Doctors and nurses are feuding as N.J. weighs possible rule change. Is it safe?
Some health care clinics and med spa sin New Jersey are rejoicing — at least for now — thanks to a new executive action by Gov. Mikie Sherrill.
With the stroke of her pen, the governor gave a new lifeline to practices that are run independently by Advanced Practice Nurses, or APNs.
Without the move, they would have had to hire collaborating physicians to run their practices — or shut their doors by Feb. 16.
“With today’s executive order, we are providing more time for advanced practice nurses and physician assistants to adjust to this new regulatory landscape, delivering on our commitment to make it easier for small businesses to thrive in New Jersey,” Sherrill said in a press release.
“These sudden regulatory changes will have wide-ranging impacts on health care professionals and patients alike – potentially even forcing clinics and small, independent practices to close their doors, making it more difficult for New Jerseyans to access critical health care services,” she said.
But the future is still unclear. Sherrill’s action gives them 45 more days to come into compliance with the collaborating physician rule. But importantly, the move also gives lawmakers who support APN independence more time to put new rules into place.
The conflict was spotlighted in an NJ.com special report earlier this month.
APNs first received autonomy during the height of the COVID pandemic when then-Gov. Phil Murphy lifted a longstanding rule that required APNs to work with a collaborating physician.
The idea was to increase access to health care at a time when hospital systems were deluged with overwhelming patient loads during the pandemic.
And it worked, but it wasn’t without controversy.
Some APNs started their own practices, focusing on everything from women’s healthcare to pediatrics to mental health care. But others opened aesthetic med spas that offer treatments like Botox and IV therapy, something critics say was not in line with the spirit of Murphy’s order.
Just before he left office, Murphy put back in place the original regulation, taking away the autonomy that APNs had enjoyed for nearly six years. Then, to keep their practices, they would need to partner with a collaborating physician or shut down, and they’d have only 30 days to do it.
It threw New Jersey’s medical community into chaos, with APNs crying foul.
It would cost from $1,000 to $2,000 a month to add a collaborating physician — who would never see patients — to his practice, said Marcel Kaganovskaya, a family and psychiatric-mental health nurse practitioner who works in Montclair and New York City.
Dr. Marcel Kaganovskaya, a dual-certified Family and Psychiatric-Mental Health Nurse Practitioner speaks durintg the hearing. The Senate Health, Human Services and Senior Citizens committee holds a hearing on S2996, which would eliminate certain practice restrictions for advanced practice nurses. The hearing was held at the Statehouse Annex in Trenton, New Jersey on Monday, February 9, 2026.
Patti Sapone | NJ.com
“This is going to be a public health emergency,” said Kaganovskaya, who also is the executive director of The Society of Psychiatric Advanced Practice Nurses.
He, and others, said they’d consider leaving the state because of the rule change.
Fighters on both sides of the issue descended on the Statehouse in Trenton earlier this week to sway lawmakers who were considering a bill that would permanently eliminate certain practice restrictions for APNs.
It would keep independent APNs in business.
More than two dozen practitioners and lobbyists pleaded their cases for more than 90 minutes at the Senate health committee hearing.
The Senate Health, Human Services and Senior Citizens committee holds a hearing on S2996, which would eliminate certain practice restrictions for advanced practice nurses. The hearing was held at the Statehouse Annex in Trenton, New Jersey on Monday, February 9, 2026. Staff | NJ.com
Doctor after doctor claimed that patient safety was at issue.
“We cannot compromise patient safety in the name of access,” said Dr. Kendrick Abad, a psychiatrist representing the New Jersey Psychiatric Association.
Emergency measures put in place during COVID should not “permanently weaken longstanding clinical safeguards — especially in complex, high-acuity areas of medicine,“ said Richard Colavita, a physician anesthesiologist and pediatrician.
”This is not safe and sets a dangerous precedent,” said Colavita, president of the New Jersey State Society of Anesthesiologists.
Richard ColavitaÊspeaks during the hearing. The Senate Health, Human Services and Senior Citizens committee holds a hearing on S2996, which would eliminate certain practice restrictions for advanced practice nurses. The hearing was held at the Statehouse Annex in Trenton, New Jersey on Monday, February 9, 2026.
Patti Sapone | NJ.com
But the nurses argued that there was no evidence during the six years of independence that patients were harmed because of practices operating without a physician.
Since the pandemic, New Jersey’s APN workforce grew 75% without an uptick in reported adverse events or malpractice, said Daria Waszak, executive director for the New Jersey Collaborating Center for Nursing.
And, supporters said, access to care improved.
Larider Ruffin, an APN representing the New Jersey State Nurses Association, said losing practices like his would hurt the state’s “most vulnerable residents.”
He encouraged passage of the bill “for the sake of my patients, my families, your families and your constituents.”
Shonta Collins, a family nurse practitioner, said her clients from underserved communities count on her for care.
”I was paying thousands of dollars to this collaborator that I never saw,” she said of her practice before the pandemic.
“I am a servant and that is what I do,” she said, unable to hold back tears during her testimony.
Shonta Collins becomes emotional as she speaks during the hearing. The Senate Health, Human Services and Senior Citizens committee holds a hearing on S2996, which would eliminate certain practice restrictions for advanced practice nurses. The hearing was held at the Statehouse Annex in Trenton, New Jersey on Monday, February 9, 2026.
Patti Sapone | NJ.com
Next, lawmakers who support APN autonomy will have to hustle to find an agreement and get a bill passed before the 45-day period ends.
State Sen. Joseph Vitale, D-Middlesex and co-sponsor of the bill to give autonomy back to nurses permanently, said he was grateful for the time to find a legislative solution
“Nurse practitioners for the past six years – since COVID – have worked to the full extent of their training, providing care to thousands of New Jerseyans, whether it’s physical health or mental health,” said Vitale, chairman of the Senate health committee.
“They have not only filled the gap, they have extended the level of care,” he said. “Safety has never been an issue.”
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