New York passed the Nurse Practitioner Modernization Act (NPMA) in 2022 under Governor Kathy Hochul. The law granted full practice authority to experienced NPs — specifically those with 3,600+ hours of clinical practice over at least two years. Under the NPMA, qualified NPs can prescribe, diagnose, and treat patients without a written collaborative agreement with a supervising physician.
What the law also included, buried in the legislative text: a sunset clause. The NPMA's full practice authority provisions expire July 1, 2026 unless the legislature acts to make them permanent.
That deadline is 39 days away.
What S2360 Would Do
Senate Bill S2360, sponsored by Senator Gustavo Rivera, would remove the sunset clause from the NPMA and make the 2022 reforms permanent. The bill also preserves a structured pathway for newly certified NPs: new graduates can still choose to collaborate with either a supervising physician or an experienced NP for the first two years of practice. After that supervised period, they can practice fully independently.
The bill passed out of committee but has not yet received a floor vote in the full Senate as of May 23. The Assembly companion bill is similarly pending. The legislative session typically ends in June.
What Happens if the Legislature Doesn't Act
The language is unambiguous: if S2360 is not passed and signed by July 1, NPs who currently practice without a collaborative agreement under the NPMA will be legally required to either establish a formal written collaborative agreement with a physician or stop seeing patients independently. There is no grace period built into the existing statute.
New York has approximately 20,000 licensed nurse practitioners. A significant portion of those who have accumulated 3,600+ hours of supervised practice since 2022 are currently relying on the NPMA's independent practice provisions. If the law sunsets, those practitioners face an immediate compliance problem: finding a physician willing to enter a collaborative agreement (a transaction that historically involves fees, paperwork, and physician availability that varies widely by specialty and geography) on a compressed timeline.
In rural New York — upstate, the North Country, the Southern Tier — the physician shortage means some NPs simply cannot source a collaborating physician even if they want one. That's the practical consequence of a sunset: not just paperwork, but potential forced closure of practices or departures from regions that have no other primary care providers.
The Politics
The medical lobby's historical position on NP full practice authority is well documented. The Medical Society of the State of New York (MSSNY) has consistently opposed FPA legislation, arguing that physician oversight protects patient safety. NP advocacy groups — the New York State Association of Nurse Practitioners, NYSNA, and others — point to 4+ years of post-NPMA data in New York and 15+ years of data from the 30+ states that have had FPA for longer as evidence that patient outcomes do not worsen under independent NP practice.
The sunset clause was a political compromise in 2022 — a way to get the NPMA passed by giving physician-aligned legislators a kill switch. Making the law permanent removes that kill switch, which is exactly why medical lobby opposition to S2360 is real and why Albany's action (or inaction) before July 1 is not a formality.
What NPs in New York Should Do Now
If you are a New York NP currently practicing under the NPMA's independent authority provisions, watch the legislative calendar. The session typically adjourns in mid-June. If S2360 has not passed by the time the legislature leaves Albany, the clock to July 1 becomes very short with no legislative fix available until January 2027 at the earliest.
Contact your state senator and assembly member. This is a bill where constituent calls from NPs and patients in underserved areas carry real weight, because the access-to-care argument is the strongest counter to the medical lobby's patient safety framing. Frame it as a rural access issue as much as a professional autonomy issue — that's the argument most likely to move moderate legislators.
If the worst happens and the law sunsets, the path to a collaborative agreement is not impossible — but it requires lead time. Start identifying potential collaborating physicians in your specialty now rather than scrambling after July 1.