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May 12, 2022

New York State Budget Bill Expands Independence of Nurse Practitioners

Buried within the New York State 2023 budget bill were several amendments to the state’s education law, which expand the independence of nurse practitioners (NPs). NPs are advanced practice registered nurses who are trained and qualified to engage in an expanded scope of practice, including diagnosing patient conditions, assessing patient health, and prescribing medications. 

Prior to the enactment of the budget bill, New York State law allowed NPs to practice in accordance with written protocols filed with the Department of Health in collaboration with a physician. The Nurse Practitioner Modernization Act, effective January 1, 2015, amended New York State Education Law Section 6902 by drawing a distinction depending on the NP’s level of experience. NPs with less than 3,600 hours of practice were required to have a written practice agreement with a collaborating physician who must review the NP’s patient records at least every three months. NPs with more than 3,600 hours were not required to have a written collaboration agreement with a physician as long as they maintained evidence of collaborative relationships with one or more qualified physicians or a New York State licensed health care facility (i.e., hospital, nursing home, ambulatory surgery center, or diagnostic and treatment center). The Nurse Practitioner Modernization Act was due to sunset in 2022, but has now been extended and expanded. 

Effective April 9, 2022, New York State no longer requires NPs to file their written protocols with the Department of Health. While the requirements for written collaboration agreements have not changed for less-experienced NPs, New York State now grants even more autonomy to experienced NPs with over 3,600 practice hours. Experienced NPs are no longer required to maintain a demonstrated collaborative relationship with a physician or health care facility. Moreover, for these NPs, the law eliminated the provision that in the event of a dispute regarding patient care, the recommendation of a licensed physician shall prevail. These amendments are due to expire in two years if not further renewed.

NPs have long played a vital role in providing care to patients in a wide range of settings, particularly in medically underserved communities. New York now joins 25 other states plus the District of Columbia in granting full practice authority to experienced NPs.

If you have any questions regarding the content of this article, please contact Fran Ciardullo, special counsel, at, or another member of Barclay Damon’s Health & Human Services Providers Team.


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