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Contents
Posted 02/20/02
HB 1352 - PHYSICIAN ASSISTANT:
SUPERVISORY ACCOUNTABILITY LEGISLATION
The 2001 Georgia Assembly passed legislation (HB 383), agreed upon by the Georgia Association of Physician Assistants and the Medical Association of Georgia, allowing a physician to have four PAs licensed to him or her so long as he or she only supervised two PAs at any one time, but for the exception mentioned below. The purpose of HB 383 was to inject flexibility into the PA statute in order to more fully utilize the Physician-PA team approach and to accommodate current medical practice.
This flexibility is needed in rural areas where there may not be sufficient numbers of physicians to provide access to health care at all times. HB 383 was intended to help rural hospitals, many of which are now providing much of their care through clinics and emergency room settings staffed in part by physician assistants. Increased flexibility is also needed by larger group practices (such as anesthesiology, emergency medicine) or in practices serving patients at multiple sites.
In passing HB 383 the parties involved intended to preserve the concept of the "alternate supervising physician" utilized by the Composite State Board of Medical Examiners to allow a physician other than the "regular" supervising physician to supervise a PA when that "regular" physician is absent (e.g. out of town, in another part of the medical facility such as different operating room, at a different practice site, "on call", etc.).
Unfortunately, a Georgia Court of Appeals decision (Rockefeller v. Kaiser) has cast a new light on the PA statute through which significant flaws have been identified, either by the court or the Attorney General's office:
A physician may no longer have more than four PAs licensed to him or her regardless of whether he or she is acting as an alternate; and
Lack of clear authority for a physician to act as an alternate supervisor.
As a result, there is significant concern among various physician groups, associations, hospitals, and physician assistants. Therefore, HB 1352 was drafted to address these issues and maintain current regulatory practices by the CSBME. HB 1352:
Defines and distinguishes a primary from an alternate supervising physician;
Allows the Medical Board to approve a physician as an alternate supervisingphysician;
Maintains the requirement that a primary supervising physician may have up to four PAs licensed to him or her but still supervise only two PAs at any one time, with certain exceptions, primarily when a physician is acting as an alternate; and
Provides that a physician may serve as an alternate supervising physician, when designated by the primary supervising physician, for any number of PAs but clarifies that an alternate supervising physician may only supervise simultaneously a maximum of four PAs in certain situations (e.g. group practices, institutional settings, "on call", etc.)
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HB 384 - PHYSICIAN ASSISTANTS:
PROFESSIONAL SAMPLES
HB384 was not introduced for legislative action in 2002
Fact Sheet
HB 384 would allow a supervising physician to delegate to a physician assistant(PA) the authority to request, receive, and sign for professional samples (of medication)and to distribute a sample to a patient. This legislation was introduced during the 2001General Assembly but was held over so that it could be discussed in the interim.
HB 384 addresses a problem, which is especially found in rural areas of Georgia.Frequently, a representative of a pharmaceutical manufacturer would like, but is unable,to leave professional samples at a physician's office because the physician is not in. Itmay then be several weeks before the representative can return to the physician's office.
Georgia, like moat states, allows physicians to delegate prescriptive authority toPAs. In almost all such cases, PAs are also authorized to request, sign for, receive, anddistribute professional samples. In fact, federal law - absent a specific state prohibition -assumes that PAs may be delegated such duties in "PA prescriptive authority states."Thus, only about 25% of such states even mention samples in their statutes. However, inGeorgia the Attorney General's Office has advised the Composite Board of MedicalExaminers that additional legislation, would be needed to allow physicians to delegate"sampling" authority. HB 384 was introduced for this reason.
The Georgia Association, of Physician Assistants is committed to the concept ofphysician/PA team care with appropriate safeguards to ensure and promote qualitycontrol. Thus, HB 384 contains the following features:
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Physician discretion as to whether or not to allow the employed PA to request, sign for, and distribute samples.
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Physician approval of the list of samples for which he/she is delegatingauthority to the PA.
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Physician delegation of authority must be included in the PA'S jobdescription, ensuring delegation to the PA is for samples used within the physician's scope (type) of practice.
Some benefits of HB 384 to both the public and physician/PA team practice are:
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Ensures the practice will have the use of professional samples.
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Allows indigent patients access to medication, reducing the threat of non-compliance, which can have an impact on disease management.
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Enables low income patients to try a medication to determine effectiveness and potential side effects prior to paying for a prescription.
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Allows treatment to begin immediately, eliminating potential barrier to care attributable to significant distance from a pharmacy.
For all of the above reasons, GAPA feels HB 384 is very important to today'shealth care system in Georgia, particularly for rural areas and underserved populations.This bill does not increase the scope of authority of a PA, but it does maximize the useof the Physician/PA team concept for the benefit of patients.
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To Register Contact:
Atlanta Field Division
75 Spring Street, SW, Room 740
Atlanta, GA 30303
Division Number: (404) 893-7164
Registration: (888) 869-9355
If you do not currently possess a DEA registration, request an application form DEA 224 and return to the address that is enclosed in the application form. A form can also be obtained from the DEA web site at
http://www.deadiversion.usdoj.gov/drugreg/process.htm
. You will be applying to prescribe and administer only.
The CSBME rules for carrying out a prescriptive drug order are defined in Rule 360-5-.12 and should be reviewed by you and your supervising physician to assure your compliance. These and other PA Rules and Regulations are available on the CSBME web site at
http://www.medicalboard.state.ga.us/
.
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