WEST virginia legislature
2021 regular session
Originating
Senate Bill 714
By Senators Takubo, Maroney, Grady, Weld, Rucker, Azinger, Stover, Woodrum, Stollings, Plymale, Roberts, Lindsay, and Unger
[Originating in the Committee on Health and Human Resources; reported on March 26, 2021]
A BILL to repeal §30-3E-10 of the Code of West Virginia, 1931, as amended; and to amend and reenact §30-3E-1, §30-3E-2, §30-3E-3, §30-3E-4, §30-3E-9, §30-3E-10a, §30-3E-11, §30-3E-12, §30-3E-13, and §30-3E-17 of said code, all relating to Physician Assistants Practice Act; defining terms; limiting rule-making authority; revising licensure requirements; revising practice requirements; eliminating practice agreement requirement; revising practice notification requirement; revising collaboration requirements; expanding scope of practice for physician’s assistant; and revising complaint process.
Be it enacted by the Legislature of West Virginia:
ARTICLE 3E. PHYSICIAN ASSISTANTS PRACTICE ACT.
§30-3E-1. Definitions.
As used in this article:
(1) “Advance duties” means medical acts that require
additional training beyond the basic education program training required for
licensure as a physician assistant.
(2) “Alternate collaborating physician” means one or
more physicians licensed in this state and designated by the collaborating
physician to provide collaboration with a physician assistant in accordance
with an authorized practice agreement.
(3) (1)
“Approved program” means an educational program for physician assistants
approved and accredited by the Accreditation Review Commission on Education for
the Physician Assistant or its successor. Prior to 2001, approval and
accreditation would have been by either the Committee on Allied Health
Education and Accreditation or the Commission on Accreditation Review
Commission on Education for the Physician Assistant of Allied Health
Education Programs.
(4) (2)
“Boards” means the West Virginia Board of Medicine and the West Virginia Board
of Osteopathic Medicine.
(5) (3)
“Chronic condition” means a condition which lasts three months or more,
generally cannot be prevented by vaccines, can be controlled but not cured by
medication, and does not generally disappear. These conditions include, but are
not limited to, arthritis, asthma, cardiovascular disease, cancer, diabetes,
epilepsy and seizures, and obesity.
(6) (4)
“Collaborating physician” means a doctor of medicine, osteopathy, or podiatry
fully licensed, by the appropriate board in this state, without restriction or
limitation, who collaborates with physician assistants.
(7) (5)
“Collaboration” means overseeing the activities of the medical services rendered
by a physician’s assistant. Constant physical presence of the collaborating
physician is not required as long as the collaborating physician and physician’s
assistant are, or can be, easily in contact with one another by
telecommunication. Collaboration does not require the personal presence of the
collaborating physician at the place or places where services are rendered.
(8) (6)
“Endorsement” means a summer camp or volunteer endorsement authorized under
this article.
(9) (7)
“Health care facility” means any licensed hospital, nursing home, extended care
facility, state health or mental institution, clinic, or physician’s office.
(10) “Hospital” means a facility licensed pursuant to
§16-5B-1 et seq. of this code and any acute-care facility operated by
the state government that primarily provides inpatient diagnostic, treatment,
or rehabilitative services to injured, disabled, or sick persons under the
supervision of physicians and includes psychiatric hospitals.
(11) (8)
“License” means a license issued by either of the boards pursuant to the
provisions of this article.
(12) (9)
“Licensee” means a person licensed pursuant to the provisions of this article.
(13) (10)
“Physician” means a doctor of allopathic or osteopathic medicine who is fully
licensed pursuant to the provisions of either §30-3-1 et seq. or
§30-14-1 et seq. of this code to practice medicine and surgery in this
state.
(14) (11)
“Physician’s assistant” means a person who meets the qualifications set forth
in this article and is licensed pursuant to this article to practice medicine under
with a collaboration collaborating physician.
(15) “Practice agreement” means a document that is
executed between a collaborating physician and a physician assistant pursuant
to the provisions of this article, and is filed with and approved by the
appropriate licensing board.
