On September 2, 2026, Jamie Gallagher, a North Carolina family nurse practitioner, filed a lawsuit challenging the state’s requirement that nurse practitioners maintain a physician collaboration agreement as a condition of practice. (Gallagher v. Rao-Patel and Ingram).  Gallagher argues that the requirement is unconstitutional because it imposes an unnecessary restriction on fully licensed, nationally certified NPs, alleging violations of the North Carolina Constitution’s Law of the Land and Equal Protection Clauses, and interferes with an NP’s ability to practice to the full extent of her training. The case is particularly interesting for North Carolina because it goes beyond asking the General Assembly to change scope-of-practice law—it asks a court to invalidate the physician-collaboration requirement itself, potentially opening the door to full practice authority for NPs through litigation rather than legislation. While the merits of this case have yet to be weighed in on by the court, this would be an unprecedented ruling of a regulatory issue in North Carolina.