THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

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, YOUNGBLOOD, HANNA, GEIST AND KORTZ, OCTOBER 20, 2011

AS REPORTED FROM COMMITTEE ON PROFESSIONAL LICENSURE, HOUSE OF REPRESENTATIVES, AS AMENDED, FEBRUARY 15, 2012   

AN ACT

Amending the act of October 5, 1978 (P.L.1109, No.261), entitled

"An act requiring the licensing of practitioners of

osteopathic medicine and surgery; regulating their practice;

providing for certain funds and penalties for violations and

repeals," further providing for licenses, exemptions,

nonresident practitioners, graduate students, biennial

registration and continuing medical education.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Section 10(g) and (g.2) of the act of October 5,

1978 (P.L.1109, No.261), known as the Osteopathic Medical

Practice Act, amended July 20, 2007 (P.L.316, No.47) and July 4,

2008 (P.L.589, No.46), are amended to read:

Section 10.  Licenses; exemptions; nonresident practitioners;

graduate students; biennial registration and

continuing medical education.

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(g)  

(1)  It is the obligation of each team of physician and

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physician assistant to ensure that:

(i)  the physician assistant's scope of practice is

identified;

(ii)  delegation of medical tasks is appropriate to

the physician assistant's level of competence;

(iii)  the relationship of, and access to, the

supervising physician is defined; and

(iv)  that a process for evaluation of the physician 

assistant's performance is established.

(2)  The requirements of paragraph (1) shall be reflected

in the written agreement signed by each team of physician and

physician assistant. [(1)  The supervising physician shall

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file] A a copy of the written agreement shall be filed with

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the board [an application to utilize a physician assistant

containing] which contains a description of the manner in

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which the physician assistant will assist the supervising

physician in his practice, the method and frequency of

supervision and the geographic location of the physician

assistant].

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(3) (2)  Counter signature of charts is not necessarily

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required. All decisions regarding physician countersignature

of patient charts, including the number of charts to be

countersigned and the frequency with which chart review is to

occur, shall be made at the practice or facility level by

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each team of between a supervising physician and physician

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assistant.

(4) (3)  There shall be no more than four physician

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assistants for whom a physician has responsibility or

supervises pursuant to a written agreement at any time. In

health care facilities licensed under the act of July 19,

1979 (P.L.130, No.48), known as the "Health Care Facilities

Act," a physician assistant shall be under the supervision

and direction of a physician or physician group pursuant to a

written agreement, provided that a physician supervises no

more than four physician assistants at any time. A physician

may apply for a waiver to employ or supervise more than four

physician assistants at any time under this section for good

cause, as determined by the board. In cases where a group of

physicians will supervise a physician assistant, the names of

all supervisory physicians shall be included on the

application.

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(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, athletic trainer and

dietitian referrals.

(iv)  Order respiratory and occupational therapy

referrals.

(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.

(viii)  Sign and approve day-care physicals.

(ix)  Sign and approve foster care physicals.

(x)  Sign and approve State and municipal police

officer physicals.

(xi)  Authenticate with the physician assistant's

signature any form that may otherwise be authenticated by

a physician's signature as permitted by the supervising

physician, State or Federal law and facility protocol, if

applicable.

(2)  Nothing in this subsection shall be construed to:

(i)  Supersede the authority of the Department of

Health and the Department of Public Welfare 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.

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Section 2.  The State Board of Osteopathic Medicine shall

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promulgate regulations to carry out the amendment of section

10(g) and (g.2) of the act within 18 months of the effective

date of this section, but promulgation of any such regulations

shall not act to delay the implementation or effectiveness of

the amendment of section 10(g) and (g.2) of the act.

Section 2 3.  This act shall take effect in 60 days.

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