PA 12-37—sHB 5515

Public Health Committee

AN ACT CONCERNING PHYSICIAN ASSISTANTS

SUMMARY: This act revises the supervision requirements for physician assistants (PAs). By law, each PA must have a clearly identified supervising physician who has final responsibility for patient care and the PA's performance. Under prior law, the functions a physician delegated to a PA he or she supervised had to be implemented in accordance with written protocols the supervising physician established. The act renames the written protocols the “written delegation agreement” between the physician and PA and specifies its required contents.

The act eliminates the requirement that a supervising physician personally review the PA's practice or services at least weekly or more frequently as necessary, instead requiring the personal review to occur according to the written delegation agreement.

The law allows PAs to perform delegated medical functions when, among other requirements, the supervising physician is satisfied as to the PA's ability and competency. The act specifies that the physician must be satisfied as to the PA's ability and demonstrated competency.

The law allows PAs to prescribe and administer schedule II through V controlled substances, as delegated by their supervising physician. Under prior law, when a PA prescribed a schedule II or III drug, the supervising physician had to document his or her approval in the patient's medical record within one day after the prescription was issued. The act instead requires the supervising physician to document his or her approval in the manner set forth in the written delegation agreement.

EFFECTIVE DATE: October 1, 2012

WRITTEN DELEGATION AGREEMENTS

Under the act, the supervising physician must establish the terms of the written delegation agreement between the physician and PA. Such agreements must at least:

1. describe the professional relationship between the supervising physician and the PA;

2. identify the medical services the PA may perform;

3. describe how the PA's prescribing of controlled substances must be documented in patient medical records; and

4. describe how the supervising physician will evaluate the PA's performance, including (a) how often the physician intends to personally review the PA's practice and performance of delegated medical services and (b) how often, and in what manner, the physician intends to review the PA's prescription and administration of schedule II or III controlled substances.

Under the act, supervising physicians in hospitals must also include or reference in their written delegation agreements applicable hospital policies, protocols, and procedures.

The act requires supervising physicians to review written delegation agreements at least annually. Supervising physicians must also revise the agreements as they deem necessary to reflect changes in (1) the physician's professional relationship with the PA, (2) the medical services the PA may perform, or (3) how the physician evaluates the PA.

PERSONAL REVIEW

The law requires a supervising physician's supervision of a PA to include, among other things, the physician's personal review of the PA's practice (in hospitals) or services (in other settings). The act eliminates the requirement that the personal review be conducted at least weekly or more frequently as needed to ensure quality patient care. It also eliminates the requirement that the personal review in non-hospital settings occur through face-to-face meetings.

Instead, the act requires the personal review in hospital settings to occur on a regular basis as necessary to ensure quality patient care in accordance with the written delegation agreement. In non-hospital settings, the personal review must occur in accordance with the written delegation agreement, to ensure quality patient care.

OLR Tracking: JO: MJ: PF: DY