PRINTER'S NO. 385
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
397
Session of
2021
INTRODUCED BY PITTMAN, SCAVELLO, COLLETT, YUDICHAK, MENSCH, YAW,
BAKER, HUTCHINSON, STEFANO, REGAN, BOSCOLA AND BARTOLOTTA,
MARCH 11, 2021
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE,
MARCH 11, 2021
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 definitions, for State Board
of Osteopathic Medicine and 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. The definition of "physician assistant" in
section 2 of the act of October 5, 1978 (P.L.1109, No.261),
known as the Osteopathic Medical Practice Act, is amended to
read:
Section 2. Definitions.
The following words and phrases when used in this act shall
have, unless the context clearly indicates otherwise, the
meanings given to them in this section:
* * *
"Physician assistant." [A person licensed by the board to
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
assist a physician or group of physicians in the provision of
medical care and services and under the supervision and
direction of the physician or group of physicians.] An
individual who is licensed as a physician assistant by the
board.
* * *
Section 2. Section 2.1(a) of the act is amended to read:
Section 2.1. State Board of Osteopathic Medicine.
(a) The State Board of Osteopathic Medicine shall consist of
the Commissioner of Professional and Occupational Affairs or his
designee; the Secretary of Health or his designee; two members
appointed by the Governor who shall be persons representing the
public at large; one member appointed by the Governor who is a
physician assistant; one member appointed by the Governor who
shall be a respiratory therapist, a perfusionist[, a physician
assistant] or a licensed athletic trainer; and six members
appointed by the Governor who shall be graduates of a legally
incorporated and reputable college of osteopathic medicine and
shall have been licensed to practice osteopathic medicine under
the laws of this Commonwealth and shall have been engaged in the
practice of osteopathy in this Commonwealth for a period of at
least five years. All professional and public members of the
board shall be appointed by the Governor with the advice and
consent of a majority of the members elected to the Senate. The
Governor shall assure that respiratory therapists,
perfusionists[, physician assistants] and certified athletic
trainers are appointed to four-year terms on a rotating basis.
* * *
Section 3. Section 10(g) and (j.1) of the act, amended July
2, 2019 (P.L.415, No.69), are amended and the section is amended
20210SB0397PN0385 - 2 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
by adding a subsection to read:
Section 10. Licenses; exemptions; nonresident practitioners;
graduate students; biennial registration and
continuing medical education.
* * *
(g) The supervising physician shall file, or cause to be
filed, with the board [an application to utilize a physician
assistant including a written agreement containing a description
of] a written agreement that identifies the manner in which the
physician assistant will assist the supervising physician in his
practice[,] and the method and frequency of supervision.[,
including, but not limited to, the number and frequency of the
patient record reviews required by subsection (j.1) and the
criteria for selecting patient records for review when 100%
review is not required, and the geographic location of the
physician assistant. The written agreement and description may
be prepared and submitted by the primary supervising physician,
the physician assistant or a delegate of the primary supervising
physician and the physician assistant. It shall not be a defense
in any administrative or civil action that the physician
assistant acted outside the scope of the board-approved
description or that the supervising physician utilized the
physician assistant outside the scope of the board-approved
description because the supervising physician or physician
assistant permitted another person to represent to the board
that the description had been approved by the supervising
physician or physician assistant. Upon submission of the
application, board staff shall review the application only for
completeness and shall issue a letter to the supervising
physician providing the temporary authorization for the
20210SB0397PN0385 - 3 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
physician assistant to begin practice. If the application is not
complete, including, but not limited to, required information or
signatures not being provided or the fee not being submitted, a
temporary authorization for the physician assistant to begin
practicing shall not be issued. The temporary authorization,
when issued, shall provide a period of 120 days during which the
physician assistant may practice under the terms set forth in
the written agreement as submitted to the board. Within 120 days
the board shall notify the supervising physician of the final
approval or disapproval of the application. If approved, a final
approval of the written agreement shall be issued to the
supervising physician. If there are discrepancies that have not
been corrected within the 120-day period, the temporary
authorization to practice shall expire. There shall be no more
than four physician 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
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.] The supervising physician shall determine the
number of physician assistants supervised at any one time. The
supervising physician shall be responsible for the medical
20210SB0397PN0385 - 4 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
services that a physician assistant renders. Supervision shall
not require the onsite presence or the personal direction of the
supervising physician.
* * *
(g.4) A physician assistant shall provide medical services
according to a written agreement which provides for all of the
following:
(1) Identifies and is signed by the primary supervising
physician.
(2) Describes the physician assistant's scope of
practice.
(3) Describes the nature and degree of supervision the
supervising physician will provide the physician assistant.
(4) Designates one physician as having the primary
responsibility for supervising the physician assistant.
(5) Is maintained by the supervising physician at the
practice or health care facility and available to the board
upon request. The written agreement shall be supplied to the
board within 30 days of the request. A physician assistant
shall provide medical services in a manner as described in
the agreement.
* * *
[(j.1) (1) The approved physician shall countersign 100% of
the patient records completed by the physician assistant
within a reasonable time, which shall not exceed ten days,
during each of the following time periods:
(i) The first 12 months of the physician assistant's
practice post graduation and after the physician
assistant has fulfilled the criteria for licensure set
forth in subsection (f).
20210SB0397PN0385 - 5 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
(ii) The first 12 months of the physician
assistant's practice in a new specialty in which the
physician assistant is practicing.
(iii) The first six months of the physician
assistant's practice in the same specialty under the
supervision of the approved physician, unless the
physician assistant has multiple approved physicians and
practiced under the supervision of at least one of those
approved physicians for six months.
(2) In the case of a physician assistant who is not
subject to 100% review of the physician assistant's patient
records pursuant to paragraph (1), the approved physician
shall personally review on a regular basis a selected number
of the patient records completed by the physician assistant.
The approved physician shall select patient records for
review on the basis of written criteria established by the
approved physician and the physician assistant. The number of
patient records reviewed shall be sufficient to assure
adequate review of the physician assistant's scope of
practice.]
* * *
Section 4. The State Board of Medicine shall promulgate
rules and regulations necessary to carry out this act within 180
days of the effective date of this section.
Section 5. This act shall take effect in 60 days.
20210SB0397PN0385 - 6 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25