On March 23, 2026, the New Jersey Senate and Assembly passed Senate Bill 2996 (SB 2996). As currently passed, the bill would permit Advanced Practice Nurses (APNs) with more than 5,000 hours of licensed, active, advanced nursing experience to practice independently, provided they operate within certain population focuses and deliver primary or behavioral health care. The amended bill also notably excludes APNs providing elective aesthetic or cosmetic services from independent practice authority.
Background: Executive Orders and Proposed Legislation
As we highlighted previously, former Governor Phil Murphy’s Executive Order 415 terminated the COVID-19 emergency, reinstating the requirement that APNs maintain joint protocols with collaborating physicians in order to prescribe medications or medical devices.
Shortly thereafter, Governor Mikie Sherrill signed Executive Order 13 (EO 13), which extended the COVID-era waiver for 45 days until April 2, 2026, for the limited purpose of preserving APNs’ ability to practice without a joint protocol. In EO 13, Governor Sherrill notably referenced SB 2996 and indicated that “reinstating the joint protocol requirement for these advanced practice nurses only to eliminate it through subsequent legislation would lead to unnecessary disruption and confusion among patients and healthcare professionals alike.”
SB 2996 was originally introduced on January 13, 2026, and, as introduced, would have permitted APNs with greater than 24 months or 2,400 hours of licensed, active, advanced nursing practice to practice without a joint protocol. However, the bill was significantly amended during the committee process, and the version that passed the Senate contains substantially different provisions from the original, including an increased threshold of 5,000 hours of practice, a narrowed scope limited to APNs practicing within specific population focuses such as lifespan, adult gerontology, pediatrics, women’s health, or behavioral health, and a requirement that APNs provide either primary or behavioral health care.
The Bill as it Currently Stands
The committee substitute adopted on March 19, 2026, introduces several significant changes from the original version of the bill. Most notably:
Increased Hour Threshold
The original bill would have allowed APNs with more than 2,400 hours of licensed, active, advanced nursing practice to practice independently. The amended version more than doubles that requirement, now mandating that an APN have more than 5,000 hours of licensed, active, advanced nursing practice in a role with the applicable population focus before becoming eligible to practice without a joint protocol.
Narrowed Scope of Eligible Specialties
Under the amended bill, independent practice authority is limited to APNs who are authorized to practice within a population focus of family or individual across the lifespan, adult gerontology, pediatrics, women’s health, or behavioral health.
Exclusion of Cosmetic and Aesthetic Services
The amended bill expressly provides that an APN seeking to practice independently must not be providing elective aesthetic or cosmetic services. This exclusion has drawn considerable attention and concern from APNs working in medical spas, aesthetics practices, and similar settings.
Required Primary or Behavioral Health Care Focus.
Even for APNs within an eligible population focus, independent practice authority applies only to those providing primary health care or behavioral health care. The bill defines “primary health care” broadly to encompass screening, assessment, diagnosis, treatment, management, or reassessment services provided in a family-centered and community-oriented manner across a range of areas, including family practice, general internal medicine, general pediatrics, general obstetrics, gynecology and reproductive health services, or clinical prevention. “Behavioral health care” is defined as procedures or services rendered for the treatment of a mental illness, emotional disorder, or drug or alcohol use disorder.
Transition Provisions for Currently Practicing APNs
The bill also includes important transition provisions for APNs who are currently practicing without a joint protocol under EO 13. If an APN would reach 5,000 hours of licensed, active, advanced nursing practice within 12 months of the bill’s effective date, the APN may continue practicing without a joint protocol. However, if an APN would have fewer than 5,000 hours within 12 months of the effective date, the APN may continue practicing without a joint protocol for only six months, after which the APN must establish a joint protocol with a collaborating physician. Importantly, any hours of practice without a joint protocol during this transition period would count toward the 5,000-hour threshold.
Will Governor Sherrill Sign the Bill?
It remains unclear whether Governor Sherrill will sign the legislation in its current amended form or send it back to the legislature. While EO 13 contained language that appeared to signal support for expanding APN independent practice authority, the significantly amended version of SB 2996, with its narrower scope, higher hour threshold, and exclusion of aesthetic and cosmetic services, is a very different bill than what was originally introduced. Whether the Governor views these amendments as appropriate guardrails or as provisions warranting further revision remains to be seen. APNs and healthcare providers across New Jersey should be monitoring the status of SB 2996 closely.
How Frier Levitt Can Help
The amended SB 2996 raises important compliance questions for APNs across the state, particularly those practicing in aesthetic and cosmetic settings who may find themselves excluded from independent practice authority, or those APNs who are unsure of whether they qualify under the new law. Frier Levitt is actively monitoring this legislation and all regulatory developments affecting APNs in New Jersey. If you have questions about how the amended bill may impact your practice, your compliance obligations, or alternative practice structures, our team is ready to assist.
Read our previous updates:
– New Jersey Revokes COVID-Era Waivers for Advanced Practice Nurses
