Can Nurse Practitioners Practice Independently in New York State?

In 2022, Governor Kathy Hochul signed legislation granting full practice authority to Nurse Practitioners (NPs) in New York State. This law allows NPs to practice independently without the need for physician supervision. While this expansion of authority is a significant advancement for healthcare in New York, there are still important guidelines NPs must follow, particularly for those with less than 3,600 hours of experience.

Full Practice Authority for Nurse Practitioners in New York

As of 2022, NPs with over 3,600 hours of practical experience can practice independently in New York. In particular, they can diagnose and treat their patients without the necessity for physician supervision. It is most important to note that while this grant of authority was incorporated into the nursing laws of New York, there is a sunset provision of July 1, 2026, which means if the NYS legislature fails to implement superseding legislation to protect this authority, NPs could be reverted back to requiring physician supervision.

What About NPs with Less Than 3,600 Hours of Experience?

Nurse practitioners with less than 3,600 hours of practice may practice independently; however, they are still required to work with a collaborating physician. Here are the key steps to ensure that NPs with less than 3,600 hours of practical experience are staying in compliance with New York law:

Written Practice Protocols: NPs must follow written practice protocols reflecting their sub-speciality area of practice, e.g., adult health, family health, psychiatry, etc. These protocols outline the scope of practice, standards of care, and must reflect current, accepted medical and nursing practice.
Written Practice Agreement: A formal Written Collaborative Practice Agreement must be in place between the NP and the supervising physician. This agreement specifies the collaboration terms, including patient care responsibilities, patient referral and consultation, coverage for emergency absences, resolution of disagreements, identification of the written practice protocols utilized by the NP and peer review of patient records.
Filing Form 4NP with NYSED: NPs with less than 3,600 hours of practical experience are required to file Form 4NP with the New York State Education Department (NYSED) to document their collaborative agreement and practice protocols. This is a mandatory step for NPs working under supervision until they complete the required 3,600 hours of experience.

Starting a PLLC for your Private Practice

Regardless of whether the NP has under or over 3,600 hours of experience, they are permitted to set up their own private practice utilizing a professional service limited liability company, which provides liability protection and corporate entity structure to manage their business affairs.

Conclusion

New York’s full practice authority for nurse practitioners is a significant step forward for the profession, allowing NPs to practice independently without physician supervision. For NPs with less than 3,600 hours of experience, following the required steps—establishing written collaborative practice agreements, written practice protocols, and filing Form 4NP—ensures compliance with state law while gaining valuable practical experience.

How We Can Help

If you are an NP looking to set up your own private practice, feel free to contact us for assistance in ensuring you meet the necessary legal requirements to practice in New York State. If you are interested in setting up a PLLC, please do not hesitate to give us a call at (212) 547-8857 or schedule a consultation online and we'd be happy to work with you. Our experienced business attorneys are here to provide the advice you need.

Disclaimer: This blog post and similar posts are not to be considered as providing legal advice. The discussion here is meant for educational and informational purposes only and shall not create an attorney-client relationship with the readers of this content.