TAKE ACTION: Modernization Act Proposed Rulemaking Comment Period Now Open

Posted on by PSPA

The 30-day public comment period is now open for the Proposed Rulemaking for Regulations 16A-4955 (Physician Assistants) to implement the regulations for Act 79 of 2021 which modernized the Medical Practice Act for PAs working under the State Board of Medicine.

Act 79 removed certain restrictions on physician assistant practice to provide greater autonomy for PAs.

Act 79 contained the following key elements:

  1. Creating a permanent seat for physician assistants on the medical board.
  2. Removing the requirement that a supervising physician countersign 100% of patient’s charts.
  3. Allowing all written agreements between physicians and physician assistants to be “filed” with the Board instead of “approved” by the Board.
  4. Outlining appropriate supervision requirements based on the needs of the physicians, physician assistants, and overall health care system.
  5. Increased the number of physician assistants that a physician may have primary responsibility over from four to six.

In the process of opening the regulations for the State Board of Medicine that govern the practice for PAs in Pennsylvania, the PSPA had the opportunity to request revisions, add clarification and further modernize the PA’s functionality.

We are asking for all PAs, PA students, PA program faculty, practice administrators, health systems and other stake holders to write letters of support by January 15, 2024.

Letters can be sent to:

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and/or

Board Counsel Dana Wucinski
State Board of Medicine
P.O. Box 69523
Harrisburg, PA 17106- 5923

All that is needed is a simple message such as the following:

I am writing in support of the Proposed Rulemaking 16-4955 in reference to Physician Assistants as written. The changes in these regulations will modernize the delivery of patient care by the Physician – PA teams in Pennsylvania.

For your reference, the following list is the significant proposed new revisions.

TITLE 59 PART 1 Subpart 1 CHAPTER 18 PROPOSED NEW REVISIONS
Section 18.122 Definitions Addition of definition of scope of practice for a PA:

The medical services within a physician assistant’s skills, training, and experience that a physician assistant may perform as set forth in the written agreement.
Section 18.142 Written agreements
  • No longer need to name each substitute physician the PA would work with.
  • No longer need to list all delegated functions the PA can perform. The new requirement is to describe the PA’s scope of practice.
  • No longer need to describe the frequency of the personal contact the physician will have with the PA. The new requirement is to describe the nature and degree of supervision.
  • Additional language added to outline the ability for a delegate to complete the written agreement.
  • Requires only one primary practice setting be listed.
Section 18.144 Responsibility of primary supervising physician
  • The physician is no longer required to see a hospitalized patient at least once.
  • Clarifies the list of additional substitute supervising physicians. It only needs to be kept at the practice level.
Section 18.151 Role of the physician assistant
  • Outlines that PAs may provide medical services when they are within the PA’s scope of practice.
  • Clarifies the PA may determine the cause of death.
Section 18.152 Prohibitions
  • The PA is now permitted to independently bill.
  • Provides an option for the supervising physician to apply to primarily supervise more than 6 PAs.
Section 18.153 Executing and relaying medical regimens The PA is no longer required to notify their supervising physician within 36 hours when a medical regimen is executed or relayed when the physician is off-site.
Section 18.154 Substitute supervising physician Adds a provision for the substitute supervising physician to assume primary responsibility for 30 days if the primary is permanently unable to supervise while a new written agreement is being filed.
Section 18.155 Satellite locations The registration of a satellite location is no longer required. This section has been completely removed.
Section 18.158 Prescribing and dispensing drugs, pharmaceutical aids, and devices
  • Clarified that electronic prescriptions are permitted.
  • Removes requirement for the PA to notify the supervising physician when a medication is prescribed or dispensed within 36 hours if the physician is off-site.
Section 18.161 Physician assistants employed by health care facilities Restriction removed that a PA could only be responsible to three supervising physicians in a medical care facility

The full explanation for the revisions as well as the revised language can be found at this link:

Pennsylvania Bulletin (pacodeandbulletin.gov)

The wording in the revised language that is between brackets [ ] is removed. New language that is added is underlined and bolded.

If you have questions about the proposed rulemaking, please reach out to the PSPA Governmental Affairs committee at &cHNwYSBhdCBwc3BhIGRvdCBuZXQ=&