Eliminates certain practice restrictions for advanced practice nurses.

The threshold for independent practice without a joint protocol changed from 24 months or 2,400 hours of licensed active advanced nursing practice to more than 5,000 hours in a role with an applicable population focus (family/individual across lifespan, adult gerontology, pediatrics, women's health, or behavioral health).

Independent practice without a joint protocol is now limited to APNs providing primary health care or behavioral health care. APNs providing general obstetrics services or elective aesthetic/cosmetic services are explicitly excluded from the exemption.

The definition of 'collaborating provider' (which allowed an experienced APN with 24 months/2,400 hours to serve as a collaborator) was replaced with 'collaborating physician,' limited to a person licensed to practice medicine and surgery.

The provisions granting APN-Anesthesia (Certified Registered Nurse Anesthetist) full independent practice authority after 24 months/2,400 hours without physician supervision or joint protocols were removed entirely.

The original bill repealed sections 10 of P.L.1999 c.85, section 12 of P.L.1991 c.377, and section 13 of P.L.1991 c.377. The substitute instead amends these sections to preserve their rulemaking functions while ensuring rules are not more restrictive than the act.

The medical cannabis authorization provision was restructured so that APNs meeting the 5,000-hour and population focus criteria can authorize qualifying patients without a joint protocol, subject to the same exclusions (no general obstetrics, no elective aesthetic services) and the behavioral health referral requirement.

APNs practicing independently must be covered by malpractice liability insurance (or a letter of credit) at least equal to the minimum amount applicable to a licensed physician, and must notify the Board of Nursing of the carrier's name and address.

Continuing professional education in pharmacology related to controlled substances increased from 6 contact hours to 14 contact hours. The separate requirement for 10 contact hours each biennial period was removed.

APNs practicing independently must be held to the same standard of care as other independent health care practitioners, and if not providing services to Medicare beneficiaries, must prominently display an appropriate notice in their office and inform the Board of Nursing in writing.

APNs practicing independently must immediately notify the Board of Nursing if they are medically incapable of discharging their functions, indicted or convicted of a crime involving moral turpitude, named in a civil/criminal/administrative investigation for malpractice or misconduct, subject to disciplinary action by any state or federal agency, or fail to maintain required certification.

New Board of Nursing disciplinary authority added allowing the board to limit, restrict, deny, suspend, or revoke an APN's licensure or prescriptive/dispensing authority for unsafe prescribing, prescribing outside the APN's role or population focus, or prescribing outside applicable state and federal laws.

New section requires the Board of Nursing and Commissioner of Health to adopt regulations immediately upon filing notice with the Office of Administrative Law (bypassing normal APA timelines), effective for up to 18 months, including a process for verifying hours completed by APNs seeking independent practice.

Effective date changed from the first day of the fourth month following enactment (90 days) to immediate effect, with transition provisions: APNs who would reach 5,000 hours within 12 months of the effective date may continue without a joint protocol; those who would not get a 6-month grace period after which they must establish a joint protocol.

New definitions added for 'primary health care' (preventative, diagnostic, treatment, management, or reassessment services in family-centered and community-oriented manner), 'reproductive health services,' 'behavioral health care,' and 'higher level of care.'