Changes to Collaborative and Supervised Practice Rules Effective June 14, 2021

Board rules regarding collaborative and supervised practices were recently amended, most notably to increase the maximum number of Certified Registered Nurse Practitioners, Certified Nurse Midwives, and assistants to physicians a physician may collaborative with/supervise in all states from four to nine full-time equivalent hours (FTEs) per week.  The amendments became effective on June 14, 2021.

Documented quality assurance review will be required for physicians collaborating with/supervising more than 4 FTEs per week, every month for six (6) months following the commencement of a collaborative practice or application for registration with a new mid-level practitioner.

Additionally, physicians will be required to disclose the existence of all collaborative/supervisory agreements in all states upon submission of a new collaborative practice commencement or application for registration. 

Other changes include:

  • Continuing medical education requirements for physicians and advanced practice practitioners for initial and renewal applications.
  • Collaborating physicians must be readily available at each remote practice site.
  • Collaborating physicians must certify at least annually that any approved covering physician continues to agree to serve as a covering physician and to inform the Board of the termination of a covering physician within ten days of the covering physician relationship being terminated.
  • Covering physicians must agree in writing to be readily available for collaboration, to provide medical oversight, and, if indicated, to provide direct medical intervention in the absence of the collaborating physician. The covering physician must be either a member of the same medical practice, practice group, or multidisciplinary medical team, or of the same or similar practice specialty as the collaborating physician.


View the rule amendment documents here