New Jersey: Ownership and Oversight
Strict CPOM (BME rule + PSC Act), reshaped March 2026. New Jersey runs on a Board of Medical Examiners rule about who may own and control practices, plus a brand-new APN independence law (P.L. 2026, c.6, signed March 30, 2026) that rewrote the oversight side for primary and behavioral health while deliberately leaving medspas and aesthetics behind.
Who the statute actually covers
- "Plenary licensee" vs. "limited licensee" (N.J.A.C. 13:35-6.16): a plenary-licensed physician holds an unlimited medical license; podiatrists, PAs, midwives, and similar are limited licensees. In any mixed entity, the plenary licensee must hold the greater interest and control; a limited licensee may never employ or control a plenary licensee.
- Closely allied professions: the BME-recognized set that may co-own with physicians under the PSC Act (N.J.S.A. 14A:17) and 13:35-6.16.
- "Exempt APN" (P.L. 2026, c.6): an APN with more than 5,000 hours of licensed, active advanced nursing practice in an eligible population focus (family/lifespan, adult-gero, pediatrics, women's health, behavioral health), providing primary or behavioral health care, and NOT providing general obstetrics or elective aesthetic/cosmetic services.
- "Joint protocol" (N.J.S.A. 45:11-49; N.J.A.C. 13:37-8.1): the written APN-physician agreement required for prescribing by non-exempt APNs; reviewed, updated, and signed at least annually.
1. Who can own what
| Entity / Path | Who may own | Key limits |
|---|---|---|
| Physician practice entities | Physicians alone, or with closely allied professionals, with the physician holding the greater (majority) interest and control. | A limited licensee cannot employ or control a physician. Sham structures are void: Allstate v. Northfield Med. Ctr., 228 N.J. 596 (2017). |
| PA ownership | Minority co-ownership with a physician majority under the closely-allied framework; no solo PA medical practice. | The plenary/limited hierarchy is the operative constraint. |
| APN ownership | APN-owned nursing practices sit under Board of Nursing jurisdiction. Post-March 2026, an exempt APN can run an independent primary or behavioral health practice with no physician relationship at all. | Aesthetic and medspa APN practices are expressly excluded: those APNs still need a joint protocol with a collaborating physician. |
| General corporation employment | Physicians may be employed by general corporations only in enumerated licensed settings with an on-premises medical director. | Outside those settings, the professional-entity requirement holds. |
| Lay / MSO | Not permitted in the practice entity; MSO at FMV without control. | Northfield is the cautionary case: NJ courts look through paper to actual control. |
2. Collaborative and supervisory oversight
| Role | Agreement required | Oversight mechanics | Path to independence |
|---|---|---|---|
| PA | Practice under physician supervision/delegation per the PA Licensure Act and BME rules; written delegation framework maintained at the practice. | No numeric statutory ratio; supervising physician need not be on site. Scope and review mechanics set at the practice level. | None. NJ PAs have no independence pathway. |
| APN | Non-exempt APNs (under 5,000 hours, or any APN in aesthetics/cosmetics or general OB): joint protocol, written, signed, reviewed and updated at least annually. Exempt APNs: none. | No numeric ratio and no statutory chart-review percentage; the protocol defines review methodology. Exempt APNs must carry required CE (14 hours controlled substance pharmacology, plus 10 pharmacology hours per biennial renewal), insurance, and Board notices. | Yes: P.L. 2026, c.6: more than 5,000 hours in an eligible focus, primary or behavioral health, ends the joint protocol requirement. Grace period applies. |
3. Primary authorities
- N.J.A.C. 13:35-6.16; N.J.S.A. 14A:17 (PSC Act).
- Allstate Ins. Co. v. Northfield Medical Center, P.C., 228 N.J. 596 (2017).
- N.J.S.A. 45:11-49; N.J.A.C. 13:37-8.1; P.L. 2026, c.6 (S2996, signed March 30, 2026).
- Executive Orders 415 (2026) and 13 (2026).
Practical read: As of March 30, 2026, New Jersey is two different states. In primary care and behavioral health, an experienced APN can own and run a practice with zero physician involvement. In aesthetics and medspa work, nothing changed — the carve-out was deliberate. Any NJ medspa deal priced on APN independence is priced wrong.
General education, not legal advice.