Disclaimer: This material is provided for educational and informational purposes only. It does not constitute legal or medical advice or regulatory guidance. Requirements and interpretations may vary and change over time. Always verify current rules directly with the New York State Education Department (NYSED) Office of the Professions, the New York State Board of Medicine, and the New York State Board of Pharmacy, and consult qualified legal counsel before making decisions or taking action.
Executive Summary
- Strict Corporate Practice of Medicine (CPOM) Enforcement: Only a New York–licensed MD or DO may own or control a medical practice. All clinical services must be provided through a physician-owned PC or PLLC, while non-clinical operations may be managed by an MSO that has no influence over medical decisions.
- Medical Director Requirements: The medical director must be an actively licensed New York MD or DO responsible for clinical oversight, delegation, prescribing, and QA documentation. Specialty is flexible, but ongoing supervision and compliance are mandatory under Regents Rules Part 29.
- Prescriptive Authority & Delegation: Nurse Practitioners (NPs) may practice independently after 3,600 hours under the Nurse Practitioner Modernization Act, while Physician Assistants (PAs) require continuous supervision per 10 NYCRR §94.2. Only licensed clinicians may perform or delegate medical procedures under Education Law §6521.
- Controlled & Non-Controlled Medications: Phentermine (Schedule IV) requires DEA registration and I-STOP/PMP checks before and during therapy. GLP-1 drugs (e.g., semaglutide, tirzepatide) are not controlled but must be sourced from FDA-registered or NY-licensed compounding pharmacies following 503A/503B standards.
- Telehealth Compliance: Governed by Public Health Law §2999-cc, telehealth requires synchronous video or in-person exams, informed consent, and HIPAA-compliant technology. The same standard of care and documentation applies as in-person visits, especially when prescribing controlled substances.
- Advertising & Enforcement: Marketing must be truthful and accurately represent licensure under Education Law §6530(27) and General Business Law §349. Deceptive or misleading claims, misuse of titles, or unlicensed practice can trigger enforcement from the NYSED, Attorney General, or DEA, leading to fines, discipline, or license action.
Quick Compliance Checklist (New York 2025)
Entity & Ownership Structure
- All medical services must be delivered through a physician-owned Professional Service Corporation (PC) or Professional Limited Liability Company (PLLC) authorized by the New York State Education Department (NYSED).
- Non-physician entities (MSOs) may manage administrative operations (billing, staffing, marketing) but cannot control or influence medical decisions, per Education Law §6522 and the state’s Corporate Practice of Medicine (CPOM) prohibition.
- A New York–licensed MD or DO must oversee all clinical activities, delegation, and prescribing within the practice.
- Verify licensure and disciplinary status using the NYSED License Lookup.
- The medical director must maintain active oversight and document supervision through quality assurance (QA) activities and chart reviews.
- Weight loss clinics must establish written prescribing, chart review, and communication protocols.
- All prescribers must comply with mandatory electronic prescribing (e-Rx) under Public Health Law §281, and perform I-STOP / Prescription Monitoring Program (PMP) checks before issuing or renewing any Schedule II–IV prescriptions.
Delegation & Supervision
Nurse Practitioners (NPs)
Qualified NPs may practice independently after completing 3,600 hours of qualifying practice experience under Education Law §6902(3)(b-1).
Before reaching this threshold, NPs must maintain a collaborative agreement or relationship with a supervising physician. See NYSED NP Practice Guidance.
Physician Assistants (PAs)
PAs must practice under continuous physician supervision per 10 NYCRR §94.2, with a written supervisory agreement outlining duties, prescribing authority, and communication protocols.
Supervision may be remote but must be ongoing and documented.
- Clinics prescribing medications such as phentermine (Schedule IV) must maintain a valid DEA registration and follow PMP (I-STOP) procedures under Public Health Law §3309-a.
- Document all controlled-substance prescriptions, follow-ups, and clinical rationale for continued therapy.
- Telehealth visits must meet the same standard of care as in-person encounters.
- Providers must hold an active New York license and comply with consent, privacy, and documentation requirements set by the NYSDOH Medicaid Telehealth Provider Manual.
- If prescribing controlled substances via telehealth, ensure adherence to PMP/iSTOP requirements and proper recordkeeping.
