§ 6902. Definition of practice of nursing. 1. The practice of the
profession of nursing as a registered professional nurse is defined as
diagnosing and treating human responses to actual or potential health
problems through such services as casefinding, health teaching, health
counseling, and provision of care supportive to or restorative of life
and well-being, and executing medical regimens prescribed by a licensed
physician, dentist or other licensed health care provider legally
authorized under this title and in accordance with the commissioner's
regulations. A nursing regimen shall be consistent with and shall not
vary any existing medical regimen.

2. The practice of nursing as a licensed practical nurse is defined as
performing tasks and responsibilities within the framework of
casefinding, health teaching, health counseling, the application of
topical fluoride varnish, and provision of supportive and restorative
care under the direction of a registered professional nurse or licensed
physician, dentist or other licensed health care provider legally
authorized under this title and in accordance with the commissioner's
regulations.

3. (a) (i) The practice of registered professional nursing by a nurse
practitioner, certified under section six thousand nine hundred ten of
this article, may include the diagnosis of illness and physical
conditions and the performance of therapeutic and corrective measures
within a specialty area of practice, in collaboration with a licensed
physician qualified to collaborate in the specialty involved, provided
such services are performed in accordance with a written practice
agreement and written practice protocols except as permitted by
paragraph (b) of this subdivision. The written practice agreement shall
include explicit provisions for the resolution of any disagreement
between the collaborating physician and the nurse practitioner regarding
a matter of diagnosis or treatment that is within the scope of practice
of both. To the extent the practice agreement does not so provide, then
the collaborating physician's diagnosis or treatment shall prevail.

(ii) Prescriptions for drugs, devices and immunizing agents may be
issued by a nurse practitioner, under this paragraph and section six
thousand nine hundred ten of this article, in accordance with the
practice agreement and practice protocols except as permitted by
paragraph (b) of this subdivision. The nurse practitioner shall obtain a
certificate from the department upon successfully completing a program
including an appropriate pharmacology component, or its equivalent, as
established by the commissioner's regulations, prior to prescribing
under this paragraph. The certificate issued under section six thousand
nine hundred ten of this article shall state whether the nurse
practitioner has successfully completed such a program or equivalent and
is authorized to prescribe under this paragraph.

(iii) Each practice agreement shall provide for patient records review
by the collaborating physician in a timely fashion but in no event less
often than every three months. The names of the nurse practitioner and
the collaborating physician shall be clearly posted in the practice
setting of the nurse practitioner.

* (iv) The practice protocol shall reflect current accepted medical
and nursing practice and may be updated periodically. The commissioner
shall make regulations establishing the procedure for the review of
protocols and the disposition of any issues arising from such review.

* NB Effective until July 1, 2026

* (iv) The practice protocol shall reflect current accepted medical
and nursing practice. The protocols shall be filed with the department
within ninety days of the commencement of the practice and may be
updated periodically. The commissioner shall make regulations
establishing the procedure for the review of protocols and the
disposition of any issues arising from such review.

* NB Effective July 1, 2026

(v) No physician shall enter into practice agreements with more than
four nurse practitioners who are not located on the same physical
premises as the collaborating physician.

* (b) Notwithstanding subparagraph (i) of paragraph (a) of this
subdivision, a nurse practitioner, certified under section sixty-nine
hundred ten of this article and practicing for more than three thousand
six hundred hours shall not be required to comply with the requirements
of paragraph (a) of this subdivision relating to collaboration with a
physician, a written practice agreement and written practice protocols.

* NB Effective until July 1, 2026

* (b) Notwithstanding subparagraph (i) of paragraph (a) of this
subdivision, a nurse practitioner, certified under section sixty-nine
hundred ten of this article and practicing for more than three thousand
six hundred hours may comply with this paragraph in lieu of complying
with the requirements of paragraph (a) of this subdivision relating to
collaboration with a physician, a written practice agreement and written
practice protocols. A nurse practitioner complying with this paragraph
shall have collaborative relationships with one or more licensed
physicians qualified to collaborate in the specialty involved or a
hospital, licensed under article twenty-eight of the public health law,
that provides services through licensed physicians qualified to
collaborate in the specialty involved and having privileges at such
institution. As evidence that the nurse practitioner maintains
collaborative relationships, the nurse practitioner shall complete and
maintain a form, created by the department, to which the nurse
practitioner shall attest, that describes such collaborative
relationships. For purposes of this paragraph, "collaborative
relationships" shall mean that the nurse practitioner shall communicate,
whether in person, by telephone or through written (including
electronic) means, with a licensed physician qualified to collaborate in
the specialty involved or, in the case of a hospital, communicate with a
licensed physician qualified to collaborate in the specialty involved
and having privileges at such hospital, for the purposes of exchanging
information, as needed, in order to provide comprehensive patient care
and to make referrals as necessary. Such form shall also reflect the
nurse practitioner's acknowledgement that if reasonable efforts to
resolve any dispute that may arise with the collaborating physician or,
in the case of a collaboration with a hospital, with a licensed
physician qualified to collaborate in the specialty involved and having
privileges at such hospital, about a patient's care are not successful,
the recommendation of the physician shall prevail. Such form shall be
updated as needed and may be subject to review by the department. The
nurse practitioner shall maintain documentation that supports such
collaborative relationships. Failure to comply with the requirements
found in this paragraph by a nurse practitioner who is not complying
with such provisions of paragraph (a) of this subdivision, shall be
subject to professional misconduct provisions as set forth in article
one hundred thirty of this title.

* NB Effective July 1, 2026

(c) Nothing in this subdivision shall be deemed to limit or diminish
the practice of the profession of nursing as a registered professional
nurse under this article or any other law, rule, regulation or
certification, nor to deny any registered professional nurse the right
to do any act or engage in any practice authorized by this article or
any other law, rule, regulation or certification.

(d) The provisions of this subdivision shall not apply to any activity
authorized, pursuant to statute, rule or regulation, to be performed by
a registered professional nurse in a hospital as defined in article
twenty-eight of the public health law.