(16) (12)
“Practice notification” means a written notice to the appropriate licensing
board that a physician’s assistant will practice in collaboration with one or
more collaborating physicians in a hospital in the state of West
Virginia.
§30-3E-2. Powers and duties of the boards.
In addition to the powers and duties set forth in this code for the boards, the boards shall:
(1) Establish the requirements for licenses and temporary licenses pursuant to this article;
(2) Establish the procedures for submitting, approving, and rejecting applications for licenses and temporary licenses;
(3) Propose rules for legislative approval in
accordance with the provisions of article three, chapter twenty-nine-a §29A-3-1
et seq. of this code to implement the provisions of this article;
(4) Compile and publish an annual report that includes
a list of currently licensed physician assistants their collaborating
physicians and their primary practice locations in the state; and
(5) Take all other actions necessary and proper to effectuate the purposes of this article.
§30-3E-3. Rulemaking.
(a) The boards shall propose rules for legislative approval in accordance with the provisions of §29A-3-1 et seq. of this code to implement the provisions of this article, including:
(1) The extent to which physician assistants may practice in this state;
(2) The extent to which physician assistants may pronounce death;
(3) Requirements for licenses and temporary licenses;
(4) Requirements for practice agreements and
practice notifications;
(5) Requirements for continuing education;
(6) Conduct of a licensee for which discipline may be imposed;
(7) The eligibility and extent to which a physician’s
assistant may prescribe, including: A state formulary classifying those
categories of drugs which may not be prescribed by a physician’s assistant,
including, but not limited to, Schedules I and II of the Uniform Controlled
Substances Act, antineoplastics, radiopharmaceuticals, and general anesthetics.:
Provided, That a physician’s assistant may prescribe no more
than a three-day supply, without refill, of a drug listed in the Uniform
Controlled Substances Act as a Schedule II drug. Drugs listed under
Schedule III shall be limited to a 30-day supply without refill. In addition to
the above referenced provisions and restrictions and pursuant to a practice
agreement or practice notification as set forth in this article, the rules
shall permit the prescribing of an annual supply of any drug, with the
exception of controlled substances, which is prescribed for the treatment of a
chronic condition, other than chronic pain management. For the purposes of this
section, a chronic condition is a condition which lasts three months or more,
generally cannot be prevented by vaccines, can be controlled but not cured by
medication, and does not generally disappear. These conditions, with the
exception of chronic pain, include, but are not limited to, arthritis, asthma,
cardiovascular disease, cancer, diabetes, epilepsy and seizures, and obesity;
(8) The authority a collaborating physician may
delegate for prescribing, dispensing, and administering of controlled
substances, prescription drugs, or medical devices if the practice agreement
includes:
(A) A notice of intent to delegate prescribing of
controlled substances, prescription drugs, or medical devices;
(B) An attestation that all prescribing activities of
the physician assistant shall comply with applicable federal and state law
governing the practice of physician assistants;
(C) An attestation that all medical charts or records
shall contain a notation of any prescriptions written by a physician assistant;
(D) An attestation that all prescriptions shall
include the physician assistant’s name and the collaborating physician’s name,
business address, and business telephone number legibly written or printed; and
(E) An attestation that the physician assistant has
successfully completed each of the requirements established by the appropriate
board to be eligible to prescribe pursuant to a practice agreement accompanied
by the production of any required documentation establishing eligibility;
(9) (8)
A fee schedule; and
(10) (9)
Any other rules necessary to effectuate the provisions of this article.
(b) The boards may propose emergency rules pursuant to §29A-3-1 et seq. of this code to ensure conformity with this article.
§30-3E-4. License to practice as a physician’s assistant.
(a) A person seeking licensure as a physician’s assistant shall apply to the Board of Medicine or to the Board of Osteopathic Medicine. The appropriate board shall issue a license to practice as a physician’s assistant with the collaboration of that board’s licensed physicians or podiatrists.
