Table of Changes to the State Board of Medicine Regulations—Published in Pennsylvania Bulletin, July 5, 2025

FAQs on act 79 of 2021 and regulatory amendments

State Board of Medicine Regulations Updated- Dane Doornbos, DMSc, PA-C, Government Affairs Chair

We have good news to share: the final-form regulations from the State Board of Medicine were published in the Pennsylvania Bulletin on July 5^th, 2025.  This solidifies the modernized changes that were proposed and enacted in Act 79 in 2021.  These changes have been long-awaited and help to improve how physician assistants can care for their patients in Pennsylvania, while simultaneously expanding access for patients by helping to remove some administrative burdens.  The State Board of Osteopathic Medicine is working through this process as well for Act 78 of 2021 and the PSPA is actively involved in this process.

As a reminder, these are the key points that were adopted by the State Board of Medicine:

1. Created a permanent seat for a physician assistant on the Board of Medicine.
2. Removed the requirement that a supervising physician countersign patient records.
   1. NOTE: The regulations still require that 100% of records are countersigned for new graduates and for PAs who change specialties for a period of 1 year.
   2. After the required 1-year period as noted above, countersignature can be determined by the PA and the supervising physician at the practice level.
   3. A change to the written agreement should be made through the PALS system if there is a change to countersignature from the previously submitted written agreement.
   4. The Board of Medicine has indicated that it is acceptable for work agreements for new graduates and for those changing specialties to state that 100% of charts will be countersigned for a period of 1 year and then countersignature will not be continued (or to state what countersignature requirements will continue at that time). This will negate the need to remember to update the work agreement again in 1 year.
3. Allowed for written agreements to be “filed” with the Board of Medicine, instead of being “approved” by the Board of Medicine. Work agreements become effective immediately upon filing.
4. Establishing appropriate supervision at the practice level, based on the needs of the physicians, physician assistants, and the healthcare system.
5. Increased the number of physician assistants able to be supervised by a physician to six.

This is a brief overview of the key changes in the new regulations.  Please refer to the table of the specific changes that were made to the regulations.  As of now, the regulations have not been updated on the State Board of Medicine website, however, the State Board of Medicine has approved a Frequently Asked Questions document for the new Regulations.  The PSPA will continue to work with the State Board of Medicine to ensure the regulations are updated and to educate PAs about the specific changes.

It should be noted that part of the regulatory process allows for comments and questions from the public, health systems, and organizations to be entertained by and responded to by the Board of Medicine. The overwhelming majority of comments submitted to the Board of Medicine were in support of these regulations.  This is encouraging, especially as we move forward with further modernization efforts.

We continue to focus our efforts to further our state legislation to reflect our modern practice habits by working to eliminate PA-to-physician ratios, establishing all countersignature requirements at the practice level, and recognizing our national title change to Physician Associate. There will be more to come on all these topics in the coming months.