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New York, Kansas, Massachusetts, and Delaware Become the latest States to Adopt Full Practice Authority for Nurse Practitioners

Client Alert

While the COVID-19 pandemic certainly created many obstacles and hardships, it also created many opportunities to try doing things differently. This can be seen in the instant rise of remote work opportunities, telehealth visits, and virtual meetings. Many States took the challenges of the pandemic and turned them into an opportunity to adjust the regulations governing licensed professionals, including for advanced practice registered nurses (APRNs). 

On April 15, 2022, Kansas became the latest state to remove practice restrictions on nurse practitioners and allow them to practice completely independent of any regulatorily mandated contractual relationship with a physician. This was very shortly after similar changes were made in New York, Massachusetts, and Delaware. In total, 26 States, the District of Columbia, and two U.S. territories (Guam and Northern Mariana Islands) now permit nurse practitioners to practice without any mandated collaborative agreement or supervision. Many other States, including Ohio, are currently evaluating legislation to implement full practice authority for APRNs. A map illustrating the current position of all U.S. States and territories regarding full practice authority can be found here.

It should be noted that each full practice authority State is different with regards to the requirements to practice independently. For example, some States require a transition to practice period where the APRN practices under supervision or regulatory collaboration for a minimum period of time before being licensed to practice independently.

The trend towards adopting full practice authority for APRNs will have a direct impact on the number of patient care roles that will be filled by APRNs. Over the course of seven years (as reported in 2020), the number of nurse practitioners in the U.S. more than doubled. Additionally, the U.S. Department of Labor expects the number of jobs held by nurse practitioners, CRNAs, and certified nurse midwives to increase 45% between 2020 and 2030.

If you have questions about APRN practice rules or starting an APRN-driven business, please don’t hesitate to contact Jeana Singleton by email at: jmsingleton@bmdllc.com, or by phone at: (330) 253-2001 or another member of the Health Law Department at Brennan, Manna & Diamond.


Florida Super Lawyers® Recognizes Brennan Manna Diamond Attorneys to the 2026 Lists

BRENNAN, MANNA & DIAMOND is proud to announce that three of our attorneys have been designated to the 2026 Florida Super Lawyers® and Florida Rising Stars® lists. Super Lawyers is based on multiple categories of independent research and peer evaluation to identify outstanding lawyers.

Supreme Court Clears Path for TPS Terminations: What Employers Need to Know

The U.S. Supreme Court's June 25, 2026 decision in Mullin v. Doe and Trump v. Miot removed legal obstacles that had delayed the termination of Temporary Protected Status (TPS) for Haiti and Syria. The ruling also reinforces the administration's authority to terminate other TPS designations currently under review. Employers should immediately identify workers whose employment authorization is tied to affected TPS programs, review Form I-9 records, and prepare for forthcoming USCIS guidance before taking any employment action.

The Risks of Outsourcing Medical Billing and the Importance of State-Law Compliance

Offshoring medical billing and other administrative functions can reduce costs, but it also raises significant compliance, operational, and contractual risks. Although HIPAA does not explicitly prohibit protected health information from being accessed or stored outside the United States, healthcare providers and their vendors remain responsible for safeguarding patient information and complying with state-specific restrictions that may limit or prohibit offshore subcontracting.

Risks of Using AI-Generated, Implied Celebrity Endorsements in Advertising

Businesses using AI-generated celebrity images, videos, or voice simulations in advertising may face significant legal risks if the content falsely implies an endorsement, affiliation, or sponsorship. This article discusses potential exposure under false advertising, right of publicity, consumer protection, and professional conduct laws, and explains why disclaimers may not be enough to avoid liability.

CMS Requires Providers to Use an Updated Advance Beneficiary Notice (ABN) Form by May 12, 2026

CMS has released an updated Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, that all providers and suppliers must begin using by May 12, 2026. The revised form includes clearer language and formatting updates intended to improve patient understanding and compliance.