- Compounding or dispensing of GLP-1 medications (e.g., semaglutide, tirzepatide) must comply with FDA 503A/503B and New York Board of Pharmacy standards.
- Clinics must ensure compounded medications are sourced only from licensed pharmacies following FDA Compounding Policies and NYS Pharmacy Board Regulations.
All advertising and promotional materials must be truthful, non-deceptive, and consistent with professional licensure.
Avoid:
- Guaranteed or exaggerated weight-loss claims
- Misuse of professional titles (e.g., “Doctor” by non-physicians)
- Implying medical services are offered by non-physicians
Violations may constitute professional misconduct under Education Law §6530(27) and false advertising under General Business Law §349.
Corporate Practice of Medicine (CPOM) in New York
CPOM in New York
New York prohibits non-physicians from owning or controlling medical practices. Only licensed physicians may direct medical decisions, while MSOs can handle administrative functions like billing or HR but not clinical care. Violations—such as fee-splitting or lay control—may lead to enforcement by the NYSED or Attorney General under Education Law §6522 and §6530(19).
Who Can Serve as Medical Director
Only a New York–licensed MD or DO in good standing may serve as medical director. Specialty is flexible, but the physician must demonstrate competence, provide active supervision, and ensure compliance with delegation and QA requirements. Common specialties include internal medicine, family medicine, and psychiatry. See NYSED Physicians – Laws & Rules.
Prescriptive Authority and Delegation
Nurse Practitioners
Under New York’s Nurse Practitioner Modernization Act (Education Law §6902[3][b-1]), NPs with over 3,600 hours of clinical experience may practice independently without a written practice agreement. Those with fewer hours must maintain a collaborative agreement or collaborative relationship with a supervising physician. DEA-registered NPs may prescribe weight loss medications, including controlled substances, in compliance with I-STOP/PMP monitoring and e-prescribing laws. See NYSED Nurse Practitioner Practice Guidance.
Physician Assistants
PAs must operate under a written supervisory agreement with a licensed physician defining scope, prescribing authority, communication procedures, and chart review cadence, as required by 10 NYCRR §94.2. Supervision must be continuous but may be remote. The supervising physician remains legally responsible for delegated tasks. See NYSED PA Supervision Standards.
Delegation Rules
Under Education Law §6521, only licensed practitioners may perform medical acts. Unlicensed individuals—including estheticians, nutritionists, or administrative staff—cannot prescribe or perform medical procedures. Physicians hold ultimate accountability for all delegated activities, consistent with Regents Rules Part 29 – Professional Conduct Standards. See NYSED Professional Conduct Rules.
Prescribing Rules in New York
Phentermine (Controlled, Schedule IV)
- Classified as a Schedule IV controlled substance; prescribers must hold active DEA registration.
- Prescribers must query the I-STOP Prescription Monitoring Program (PMP) before issuing or renewing controlled prescriptions, per Public Health Law §3309-a.
- Documentation should demonstrate medical necessity, individualized treatment planning, and follow-up.
- Avoid generic “cookie-cutter” protocols to ensure compliant, patient-specific care.
GLP-1 Medications (Semaglutide, Tirzepatide)
- Not controlled substances but subject to heightened oversight due to compounding and supply issues.
- Must be sourced from FDA-approved manufacturers or compounded in compliance with FDA 503A/503B and New York Board of Pharmacy rules.
- Can be prescribed by physicians, NPs, or PAs within their authorized scope and under required agreements.
IV Therapy and Supplements
- Must operate under physician-approved and signed protocols per Education Law §6902 and Regents Rules Part 29.
- Staff must have documented competencies and up-to-date training verification.
- Maintain written emergency procedures for adverse events such as anaphylaxis or IV infiltration.
- Conduct regular safety drills and retain logs for inspection readiness.
- Reference: NYSED Regents Rules – Professional Conduct.
Advertising Rules in New York
- Advertising for medical or weight loss services in New York is governed by New York General Business Law §349 (consumer protection) and Education Law §6530(27) (professional misconduct).
- Prohibits deceptive, false, or misleading statements, including exaggerated promises such as “Lose 30 lbs in 30 days” or unsubstantiated medical claims.
- Non-physicians (e.g., NPs, RNs, estheticians, or MSO owners) may not be presented or implied as “doctors” or independent medical providers.
- Advertising must accurately represent licensure, supervision, and scope of practice and include truthful information about available services.