(b) A license may be granted to a person who:
(1) Files a complete application;
(2) Pays the applicable fees;
(3) Demonstrates to the board’s satisfaction that he or she:
(A) Obtained a baccalaureate or master’s degree from an accredited program of instruction for physician assistants;
(B) Prior to July 1, 1994, graduated from an approved program of instruction in primary health care or surgery; or
(C) Prior to July 1, 1983, was certified by the Board of Medicine as a physician’s assistant then classified as Type B;
(4) Has passed the Physician Assistant National Certifying Examination administered by the National Commission on Certification of Physician Assistants;
(5) Has a current certification from the National Commission on Certification of Physician Assistants or has a current license in good standing from a state that does not require a physician’s assistant to maintain national certification;
(6) Is mentally and physically able to engage safely in practice as a physician’s assistant;
(7) Has not had a physician’s assistant license, certification, or registration in any jurisdiction suspended or revoked;
(8) Is not currently subject to any limitation, restriction, suspension, revocation, or discipline concerning a physician’s assistant license, certification, or registration in any jurisdiction: Provided, That if a board is made aware of any problems with a physician’s assistant license, certification, or registration and agrees to issue a license, certification, or registration notwithstanding the provisions of this subdivision or subdivision (7) of this subsection;
(9) Is of good moral character; and
(10) Has fulfilled any other requirement specified by the appropriate board.
(c) A board may deny an application for a physician’s assistant license to any applicant determined to be unqualified by the board.
§30-3E-9. Practice requirements.
(a) A physician’s assistant may not practice independent of a collaborating physician.
(b) A physician assistant may practice in a
hospital in collaboration with physicians after filing a practice notification
with the appropriate board. A physician’s assistant may practice
in collaboration with physicians in any practice setting pursuant to a practice
notification which has been filed with, and activated by, the appropriate board
in accordance with §30-3E-10a of this code: Provided, That a physician’s
assistant who is currently practicing in collaboration with physicians pursuant
to a practice agreement which was authorized by a board prior to June 1, 2021
may continue to practice under that authorization until the practice agreement
terminates or until June 1, 2022, whichever is sooner.
(c) Except as set forth in subsection (b) of this
section, before a licensed physician assistant may practice and before a
collaborating physician may delegate medical acts to a physician assistant, the
collaborating physician, and the physician assistant shall:
(1) File a practice agreement with the appropriate
licensing board, including any designated alternate collaborating physicians;
(2) Pay the applicable fees; and
(3) Receive written authorization from the appropriate
licensing board to commence practicing as a physician assistant pursuant to the
practice agreement.
(d) A
physician applying to collaborate with a physician assistant shall affirm that:
(1) The medical services set forth in the practice
agreement are consistent with the skills and training of the collaborating
physician and the physician assistant; and
(2) The activities delegated to a physician assistant
are consistent with sound medical practice and will protect the health and
safety of the patient.
(e) A collaborating physician may enter into practice
agreements with up to five full-time physician assistants at any one time.
(f) A physician may collaborate with physician
assistants in a hospital as approved by the hospital.
(c) Notwithstanding any other provision of this code to the contrary, and to the degree permitted by federal law, physician assistants shall be considered providers and shall not be reimbursed at rates lower than other providers who render similar health services by health insurers as well as health plans operated or paid for by the state.
§30-3E-10. Practice agreement requirements.
[Repealed.]
§30-3E-10a. Practice notification requirements.
(a) A physician assistant shall collaborate with
physicians in a hospital only after the physician assistant is notified by the
appropriate licensing board that a complete practice notification has been
filed with the board. Before a licensed physician’s assistant may
practice in collaboration with physicians, the physician’s assistant and a
health care facility shall:
(1) File a practice notification with the appropriate licensing board;
(2) Pay the applicable fee; and
(3) Receive written notice from the appropriate licensing board that the practice notification is complete and active.
(b) The licensing boards shall promulgate emergency
rules to establish the content and criteria for submission of practice
notifications for physician assistant hospital practice.
(c) A physician’s assistant shall notify the board, in writing, within 10 days of the termination of a practice notification. Failure to provide timely notice of the termination constitutes unprofessional conduct and disciplinary proceedings may be instituted by the appropriate licensing board.
§30-3E-11. Collaboration with physician assistants.
