New York’s 2023 state budget, signed into law on April 9, included an amendment to the state’s Education Law establishing 3,600 practice hours as a threshold beyond which nurse practitioners no longer require a collaborative agreement or a collaborative relationship with a physician to practice within their educational and clinical practice area. Practitioners such as Certified Registered Nurse Anesthetists must be looked at on an individual basis to determine whether their credentials make them eligible to practice without a collaborative relationship.

New York law previously allowed experienced NPs with at least 3,600 or more practice hours to practice with less physician oversight (based on only “collaborative relationships” with a physician or hospital in the NP’s specialty) and without requiring a written collaborative agreement. Previously, experienced NPs were required to sign a Department of Health form acknowledging that in the event of a dispute regarding patient care between an NP and the collaborating physician, the physician’s recommendation would prevail.

Nurse practitioners with fewer than 3,600 practice hours must still practice pursuant to a written practice agreement and practice protocols under the supervision of a physician.  Although proposed and lobbied for, the newly enacted legislation does not permit NPs with more than 3,600 hours to oversee and supervise other less experienced NPs, who still require physician oversight.

The enacted bill also makes permanent certain provisions of the Nurse Practitioners Modernization Act which would otherwise have expired on June 30, 2022.