- Violations can result in professional discipline, civil fines, or enforcement actions by the New York State Attorney General.
Telehealth Compliance in New York
Practitioner–Patient Relationship
- Governed by N.Y. Public Health Law §2999-cc and Office of Mental Health (OMH) telehealth regulations.
- A valid practitioner–patient relationship must be established through a synchronous (real-time) video encounter or an in-person visit.
- Encounters conducted solely via questionnaires, chat, or text messages do not meet New York’s definition of a valid telehealth relationship.
Recordkeeping and Standards
- Telehealth records must include identity verification, informed consent, clinical findings, diagnoses, and treatment plans.
- Telehealth encounters must meet the same standard of care and documentation requirements as in-person services under Education Law §6530(32).
- Platforms used for telehealth must be HIPAA-compliant and ensure secure data transmission and storage. Read NYSDOH Telehealth Provider Manual.
Telehealth Prescribing
- GLP-1 Medications: May be prescribed via telehealth if a valid provider–patient relationship exists and all follow-up protocols are maintained.
- Phentermine (Schedule IV): May be prescribed remotely if the prescriber holds DEA registration, performs I-STOP (PMP) checks, and documents clinical justification and follow-up visits.
- Best practice: Require at least one live video or in-person assessment before initiating any controlled-substance prescription.
Enforcement Risks in New York
- Medical Board (NYSED Office of the Professions): Oversees physician and clinic compliance. Violations such as unlicensed practice, improper delegation, or inadequate documentation may result in disciplinary action under Education Law §6530 and Regents Rules Part 29.
- Board of Pharmacy: Regulates drug compounding and dispensing. Improper sourcing or compounding of GLP-1 medications outside FDA 503A/503B or state rules can trigger enforcement under Education Law Article 137.
- DEA (U.S. Drug Enforcement Administration): Enforces compliance with the Controlled Substances Act, including improper prescribing or failure to maintain DEA and I-STOP documentation for phentermine and other Schedule IV drugs.
- New York Attorney General (AG): Can bring civil actions under General Business Law §349 for deceptive or misleading advertising or violations of consumer protection laws related to telehealth or weight loss claims.
- Civil Litigation: Clinics and medical directors risk malpractice or negligence claims for failure to meet accepted medical standards, inadequate patient monitoring, or misuse of telehealth. Maintaining proper documentation and QA processes helps mitigate liability.
FAQs
Can a nurse practitioner run a weight loss clinic in New York?
NPs may practice independently under the Modernization Act if experienced. However, CPOM prohibits non-physicians (including NPs) from owning medical corporations.
Can GLP-1s be prescribed via telehealth?
Yes, if all state telehealth requirements are met and proper documentation is maintained.
Is phentermine prescribing allowed via telemedicine?
Yes, but requires DEA registration, I-STOP PDMP checks, and strong clinical justification.
Do NP and PA agreements need to list specific medications?
Yes. Agreements must outline drug categories authorized for prescribing.
How We Support New York Clinics
We help weight loss and telehealth practices navigate New York’s complex laws through:
- Licensed New York Physicians serving as medical directors.
- NP and PA collaborative/supervisory agreements tailored to New York law.
- Chart review templates, QA systems, and compliance trackers.
- Telehealth support: Public Health Law §2999-cc workflows, HIPAA platforms, prescribing guidance.
- Drug-specific compliance: phentermine vs. GLP-1 prescribing rules.
- MSO structuring advice: ensuring CPOM compliance.
Find a California Medical Director with Medical Director Co.
We provide medical directors and compliance services across the state, including:
Who We Serve
- Nurse Practitioners (NPs): Collaborative agreements, prescriptive authority, compliance support.
- Registered Nurses (RNs): Oversight for medspas, wellness centers, weight-loss programs.
- Physician Assistants (PAs): Supervision, protocols, chart audits.
- Estheticians: Safe treatment protocols under physician approval.
