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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| HOUSE BILL |
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| INTRODUCED BY SONNEY, BRENNAN, DAVIS, J. EVANS, FABRIZIO, GILLESPIE, HARKINS, HELM, HENNESSEY, HORNAMAN, M. K. KELLER, MILLARD, MUSTIO, OBERLANDER, PAYTON, PICKETT, READSHAW, REICHLEY, SCAVELLO, STURLA AND YOUNGBLOOD, OCTOBER 20, 2011 |
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| REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, OCTOBER 20, 2011 |
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| AN ACT |
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1 | Amending the act of December 20, 1985 (P.L.457, No.112), |
2 | entitled "An act relating to the right to practice medicine |
3 | and surgery and the right to practice medically related acts; |
4 | reestablishing the State Board of Medical Education and |
5 | Licensure as the State Board of Medicine and providing for |
6 | its composition, powers and duties; providing for the |
7 | issuance of licenses and certificates and the suspension and |
8 | revocation of licenses and certificates; providing penalties; |
9 | and making repeals," further providing for physician |
10 | assistants. |
11 | The General Assembly of the Commonwealth of Pennsylvania |
12 | hereby enacts as follows: |
13 | Section 1. Section 13(c.1), (d) and (e) of the act of |
14 | December 20, 1985 (P.L.457, No.112), known as the Medical |
15 | Practice Act of 1985, amended July 20, 2007 (P.L.314, No.46) and |
16 | July 4, 2008 (P.L.580, No.45), are amended to read: |
17 | Section 13. Physician assistants. |
18 | * * * |
19 | (c.1) Except as limited by subsection (c.2), and in addition |
20 | to existing authority, a physician assistant shall have |
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1 | authority to do all of the following, provided that the |
2 | physician assistant is acting within the supervision and |
3 | direction of the supervising physician: |
4 | (1) Order durable medical equipment. |
5 | (2) Issue oral orders to the extent permitted by a |
6 | health care facility's bylaws, rules, regulations or |
7 | administrative policies and guidelines. |
8 | (3) Order physical therapy, athletic trainer and |
9 | dietitian referrals. |
10 | (4) Order respiratory and occupational therapy |
11 | referrals. |
12 | (5) Perform disability assessments for the program |
13 | providing Temporary Assistance to Needy Families (TANF). |
14 | (6) Issue homebound schooling certifications. |
15 | (7) Perform and sign the initial assessment of methadone |
16 | treatment evaluations in accordance with Federal and State |
17 | law and regulations, provided that any order for methadone |
18 | treatment shall be made only by a physician. |
19 | (8) Sign and approve day‑care physicals. |
20 | (9) Sign and approve foster care physicals. |
21 | (10) Sign and approve State and municipal police officer |
22 | physicals. |
23 | (11) Authenticate with the physician assistant's |
24 | signature any form that may otherwise be authenticated by a |
25 | physician's signature as permitted by the supervising |
26 | physician, State or Federal law and facility protocol, if |
27 | applicable. |
28 | * * * |
29 | (d) Supervision.--A physician assistant shall not perform a |
30 | medical service without the supervision and personal direction |
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1 | of an approved physician. [The board shall promulgate |
2 | regulations which define the supervision and personal direction |
3 | required by the standards of acceptable medical practice |
4 | embraced by the medical doctor community in this Commonwealth.] |
5 | Supervision shall be continuous but shall not be construed as |
6 | necessarily requiring the physical presence of the supervising |
7 | physician at the time and place that the services are rendered. |
8 | The following apply: |
9 | (1) It is the obligation of each team of physician and |
10 | physician assistant to ensure that: |
11 | (i) the physician assistant's scope of practice is |
12 | identified; |
13 | (ii) delegation of medical tasks is appropriate to |
14 | the physician assistant's level of competence; |
15 | (iii) the relationship of, and access to, the |
16 | supervising physician is defined; and |
17 | (iv) a process for evaluation of the physician |
18 | assistant's performance is established. |
19 | The requirements of this paragraph shall be reflected in |
20 | the written agreement signed by each team of physician and |
21 | physician assistant. |
22 | (2) Countersignature of patient charts is not |
23 | necessarily required. All decisions regarding physician |
24 | countersignature of patient charts, including the number of |
25 | charts to be countersigned and the frequency with which chart |
26 | review is to occur, shall be made between a supervising |
27 | physician and physician assistant at the practice or facility |
28 | level. |
29 | (e) Written agreement.--A physician assistant shall not |
30 | provide a medical service without a written agreement with one |
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1 | or more physicians which provides for all of the following: |
2 | (1) Identifies and is signed by each physician the |
3 | physician assistant will be assisting. |
4 | (2) Describes the [manner in which the physician |
5 | assistant will be assisting each named physician] roles and |
6 | responsibilities of the physician assistant and the |
7 | supervising physician as required in subsection (d). |
8 | [(3) Describes the nature and degree of supervision and |
9 | direction each named physician will provide the physician |
10 | assistant. |
11 | (4) Designates one of the named physicians as having the |
12 | primary responsibility for supervising and directing the |
13 | physician assistant.] |
14 | (5) Has [been approved by] filed a complete application |
15 | with the board as satisfying the foregoing and as consistent |
16 | with the restrictions contained in or authorized by this |
17 | section. |
18 | A physician assistant shall not assist a physician in a manner |
19 | not described in the agreement or without the nature and degree |
20 | of supervision and direction described in the agreement. There |
21 | shall be no more than four physician assistants for whom a |
22 | physician has responsibility or supervises pursuant to a written |
23 | agreement at any time. In health care facilities licensed under |
24 | the act of July 19, 1979 (P.L.130, No.48), known as the Health |
25 | Care Facilities Act, a physician assistant shall be under the |
26 | supervision and direction of a physician or physician group |
27 | pursuant to a written agreement, provided that a physician |
28 | supervises no more than four physician assistants at any time. A |
29 | physician may apply for a waiver to employ or supervise more |
30 | than four physician assistants at any time under this section |
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1 | for good cause, as determined by the board. |
2 | * * * |
3 | Section 2. This act shall take effect in 60 days. |
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