Commerce, Occupational and Professional Licensing

Rule R156-70a

Physician Assistant Practice Act Rule

Notice of Proposed Rule

(Amendment)

DAR File No.: 33710
Filed: 06/03/2010 04:16:19 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this filing is to address the details of S.B. 139, which was passed during the 2010 Legislative Session, that permits a supervising physician to delegate to a licensed physician assistant on a temporary basis as defined by rule, the supervision of physician assistant students. Additionally, Subsection R156-70a-501(4) is updated to be consistent with current practice standards and Medicaid and Medicare rules on supervision. (DAR NOTE: S.B. 139 (2010) is found at Chapter 37, Laws of Utah 2010, and was effective 05/11/2010.)

Summary of the rule or change:

Section R156-70a-305 is added to define temporary basis in regards to a physician delegating the supervision of supervising students to a physician assistant. Subsection R156-70a-501(4) is amended to address how many physician assistants a physician may supervise. The maximum is no more than four full-time equivalents without the prior approval of the Division in collaboration with the Board. It also provides that the supervising physician shall ensure that patient health, safety and welfare is not adversely compromised by supervising more physician assistants than the physician can competently supervise.

State statutory or constitutional authorization for this rule:

• Section 58-70a-101
• Subsection 58-1-106(1)(a)
• Subsection 58-1-202(1)(a)

Anticipated cost or savings to:

the state budget:

The Division will incur minimal costs of approximately $50 to print and distribute the rule once the proposed amendments are made effective. Any costs incurred will be absorbed in the Division's current budget.

local governments:

The proposed amendments only apply to licensed physicians and physician assistants and applicants for licensure in those classifications. As a result, the proposed amendments do not apply to local governments.

small businesses:

The proposed rule amendments create a cost savings to the physician or the owner of the medical business as it will allow them to hire two additional physician assistants to serve patients instead of another physician. Additionally, it creates employment opportunities for physician assistants. Exact estimates of savings cannot be determined due to a wide range of circumstances.

persons other than small businesses, businesses, or local governmental entities:

The proposed rule amendments create a cost savings to the physician or the owner of the medical business as it will allow them to hire two additional physician assistants to serve patients instead of another physician. Additionally, it creates employment opportunities for physician assistants. Exact estimates of savings cannot be determined due to a wide range of circumstances.

Compliance costs for affected persons:

The proposed rule amendments do not cost affected persons because it simply establishes criteria for supervision of students which allows for delegation which in the past was not allowed. Additionally, it accommodates physicians to supervise additional physician assistants in order to serve more patients at a potential lower cost and provide employment opportunities for physician assistants. Exact estimates cannot be determined due to a wide range of circumstances.

Comments by the department head on the fiscal impact the rule may have on businesses:

No fiscal impact to businesses is anticipated from this rule filing beyond those addressed by the passage of recent statutory amendments.

Francine A. Giani, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Commerce
Occupational and Professional Licensing
160 E 300 S
SALT LAKE CITY, UT 84111-2316

Direct questions regarding this rule to:

• Noel Taxin at the above address, by phone at 801-530-6621, by FAX at 801-530-6511, or by Internet E-mail at ntaxin@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

08/02/2010

Interested persons may attend a public hearing regarding this rule:

• 07/20/2010 09:00 AM, Heber Wells Bldg, 160 E 300 S, Conference Room 464, Salt Lake City, UT

This rule may become effective on:

08/09/2010

Authorized by:

Mark Steinagel, Director

R156. Commerce, Occupational and Professional Licensing.

R156-70a. Physician Assistant Practice Act Rule.

R156-70a-305. Exemptions from Licensure.

"Temporary basis", as used in Subsection 58-70a-305(1)(b)(ii), shall be limited as defined by the Delegation of Service Agreement and shall include the following:

(1) the circumstances and purpose under which any temporary supervision is permitted;

(2) the temporary supervision duties to be performed by the physician assistant;

(3) the amount of temporary supervision that is allowed; and

(4) how the physician will review the activities of students while under temporary supervision.

 

R156-70a-501. Working Relationship and Delegation of Duties.

In accordance with Section 58-70a-501, the working relationship and delegation of duties between the supervising physician and the physician assistant are specified as follows:

(1) The supervising physician shall provide supervision to the physician assistant to adequately serve the health care needs of the practice population and ensure that the patient's health, safety and welfare will not be adversely compromised. The degree of on-site supervision shall be outlined in the Delegation of Services Agreement maintained at the site of practice. Physician assistants may authenticate with their signature any form that may be authenticated by a physician's signature.

(2) There shall be a method of immediate consultation by electronic means whenever the physician assistant is not under the direct supervision of the supervising physician.

(3) The supervising physician shall review and co-sign sufficient numbers of patient charts and medical records to ensure that the patient's health, safety, and welfare will not be adversely compromised. The Delegation of Services Agreement, maintained at the site of practice, shall outline specific parameters for review that are appropriate for the working relationship.

(4) A supervising physician [shall]may not supervise more than [two]four full time equivalent (FTE) physician assistants without the prior approval of the division in collaboration with[and] the board, and only for extenuating circumstances with a written request with justification. The supervision physician shall ensure that[if] patient health, safety, and welfare [will not be]is not adversely compromised by supervising more physician assistants than the physician can competently supervise.

 

KEY: licensing, physician assistants

Date of Enactment or Last Substantive Amendment: [July 23, 2009]2010

Notice of Continuation: February 27, 2007

Authorizing, and Implemented or Interpreted Law: 58-70a-101; 58-1-106(1)(a); 58-1-202(1)(a)