. The APRN Compact is designed to allow advanced practice registered nurses, including CRNAs and CNSs, to practice across state lines with a single multistate license. However, it has not yet been fully implemented. A minimum of seven states must enact legislation before it becomes active.
What Is the APRN Compact?
Developed by the National Council of State Boards of Nursing (NCSBN), the APRN Compact allows eligible APRNs to:
- Hold one multistate license
- Practice in all other compact states without additional applications
- Maintain compliance with only one state board
It’s designed to mirror the success of the Nurse Licensure Compact (NLC) for RNs and LPNs.
What Are the Eligibility Requirements for the APRN Compact?
To qualify, CRNAs and CNSs must:
- Hold an active, unencumbered APRN license
- Be certified by a national board (e.g., NBCRNA for CRNAs)
- Pass background checks and meet all compact eligibility criteria
- Reside in a participating compact state once enacted
Can CRNAs and CNSs Still Practice Across State Lines?
Yes, but it requires applying separately to each state. Some states offer streamlined processes or reciprocity agreements, but most require full licensure applications and fees. Telehealth, temporary permits, and employer-sponsored licensing can help in certain situations.
Are Any States Easier for Multistate Practice?
Some states are known for more flexible licensing policies for APRNs, including compact participation or fast-track processes. If you're pursuing cross-state work, start by identifying states that support the APRN Compact and have clear, online-friendly licensing portals.
How Can You Prepare for the APRN Compact?
- Track legislative progress in your state and nationally
- Make sure your license is in good standing
- Maintain active national certification
- Keep detailed CME and renewal documentation
Being ready in advance means you can apply immediately once your state activates the compact.
Final Thoughts
CRNAs and CNSs are not eligible for the IMLC, but progress is being made through the APRN Compact. Until then, multistate licensing requires individual applications, careful tracking, and strategic planning.
The landscape is changing — and staying informed ensures you're ready to practice where you're needed most, without unnecessary delays.