CNM · Rhode Island
Collaborative Practice Agreement for Certified Nurse-Midwives in Rhode Island
No. Certified Nurse-Midwives practice independently here. Rhode Island does not require one.
R.I. Gen. Laws Ch. 23-13: midwifery is 'the independent management of cases of childbirth' and well-woman care, with 'full independent practice and prescriptive authority.' Licensure requires 'evidence of prearranged provision for collaboration with a physician' — a referral relationship on file, not an ongoing supervisory gate on day-to-day practice.
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Not codified — left to the agreement
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
May prescribe all legend medications and may apply for authorization to prescribe Schedule II–V controlled substances (Ch. 23-13; § 5-34-49).
Written agreement
Not required
No day-to-day supervisory agreement gates CNM practice. But licensure itself requires documenting a prearranged collaboration/referral relationship with a physician — distinct from the PA/pharmacist agreements above, which govern ongoing practice rather than a one-time licensure condition.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Service Corporation under R.I. Gen. Laws § 7-5.1-1 et seq. — 'midwives or nurse-midwives' are explicitly listed among the eligible healing-arts licensees.
Legal sources for these rules (2)
What a collaborating physician costs here
Typical monthly cost in Rhode Island
$500 – $600
Estimate for one Certified Nurse-Midwife. Standard-tier state.
About Rhode Island's rules
RI is a Full Practice Authority state for NP/CNM (R.I. Gen. Laws § 5-34-44) and, since a 2019 reform (§ 5-54-8), no longer requires PAs to have a written practice agreement — 'collaboration' with an always-accessible physician replaced supervision and hospital ratio caps. CRNAs are the exception: RI has NOT taken the Medicare physician-supervision opt-out, and CRNA scope is statutorily bounded to the perioperative period.
Other clinicians in Rhode Island: see the state overview.