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 AND YOUNGBLOOD, OCTOBER 20, 2011

REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, OCTOBER 20, 2011  

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

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. [The supervising physician shall file] A

copy of the written agreement shall be filed with the board

[an application to utilize a physician assistant containing a

description of the manner in 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].

(3)  Counter signature of charts is not necessarily

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

each team of supervising physician and physician assistant.

(4)  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 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. 

* * *

(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.

* * *

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