New Jersey advanced practice nurses (“APNs”) and physician assistants (“PAs”) have until April 2, 2026, to secure collaborating or supervising physicians before pandemic-era practice waivers expire. Healthcare practices and providers should take steps now to ensure compliance.
Background
On March 9, 2020, former New Jersey Governor Phil Murphy signed Executive Order 103 (“EO 103”), declaring a COVID-19 State of Emergency. Pursuant to that emergency declaration, the Governor subsequently issued Executive Order 112 (“EO 112”), which suspended certain regulatory requirements for APNs and PAs for the duration of the State of Emergency. On January 16, 2026, before leaving office, Governor Murphy signed Executive Order 415 (“EO 415”), officially terminating the State of Emergency declared in EO 103, effective February 16, 2026. As a result, the waivers granted under EO 112 were set to expire last month. However, on February 13, Governor Mikie Sherrill signed Executive Order 13 (“EO 13”), extending the State of Emergency for 45 days, until April 2, 2026, thereby preserving the EO 112 waivers during that period.
EO 112 significantly expanded the autonomy of APNs in New Jersey by suspending, for the duration of the State of Emergency or Public Health Emergency, certain statutory provisions that would otherwise require APNs to collaborate with or obtain authorization from a collaborating physician. Specifically, the order waived requirements related to entering into joint protocols with collaborating physicians who are present or readily available through electronic communication before ordering or prescribing medications or devices, including physician information on prescriptions, reviewing patient records with collaborating physicians, and obtaining physician approval for dispensing narcotic drugs for substance use disorder treatment.
Similarly, EO 112 expanded the autonomy of PAs by suspending statutory provisions requiring PAs to obtain physician supervision, enter into signed delegation agreements limiting their scope of practice to procedures customary to the supervising physician’s medical specialty, obtain authorization to order or prescribe controlled dangerous substances, and comply with limitations on assistance provided in the operating room.
Reinstatement of Requirements
The official termination of the State of Emergency by EO 415 revokes the waivers previously granted by EO 112. Therefore, effective April 2, New Jersey APNs and PAs will once again be required to comply fully with the underlying laws described above. Of particular note for physician practices employing APNs is the requirement under N.J.S.A. 45:11-49 that an APN may order medications and devices only when the collaborating physician is present or readily available through electronic communications. Beginning in April, New Jersey medical practices employing APNs must ensure that their APNs and collaborating physicians establish joint protocols, and must reinstate the pre-pandemic practice of jointly reviewing patient charts and records. Practices employing PAs must ensure that PAs have signed delegation agreements in place with supervising physicians that define the scope of practice and PAs must be under continuous physician supervision, either in person or through electronic communication.
Rationale for the Extension
EO 13 acknowledges that approximately 17,000 APNs and 4,000 PAs in New Jersey have been practicing under the suspended requirements since 2020. The sudden reinstatement of these requirements would disrupt healthcare and interfere with the delivery of health care to New Jersey communities and result in the potential closure of clinics, surgery centers, and independent practices, with particularly severe consequences for medically underserved populations. The 30-day wind-down period originally provided in EO 415 was deemed insufficient for APNs and PAs to secure collaborating or supervising physicians.
Other Considerations
While EO 415 and N.J.S.A. 45:11-49 require physicians to be present or readily available via electronic communication, practices and centers employing certain APNs or PAs may also need to adhere to additional, more restrictive requirements. For example, N.J.A.C. 13:35-4A.8 requires that when a certified registered nurse anesthetist (“CRNA”) administers and monitors general anesthesia, the supervising physician must be physically present and immediately available to diagnose and treat the patient in an emergency, without concurrent responsibilities. Therefore, APNs, PAs, CRNAs and their collaborating or supervising physicians should be aware of all applicable regulatory requirements, which may mandate physical physician presence and joint collaboration or supervision depending on the practice type and services provided.
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