Protocol · NP · Louisiana
Practice Protocol for Nurse Practitioners in Louisiana
Required. Louisiana law names the instrument a Collaborative Practice Agreement (CPA), and the clinical protocol is the content that instrument carries. Below: the board that governs it, what it must contain, and the terms it has to carry.
Louisiana is a 'reduced practice' state — NPs generally practice under an LSBN-approved Collaborative Practice Agreement for as long as they practice. A codified but unconfirmed hours-based CPA exemption exists (see conditions) — treat as conditional pending verification, not confirmed full independence.
Independent practice requires: Prior collaborative-practice experience above the threshold set by LSBN rule (LA Admin. Code tit. 46 §7911.A.5); confirm the hour figure and the scope of the exemption with the Board.
What a Louisiana Collaborative Practice Agreement (CPA) must contain
Governed by the Louisiana State Board of Nursing and the Louisiana Board of Pharmacy. Each numbered item is a statutory requirement the Collaborative Practice Agreement (CPA) must satisfy.
The Nurse Practitioner shall practice pursuant to a Collaborative Practice Agreement ("CPA") with the Physician, approved by the Louisiana State Board of Nursing, as required by La. R.S. 37:1021 et seq. and La. Admin. Code tit. 46, Pt. XLV, ch. 79. The Physician shall hold a current, unrestricted Louisiana medical license in good standing, actively provide direct patient care in Louisiana, and practice in a specialty comparable in scope to the Nurse Practitioner's own. The Physician shall hold hospital privileges at any facility before the Nurse Practitioner receives privileges at that same facility.
The CPA shall set out a plan of accountability covering the Nurse Practitioner's prescriptive authority and the Physician's responsibilities, and mutually agreed clinical practice guidelines, including a drug formulary. The Physician shall be available, though not necessarily physically present, for consultation, emergencies, and referral; if the Physician and any alternate are unavailable, the Nurse Practitioner may not diagnose or prescribe during that period. If the Nurse Practitioner has controlled-substance prescriptive authority, the Physician shall maintain a current DEA registration.
- The Collaborative Practice Agreement (CPA) also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the Collaborative Practice Agreement (CPA) has to carry, from Louisiana's supervision rules.
Proximity
Available remotely (no on-site requirement)
No codified mile/minute radius or on-site standard; the collaborating physician must be available by telephone or direct telecommunication for consultation and emergencies when not physically present (LAC 46:XLV.7911). A 2014 LSBME proposal would have required a 1:4 ratio and quarterly on-site visits when not sharing a practice site — secondary-sourced and not confirmed as ever finalized; do not encode it as current law.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Annually
Clinical practice guidelines within the CPA (drug types/categories/schedules and generic-substitution options) must be mutually agreed upon and reviewed annually (LAC 46:XLV.7911). No shorter recurring chart-review or meeting cadence is codified.
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
If the NP holds controlled-substance prescriptive authority, the collaborating physician must also hold current, unrestricted Louisiana and DEA registrations.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation or LLC under La. R.S. 12:901 et seq.; ownership of a nursing-services entity generally restricted to licensees of the same profession
Ownership and clinical collaboration are legally distinct: the collaborating physician under a CPA does not need to own the entity the NP practices through.
Sources for the supervision rules (4)
- La. Rev. Stat. § 37:913 — Definitions (Advanced Practice Registered Nursing, Collaborative Practice Agreement)secondary
- La. Admin. Code tit. 46, Part XLV, §7911 — Eligibility; Required Components of Collaborative Practice Agreementsecondary
- Louisiana State Board of Nursing — Joint Practice Statement
- Breazeale, Sachse & Wilson — Update on APRN Supervision Rules for Hospitals with Physician Practices (secondary source, describes historical/proposed ratio rules; confirm current status before relying on it)secondary
About Louisiana's rules
Louisiana remains a reduced-practice state for NPs; no SAVE Act-style full-practice-authority reform has passed. LA Admin. Code tit. 46 § 7911.A.5 references an hours-based exemption from the CPA requirement for NPs, CNMs and CNSs, but secondary sources give conflicting hour figures (1,000 vs. 2,080); confirm the threshold and resulting scope with LSBN before relying on it.
Other clinicians in Louisiana: see the state overview.