Protocol · NP · District of Columbia
Practice Protocol for Nurse Practitioners in District of Columbia
Nurse Practitioners practice independently in District of Columbia. A practice protocol is voluntary; here is what one covers and what the state does require.
HORA 2024 repealed D.C. Code § 3-1206.03's collaboration mandate — an NP may diagnose, treat, and prescribe under their own license with no supervising- or collaborating-physician relationship required, regardless of experience.
What a voluntary Nurse Practitioner protocol covers in District of Columbia
District of Columbia requires no written protocol for nurse practitioners. These are the clauses a practice includes when it chooses to put one in writing. The DC Board of Nursing and the DC Board of Pharmacy governs nurse practitioners here.
The District of Columbia does not require the Nurse Practitioner to enter into a collaborative practice agreement with a physician; the requirement formerly codified at DC Code § 3-1206.03 was repealed by the Health Occupations Revision Amendment Act of 2024. The Nurse Practitioner practices, diagnoses, and prescribes under the Nurse Practitioner's own license, in accordance with DC Code Title 3, Chapter 12, Subchapter VI.
This Agreement's terms regarding the Nurse Practitioner accordingly serve to define the working relationship, referral pathways, and any Medical Director oversight between the Parties, and are not themselves required by District of Columbia law as a condition of the Nurse Practitioner's authority to practice.
- A voluntary protocol also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
What District of Columbia does require
The supervision and prescribing rules that apply to nurse practitioners regardless of any protocol.
Proximity
No proximity requirement
No physician availability/proximity standard applies — HORA 2024 removed the collaboration requirement entirely (D.C. Code Title 3, Ch. 12, Subch. VI).
Supervision ratio
Not codified — no cap on file
Chart review
Not codified
Meeting cadence
Not codified
Prescriptive authority
No agreement needed to prescribe · controlled substances permitted
Requires DEA registration and a separate DC controlled-substance registration. Some secondary sources state that NPs may not issue refillable prescriptions for controlled substances; that limit is not confirmed in primary DC regulation.
Written agreement
Not required
Unconditional as of HORA 2024 (2024) — a physician relationship may still be privately negotiated (e.g. a referral arrangement or medical-director role), but DC law no longer requires one as a condition of NP practice.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Board of Nursing licensure; the § 29-508 physician-only PC/PLLC regime does not apply, and no statute sets out an NP practice-entity ownership pathway
Distinct from the clinical independence granted by HORA 2024 above — entity ownership and clinical practice authority are separate legal questions.
Sources for the supervision rules (3)
- D.C. Code § 3-1206.03 [Repealed by the Health Occupations Revision Amendment Act of 2024 (D.C. Law 25-191 / B25-0545)]
- D.C. Code § 3-1206.07a — Certified Nurse Practitioner scope of practice
- D.C. Code § 3-1201.02 — Definitions of health occupations
About District of Columbia's rules
The Health Occupations Revision Amendment Act of 2024 repealed D.C. Code § 3-1206.03, removing the collaboration mandate for every APRN category (NP, PMHNP, CRNA, CNM, CNS); DC is now a full-practice-authority jurisdiction for APRNs. PAs are not covered by that reform and still need a Board of Medicine Delegation Agreement regardless of experience.
Other clinicians in District of Columbia: see the state overview.