1Amending the act of December 20, 1985 (P.L.457, No.112),
2entitled "An act relating to the right to practice medicine
3and surgery and the right to practice medically related acts;
4reestablishing the State Board of Medical Education and
5Licensure as the State Board of Medicine and providing for
6its composition, powers and duties; providing for the
7issuance of licenses and certificates and the suspension and
8revocation of licenses and certificates; providing penalties;
9and making repeals," further providing for physician
10assistants.

11The General Assembly of the Commonwealth of Pennsylvania
12hereby enacts as follows:

13Section 1. Section 13(e) of the act of December 20, 1985
14(P.L.457, No.112), known as the Medical Practice Act of 1985,
15amended July 20, 2007 (P.L.314, No.46), is amended and the
16section is amended by adding a subsection to read:

17Section 13. Physician assistants.

18* * *

19(d.1) Patient record review.--

20(1) The approved physician shall countersign 100% of the 
21patient records completed by the physician assistant within a 
22reasonable time, which shall not exceed ten days, during each
 

1of the following time periods:

2(i) The first 12 months of the physician assistant's
3practice post graduation and after the physician
4assistant has fulfilled the criteria for licensure set
5forth in section 36(c).

6(ii) The first 12 months of the physician
7assistant's practice in a new specialty in which the
8physician assistant is practicing.

9(iii) The first six months of the physician
10assistant's practice in the same specialty under the
11supervision of the approved physician, unless the
12physician assistant has multiple approved physicians and
13practiced under the supervision of at least one of those
14approved physicians for six months.

15(2) In the case of a physician assistant who is not
16subject to 100% review of the physician assistant's patient
17records pursuant to paragraph (1), the approved physician
18shall personally review on a regular basis a selected number
19of the patient records completed by the physician assistant.
20The approved physician shall select patient records for
21review on the basis of written criteria established by the
22approved physician and the physician assistant. The number of
23patient records reviewed shall be sufficient to assure
24adequate review of the physician assistant's scope of
25practice.

26(e) Written agreement.--A physician assistant shall not
27provide a medical service without a written agreement with one
28or more physicians which provides for all of the following:

29(1) Identifies and is signed by each physician the
30physician assistant will be assisting.

1(2) Describes the manner in which the physician
2assistant will be assisting each named physician.

3(3) Describes the nature and degree of supervision and
4direction each named physician will provide the physician
5assistant[.], including, but not limited to, the number and 
6frequency of the patient record reviews required by 
7subsection (d.1) and the criteria for selecting patient 
8records for review when 100% review is not required.

9(4) Designates one of the named physicians as having the
10primary responsibility for supervising and directing the
11physician assistant.

12(5) Has been approved by the board as satisfying the
13foregoing and as consistent with the restrictions contained
14in or authorized by this section.

15A physician assistant shall not assist a physician in a manner
16not described in the agreement or without the nature and degree
17of supervision and direction described in the agreement. There
18shall be no more than four physician assistants for whom a
19physician has responsibility or supervises pursuant to a written
20agreement at any time. In health care facilities licensed under
21the act of July 19, 1979 (P.L.130, No.48), known as the Health
22Care Facilities Act, a physician assistant shall be under the
23supervision and direction of a physician or physician group
24pursuant to a written agreement, provided that a physician
25supervises no more than four physician assistants at any time. A
26physician may apply for a waiver to employ or supervise more
27than four physician assistants at any time under this section
28for good cause, as determined by the board.

29* * *

30Section 2. This act shall take effect in 60 days.