S0397B0385A01477 DMS:JMT 06/07/21 #90 A01477
AMENDMENTS TO SENATE BILL NO. 397
Sponsor: SENATOR PITTMAN
Printer's No. 385
Amend Bill, page 1, line 6, by inserting after "Medicine"
, for practice of osteopathic medicine and surgery without
license prohibited
Amend Bill, page 1, line 8, by inserting after "education"
; and abrogating regulations
Amend Bill, page 1, lines 11 through 14, by striking out all
of said lines and inserting
Section 1. The definitions of "physician assistant" and
"primary supervising physician" in section 2 of the act of
October 5, 1978 (P.L.1109, No.261), known as the Osteopathic
Medical Practice Act, are amended to read:
Amend Bill, page 2, by inserting between lines 5 and 6
"Primary supervising physician." An osteopathic physician
who is registered with the board and designated in a written
agreement with a physician assistant under section 10(g) as
having primary responsibility for [directing and personally]
supervising the physician assistant.
Amend Bill, page 2, line 7, by striking out all of said line
and inserting
Section 2. Sections 2.1(a) and 3(b) of the act are amended
to read:
Amend Bill, page 2, line 10, by inserting a bracket before
"his"
Amend Bill, page 2, line 10, by inserting after "his"
] a
Amend Bill, page 2, line 11, by inserting a bracket before
"his"
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Amend Bill, page 2, line 11, by inserting after "his"
] a
Amend Bill, page 2, line 16, by inserting a bracket before
"six"
Amend Bill, page 2, line 16, by inserting after "six"
] seven
Amend Bill, page 2, by inserting between lines 28 and 29
Section 3. Practice of osteopathic medicine and surgery without
license prohibited.
* * *
(b) Nothing in this act shall be construed to prohibit
services and acts rendered by a qualified physician assistant,
technician or other allied medical person if such services and
acts are rendered under the supervision, direction or control of
a licensed physician. It shall be unlawful for any person to
practice as a physician assistant unless licensed and approved
by the board. It shall also be unlawful for any physician
assistant to render medical care and services except under the
supervision [and direction] of the supervising physician. A
physician assistant may use the title physician assistant or an
appropriate abbreviation for that title, such as "P.A.-C."
Amend Bill, page 2, lines 29 and 30; page 3, line 1; by
striking out all of said lines on said pages and inserting
Section 3. Section 10(g), (g.2), (j) (j.1), (k) and (l) of
the act are amended and the section is amended by adding a
subsection to read:
Amend Bill, page 3, line 6, by striking out all of said line
and inserting
(g) (1) The primary supervising physician shall file, or
cause to be
Amend Bill, page 3, line 10, by inserting a bracket before
"supervising"
Amend Bill, page 3, line 11, by striking out the bracket
before the comma after "practice" where it occurs the first time
Amend Bill, page 3, line 11, by striking out "] and"
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Amend Bill, page 3, line 11, by striking out ".["
Amend Bill, page 3, line 16, by inserting after "assistant."
] primary supervising physician, according to subsection
(g.4).
Amend Bill, page 3, line 21, by inserting a bracket before
"board-approved"
Amend Bill, page 3, line 21, by inserting after "board-
approved"
] board-filed
Amend Bill, page 3, line 23, by inserting a bracket before
"board-approved"
Amend Bill, page 3, line 23, by inserting after "board-
approved"
] board-filed
Amend Bill, page 3, line 27, by inserting a bracket before
"Upon"
Amend Bill, page 4, line 14, by inserting after "expire."
]
(2) The written agreement becomes effective upon
submission by the primary supervising physician, the
physician assistant or a delegate of the primary supervising
physician and the physician assistant to the board. The board
may develop audit procedures to ensure supervision and scope
of practice protections are maintained in accordance with
this chapter. The audit shall not include more than 10% of
all written agreements on an annual basis. A written
agreement subject to an audit shall remain in effect for two
weeks after the board notifies the primary supervising
physician and the physician assistant with remedies, if
necessary, on the outcome of the audit. The primary
supervising physician, physician assistant or delegate to the
primary supervising physician and physician assistant must
submit a new written agreement which shall be effective upon
submission to the board.
