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

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

1reasonable time, which shall not exceed ten days, during each 
2of the following time periods:

3(i) The first 12 months of the physician assistant's
4practice post graduation and after the physician
5assistant has fulfilled the criteria for licensure set
6forth in section 36(c).

7(ii) The first 12 months of the physician
8assistant's practice in a new specialty in which the
9physician assistant is practicing.

10(iii) The first six months of the physician
11assistant's practice in the same specialty under the
12supervision of the approved physician, unless the
13physician assistant has multiple approved physicians and
14practiced under the supervision of at least one of those
15approved physicians for six months.

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

27(e) Written agreement.--A physician assistant shall not
28provide a medical service without a written agreement with one
29or more physicians which provides for all of the following:

30(1) Identifies and is signed by each physician the

1physician assistant will be assisting.

2(2) Describes the manner in which the physician
3assistant will be assisting each named physician.

4(3) Describes the nature and degree of supervision and
5direction each named physician will provide the physician
6assistant[.], including, but not limited to, the number and 
7frequency of the patient record reviews required by 
8subsection (d.1) and the criteria for selecting patient 
9records for review when 100% review is not required.

10(4) Designates one of the named physicians as having the
11primary responsibility for supervising and directing the
12physician assistant.

13(5) Has been approved by the board as satisfying the
14foregoing and as consistent with the restrictions contained
15in or authorized by this section. <-Upon submission of the 
16application, board staff shall review the application only 
17for completeness and shall issue a letter to the supervising 
18physician providing the temporary authorization for the 
19physician assistant to begin practice. If the application is 
20not complete, including, but not limited to, required 
21information or signatures not being provided or the fee not 
22being submitted, a temporary authorization for the physician 
23assistant to begin practicing shall not be issued. The 
24temporary authorization, when issued, shall provide a period 
25of 120 days during which the physician assistant may practice 
26under the terms set forth in the written agreement as 
27submitted to the board. Within 120 days the board shall 
28notify the supervising physician of the final approval or 
29disapproval of the application. If approved, a final approval 
30of the written agreement shall be issued to the supervising

1physician. If there are discrepancies that have not been 
2corrected within the 120- day period, the temporary 
3authorization to practice shall expire.

4A physician assistant shall not assist a physician in a manner
5not described in the agreement or without the nature and degree
6of supervision and direction described in the agreement. There
7shall be no more than four physician assistants for whom a
8physician has responsibility or supervises pursuant to a written
9agreement at any time. In health care facilities licensed under
10the act of July 19, 1979 (P.L.130, No.48), known as the Health
11Care Facilities Act, a physician assistant shall be under the
12supervision and direction of a physician or physician group
13pursuant to a written agreement, provided that a physician
14supervises no more than four physician assistants at any time. A
15physician may apply for a waiver to employ or supervise more
16than four physician assistants at any time under this section
17for good cause, as determined by the board.

18* * *

19Section 2. This act shall take effect in 60 days.