(a) A licensed physician or podiatrist may collaborate
with a physician assistant:
(1) As a collaborating physician in accordance with an
authorized practice agreement;
(2) As an alternate collaborating physician who:
(A) Collaborates in accordance with an authorized
practice agreement;
(B) Has been designated an alternate collaborating
physician in the authorized practice agreement; and
(C) Only delegates those medical acts that have been authorized
by the practice agreement and are within the scope of practice of both the
primary collaborating physician and the alternate collaborating physician; or
(3) In a hospital pursuant to a practice notification.
(a) Unless otherwise prohibited by a health care facility, a physician who practices medicine or podiatry at a health care facility may collaborate with any physician’s assistant who holds an active practice notification with the same facility.
(b) A collaborating physician When
collaborating with physician assistants, collaborating physicians shall
observe, direct, and evaluate the physician assistant’s work, records,
and practices including collaborating with the physician assistant in the
care and treatment of a patient in a health care facility as necessary
for appropriate and meaningful collaboration.
(c) A health care facility is only legally responsible for the actions or omissions of a physician’s assistant when the physician’s assistant is employed by or on behalf of the facility.
(d) Every licensed physician’s assistant shall be individually responsible and liable for the care they provide. This article does not relieve physician assistants or collaborating physicians of responsibility and liability which otherwise may exist for acts and omissions occurring during collaboration.
§30-3E-12. Scope of practice.
(a) A license issued to a physician’s assistant by the
appropriate state licensing board shall authorize the physician’s assistant to
perform medical acts: commensurate with their education, training,
and experience and which they are competent to perform, consistent with the
rules of the boards. Medical acts include prescribing,
dispensing, and administering of controlled substances, prescription drugs, or
medical devices.
(1) Pursuant
to a practice notification or delegated to the physician assistant as part of
an authorized practice agreement
(2) Appropriate
to the education, training, and experience of the physician assistant;
(3) Customary
to the practice of the collaborating physician; and
(4) Consistent with the laws of this state and rules
of the boards.
(b) A physician’s assistant shall provide only those medical services for which they have been prepared by their education, training, and experience and are competent to perform, consistent with sound medical practice and that will protect the health and safety of the patient. This may occur in any health care setting, both hospital and outpatient in accordance with their practice notification.
(c) A physician’s assistant with an active practice notification may perform medical acts and/or procedures in collaboration with physicians which are consistent with the physician assistant’s education, training and experience, the collaborating physician’s scope of practice, and any credentialing requirements of the health care facility where the physician’s assistant holds an active practice notification.
(b) (d)
This article does not authorize a physician’s assistant to perform any specific
function or duty delegated by this code to those persons licensed as
chiropractors, dentists, dental hygienists, optometrists, or pharmacists, or
certified as nurse anesthetists.
§30-3E-13. Identification.
(a) While practicing, a physician’s assistant shall wear a name tag that identifies him or her as a physician’s assistant.
(b) A physician’s assistant shall keep his or her
license and current practice agreement or practice notification
available for inspection at his or her place of practice.
§30-3E-17. Complaint process.
(a) All hearings and procedures related to denial of a
license, and all complaints, investigations, hearings, and procedures regarding
a physician’s assistant license and the discipline accorded thereto, shall be
in accordance with the processes and procedures set forth in either §30-3-1 et seq.
or articles three and/or fourteen §30-14-1 et seq.
of this chapter code,
depending on which board licenses the physician’s assistant.
(b) The boards may impose the same discipline, restrictions, and/or limitations upon the license of a physician’s assistant as they are authorized to impose upon physicians and/or podiatrists.
(c) The boards shall direct to the appropriate licensing
board a complaint against a physician’s assistant and/or a collaborating physician
and/or an alternate a collaborating physician.
(d) In the event that independent complaint processes are
warranted by the boards with respect to the professional conduct of a physician’s
assistant or a collaborating and/or alternate collaborating physician,
the boards are authorized to work cooperatively and to disclose to one another
information which may assist the recipient appropriate licensing board in its
disciplinary process. The determination of what information, if any, to
disclose shall be at the discretion of the disclosing board.
(e) A physician’s assistant licensed under this article may
not be disciplined for providing expedited partner therapy in accordance with article
four-f, chapter sixteen §16-4F-1 et seq.
of this code.