(3)
Amend Bill, page 4, line 15, by inserting a bracket before
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"four"
Amend Bill, page 4, line 15, by inserting after "four"
] six
Amend Bill, page 4, line 20, by inserting a bracket before
"and"
Amend Bill, page 4, line 20, by inserting a bracket after
"direction"
Amend Bill, page 4, line 22, by inserting a bracket before
"four"
Amend Bill, page 4, line 22, by inserting after "four"
] seven
Amend Bill, page 4, line 24, by inserting a bracket before
"than"
Amend Bill, page 4, line 24, by inserting a bracket after
"four"
Amend Bill, page 4, lines 28 through 30; page 5, lines 1
through 3; by striking out "] The supervising" in line 28, all
of lines 29 and 30 on page 4 and all of lines 1 through 3 on
page 5
Amend Bill, page 5, by inserting between lines 4 and 5
(g.2) (1) Except as limited by paragraph (2), and in
addition to existing authority, a physician assistant shall
have authority to do all of the following, provided that the
physician assistant is acting within the supervision [and
direction] of the supervising physician:
(i) Order durable medical equipment.
(ii) Issue oral orders to the extent permitted by a
health care facility's bylaws, rules, regulations or
administrative policies and guidelines.
(iii) Order physical therapy and dietitian
referrals.
(iv) Order respiratory and occupational therapy
referrals.
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(v) Perform disability assessments for the program
providing Temporary Assistance to Needy Families (TANF).
(vi) Issue homebound schooling certifications.
(vii) Perform and sign the initial assessment of
methadone treatment evaluations in accordance with
Federal and State law, provided that any order for
methadone treatment shall be made only by a physician.
(2) Nothing in this subsection shall be construed to:
(i) Supersede the authority of the Department of
Health and the Department of [Public Welfare] Human
Services to regulate the types of health care
professionals who are eligible for medical staff
membership or clinical privileges.
(ii) Restrict the authority of a health care
facility to determine the scope of practice and
supervision or other oversight requirements for health
care professionals practicing within the facility.
* * *
Amend Bill, page 5, line 12, by inserting after "the" where
it occurs the second time
primary
Amend Bill, page 5, lines 14 through 21, by striking out all
of said lines
Amend Bill, page 5, by inserting between lines 22 and 23
(j) Nothing in this act shall be construed to permit a
licensed physician assistant to practice osteopathic medicine
without the supervision [and direction] of a licensed physician
approved by the appropriate board, but such supervision [and
direction] shall not be construed to [necessarily] require the
personal presence of the supervising physician at the place
where the services are rendered.
Amend Bill, page 5, line 23, by striking out the bracket
before "(j.1)"
Amend Bill, page 5, line 23, by inserting a bracket before
"(1)"
Amend Bill, page 6, by inserting between lines 20 and 21
(3) The primary supervising physician shall determine
countersignature requirements of patient records completed by
the physician assistant in a written agreement, except as
provided for in paragraph (4).
(4) The approved physician shall countersign 100% of the
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patient records completed by the physician assistant within a
reasonable time, which shall not exceed 10 days, for the
first 12 months of the physician assistant's practice post
graduation and after the physician assistant has fulfilled
the criteria for licensure specified in subsection (f).
(k) This act shall not be construed to prohibit the
performance by the physician assistant of any service within
[his] the physician assistant's skills, which is delegated by
the supervising physician, and which forms a usual component of
that physician's scope of practice.
(l) Nothing in this act shall be construed to prohibit the
employment of physician assistants by a health care facility
where such physician assistants function under the supervision
[and direction] of a physician or group of physicians.
Amend Bill, page 6, line 22, by inserting after "of"
Osteopathic
Amend Bill, page 6, by inserting between lines 24 and 25
Section 5. Any and all regulations at 49 Pa. Code ยงยง 25.142,
25.162, 25.178 and 25.181 are abrogated to the extent of any
inconsistency with this act.
Amend Bill, page 6, line 25, by striking out "5" and
inserting
6
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See A01477 in
the context
of SB0397