New York Resources & References
NYSED Office of the Professions – Physicians
https://www.op.nysed.gov/professions/physicians
NYSDOH – Medicaid Telehealth Provider Manual
https://www.health.ny.gov/health_care/medicaid/redesign/telehealth/docs/provider_manual.pdf
New York Public Health Law §2999-cc – Telehealth
https://newyork.public.law/laws/n.y._public_health_law_section_2999-cc
New York Public Health Law §3309-a – Prescription Monitoring Program (I-STOP)
https://newyork.public.law/laws/n.y._public_health_law_section_3309-a
New York Education Law §6530 – Professional Misconduct
https://newyork.public.law/laws/n.y._education_law_section_6530
New York General Business Law §349 – Consumer Protection
https://newyork.public.law/laws/n.y._general_business_law_section_349
FDA – Human Drug Compounding Policies
https://www.fda.gov/drugs/human-drug-compounding/human-drug-compounding-policies-and-rules
DEA Diversion Control Division
https://www.deadiversion.usdoj.gov
New York State Board of Pharmacy
https://www.op.nysed.gov/professions/pharmacy
Bolton M. Harris, J.D., is a seasoned attorney with a formidable background in criminal law and a focus on healthcare law and compliance. As the in-house legal counsel at Medical Director Co., Harris brings a unique blend of prosecutorial experience and regulatory expertise to support healthcare professionals across Texas. Her career spans roles as a prosecutor in multiple counties and now as a trusted advisor on the legal intricacies of medical practice operations.
Education & Early Career
Bolton Harris completed her undergraduate studies at Southern Methodist University (SMU) in 2013. During her time at SMU, she was not only a dedicated student but also a competitive athlete on the university’s women’s swimming team. She went on to earn her Juris Doctor from Texas A&M University School of Law in 2016 and became a member of the Texas Bar that same year. Armed with a strong academic foundation and discipline honed as a student-athlete, Harris embarked on a career in criminal law immediately after law school.
Prosecutorial Experience in Texas
Bolton Harris began her legal career in public service as a criminal prosecutor. She served as an Assistant District Attorney in multiple jurisdictions, where she quickly rose through the ranks and handled a broad spectrum of cases. Some highlights of her prosecutorial career include:
- Assistant District Attorney, Dallas County, Texas: Prosecuted a high volume of criminal cases in one of the state’s busiest DA offices, gaining extensive trial experience in both misdemeanor and felony courts.
- Assistant District Attorney, Ellis County, Texas: Continued to hone her courtroom advocacy skills, known for meticulous case preparation and a tenacious pursuit of justice on behalf of the community.
- Assistant District Attorney, Navarro County, Texas: Broadened her legal expertise by handling diverse criminal matters in a smaller county, working closely with law enforcement and community leaders to uphold the law.
Through these roles, Harris built a reputation for being a tough but fair advocate. She brought numerous cases to trial and developed an in-depth understanding of the criminal justice system. This distinguished prosecutorial background laid a strong foundation for the next phase of her career in the private sector.
Healthcare Law & Compliance at Medical Director Co.
After her tenure as a prosecutor, Harris shifted her focus to healthcare law, applying her legal acumen to the medical field. She recognized that the same attention to detail and tenacity that served her in criminal law could benefit healthcare providers navigating complex regulations. Embracing this new direction, Harris became well-versed in the intricate laws governing medical practices – from licensing requirements to patient safety and privacy standards – and is passionate about helping practitioners stay compliant.
In her current role as the in-house attorney for Medical Director Co., Bolton Harris oversees all legal and compliance matters for the organization and its clients. Medical Director Co. is a nurse-owned firm that connects nurse practitioners (NPs), physician assistants (PAs), and registered nurses with qualified medical directors and collaborating physicians, offering fast placements and comprehensive compliance support for healthcare practices. Harris ensures that each of these partnerships and clinical ventures adheres to all applicable state and federal laws. She is responsible for drafting and reviewing collaborative practice agreements, advising on regulatory requirements, and providing ongoing legal counsel as clients establish and grow their clinics. Drawing on her prosecutorial eye for risk management, Harris proactively identifies potential legal issues and addresses them before they escalate, giving healthcare professionals peace of mind.
Bolton M. Harris’s multifaceted expertise – spanning high-stakes courtroom litigation to detailed healthcare compliance – makes her a formidable legal ally. Whether advocating in front of a jury or guiding a medical practice through regulatory hurdles, she remains committed to the highest standards of the legal profession. Her blend of courtroom-tested skill and healthcare law knowledge ensures that clients of Medical Director Co. receive elite-level counsel and steadfast protection in an ever-evolving legal landscape.
