PRINTER'S NO. 1197
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
895
Session of
2017
INTRODUCED BY RAFFERTY, ALLOWAY, YUDICHAK, GORDNER,
RESCHENTHALER AND HUTCHINSON, SEPTEMBER 25, 2017
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE,
SEPTEMBER 25, 2017
AN ACT
Amending the act of December 20, 1985 (P.L.457, No.112),
entitled "An act relating to the right to practice medicine
and surgery and the right to practice medically related acts;
reestablishing the State Board of Medical Education and
Licensure as the State Board of Medicine and providing for
its composition, powers and duties; providing for the
issuance of licenses and certificates and the suspension and
revocation of licenses and certificates; provided penalties;
and making repeals," further providing for the State Board of
Medicine and for physician assistants.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Sections 3(a) and (b) and 13(d), (d.1) and (e) of
the act of December 20, 1985 (P.L.457, No.112), known as the
Medical Practice Act of 1985, are amended to read:
Section 3. State Board of Medicine.
(a) Establishment.--The State Board of Medicine shall
consist of the commissioner 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 and
[seven] nine members appointed by the Governor, [six] eight of
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whom shall be medical doctors with unrestricted licenses to
practice medicine and surgery in this Commonwealth for five
years immediately preceding their appointment, one who shall be
a physician assistant and one who shall be a nurse midwife,
[physician assistant, certified registered nurse practitioner,]
respiratory therapist, licensed athletic trainer or perfusionist
licensed or certified under the laws of this Commonwealth. 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.
(b) Terms of office.--The term of each professional and
public member of the board shall be four years or until his or
her successor has been appointed and qualified, but not longer
than six months beyond the four-year period. In the event that
any of said members shall die or resign or otherwise become
disqualified during his or her term, a successor shall be
appointed in the same way and with the same qualifications and
shall hold office for the unexpired term. No member shall be
eligible for appointment to serve more than two consecutive
terms. The Governor shall assure that nurse midwives, [physician
assistants, certified registered nurse practitioners,]
perfusionists and respiratory therapists are appointed to four-
year terms on a rotating basis so that, of every four
appointments to a four-year term, one is a nurse midwife, [one
is a physician assistant, one is a certified registered nurse
practitioner and] one is a perfusionist and one is a respiratory
therapist.
* * *
Section 13. Physician assistants.
* * *
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(d) Supervision.--A physician assistant shall not perform a
medical service without the supervision [and personal direction
of an approved] of a licensed physician. [The board shall
promulgate regulations which define the supervision and personal
direction required by the standards of acceptable medical
practice embraced by the medical doctor community in this
Commonwealth.] Supervision shall not be construed as requiring
the onsite presence of the supervising physician.
[(d.1) Patient record review.--
(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 section 36(c).
(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
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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.]
(e) Written agreement.--A physician assistant shall [not
provide a medical service without] provide medical services
according to a written agreement [with one or more physicians]
which provides for all of the following:
(1) Identifies and is signed by [each] the primary
supervising physician [the physician assistant will be
assisting].
(2) Describes the physician [manner in which the
physician assistant will be assisting each named physician]
assistant's scope of practice.
(3) Describes the nature and degree of supervision [and
direction each named physician] the supervising physician
will provide the physician assistant[, including, but not
limited to, the number and frequency of the patient record
reviews required by subsection (d.1) and the criteria for
selecting patient records for review when 100% review is not
required].
(4) Designates one [of the named physicians] physician
as having the primary responsibility for supervising [and
directing] the physician assistant.
[(5) Has been approved by the board as satisfying the
foregoing and as consistent with the restrictions contained
in or authorized by this section. Upon submission of the
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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
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.]
(5.1) Is maintained 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
request.
A physician assistant shall [not assist a physician] provide
medical services in a manner [not described in the agreement or
without the nature and degree of supervision and direction] as
described in the agreement. 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
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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.
* * *
Section 2. This act shall take effect in 60 days.
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