H. B. 2301
(By Delegates Bennett, Everson, Riggs and Williams)
[Introduced January 31, 1995; referred to the
Committee on Health and Human Resources then Government
Organization.]
A BILL to amend and reenact section sixteen, article three,
chapter thirty of the code of West Virginia, one thousand
nine hundred thirty-one, as amended, relating to the
approval of educational programs for physician assistants by
the successor organization to the committee on allied health
education and accreditation of the American Medical
Association; increasing the number of physician assistants
a physician may supervise; and providing that license fees
for physician assistants shall be the same as those
established for physicians by the West Virginia board of
medicine.
Be it enacted by the Legislature of West Virginia:
That section sixteen, article three, chapter thirty of the
code of West Virginia, one thousand nine hundred thirty-one, as
amended, be amended and reenacted to read as follows:
ARTICLE 3. WEST VIRGINIA MEDICAL PRACTICE ACT.
ยง30-3-16. Physician assistants; definitions; board of medicine
rules; annual
report; licensure; temporary license;
relicensure; job description required; revocation or
suspension of licensure; responsibilities of
supervising physician; legal responsibility for
physician assistants; reporting by health care
facilities; identification; limitations on
employment and duties; fees; unlawful use of title
of "physician assistant"; continuing education;
unlawful representation of physician assistant as a
physician; criminal penalties.
(a) As used in this section:
(1) "Physician assistant" means an assistant to a physician
who is a graduate of an approved program of instruction in
primary health care or surgery, has attained a baccalaureate or
master's degree, has passed the national certification
examination and is qualified to perform direct patient care services under the supervision of a physician;
(2) "Physician assistant-midwife" means a physician
assistant who meets all qualifications set forth under
subdivision (1) above and fulfills the requirements set forth in
subsection (d); is subject to all provisions of this section; and
assists in the management and care of a woman and her infant
during the prenatal, delivery and postnatal periods;
(3) "Supervising physician" means a doctor or doctors of
medicine or podiatry permanently licensed in this state who
assume legal and supervisory responsibility for the work or
training of any physician assistant under his or her supervision;
(4) "Approved program" means an educational program for
physician assistants approved and accredited by the committee on
allied health education and accreditation on behalf of the
American Medical Association or its successor; and
(5) "Health care facility" means any licensed hospital,
nursing home, extended care facility, state health or mental
institution, clinic or physician's office.
(b) The board shall promulgate rules governing the extent to
which physician assistants may function in this state. Such rules shall provide that the physician assistant is limited to
the performance of those services for which he or she is trained
and that he or she performs only under the supervision and
control of a physician permanently licensed in this state, but
such supervision and control does not require the personal
presence of the supervising physician at the place or places
where services are rendered if the physician assistant's normal
place of employment is on the premises of the supervising
physician. The supervising physician may send the physician
assistant off the premises to perform duties under his or her
direction, but a separate place of work for the physician
assistant shall not be established. In promulgating such rules,
the board shall allow the physician assistant to perform those
procedures and examinations and in the case of certain authorized
physician assistants to prescribe at the direction of his or her
supervising physician in accordance with subsection (l) of this
section those categories of drugs submitted to it in the job
description required by subsection (g) of this section. The
board shall compile and publish a biennial report that includes
a list of currently licensed physician assistants and their employers and location in the state; a list of approved programs;
the number of graduates of such approved programs each year; and
the number of physician assistants from other states practicing
in this state.
(c) The board shall license as a physician assistant any
person who files an application and furnishes satisfactory
evidence to it that he or she has met the following standards:
(1) He or she is a graduate of an approved program of
instruction in primary health care or surgery;
(2) He or she has passed the examination for a primary care
physician assistant administered by the National Board of Medical
Examiners on behalf of the National Commission on Certification
of Physician Assistants and has maintained certification by said
commission so as to be currently certified;
(3) He or she is of good moral character; and
(4) He or she has attained a baccalaureate or master's
degree.
(d) The board shall license as a physician assistant-midwife
any person who meets the standards set forth under subsection (c)
of this section and, in addition thereto, the following standards:
(1) He or she is a graduate of a school of midwifery
accredited by the American college of nurse-midwives;
(2) He or she has passed an examination approved by the
board;
(3) He or she practices midwifery under the supervision of
a board certified obstetrician, gynecologist or a board certified
family practice physician who routinely practices obstetrics.
(e) The board may license as a physician assistant any
person who files an application and furnishes satisfactory
evidence that he or she is of good moral character and meets
either of the following standards:
(1) He or she is a graduate of an approved program of
instruction in primary health care or surgery prior to the first
day of July, one thousand nine hundred ninety-four, and has
passed the examination for a primary care physician assistant
administered by the National Board of Medical Examiners on behalf
of the National Commission on Certification of Physician
Assistants; or
(2) He or she had been certified by the board as a physician assistant then classified as "Type B," prior to the first day of
July, one thousand nine hundred eighty-three.
Licensure of an assistant to a physician practicing the
specialty of ophthalmology is permitted under this section:
Provided, That a physician assistant may not dispense a
prescription for a refraction.
(f) When any graduate of an approved program, within two
years of graduation, submits an application to the board,
accompanied by a job description in conformity with subsection
(g) of this section, for a physician assistant license, the board
shall issue to such applicant a temporary license allowing such
applicant to function as a physician assistant for the period of
one year. Said temporary certificate may be renewed for one
additional year upon the request of the supervising physician.
A physician assistant who has not been certified as such by the
National Board of Medical Examiners on behalf of the National
Commission on Certification of Physician Assistants will be
restricted to work under the direct supervision of the
supervising physician.
(g) Any physician applying to the board to supervise a physician assistant shall provide a job description that sets
forth the range of medical services to be provided by such
assistant. Before a physician assistant can be employed or
otherwise use his or her skills, the supervising physician must
obtain approval of the job description from the board. The board
may revoke or suspend any license of an assistant to a physician
for cause, after giving such person an opportunity to be heard in
the manner provided by article five of chapter twenty-nine-a of
this code and as set forth in rules duly adopted by the board.
(h) The supervising physician is responsible for observing,
directing and evaluating the work, records and practices of each
physician assistant performing under his or her supervision. He
or she shall notify the board in writing of any termination of
his or her supervisory relationship with a physician assistant
within ten days of the termination. The legal responsibility for
any physician assistant remains with the supervising physician at
all times, including occasions when the assistant under his or
her direction and supervision, aids in the care and treatment of
a patient in a health care facility. In his or her absence, a
supervising physician must designate an alternate supervising physician, however, the legal responsibility remains with the
supervising physician at all times. A health care facility is
not legally responsible for the actions or omissions of the
physician assistant unless the physician assistant is an employee
of the facility.
(i) The acts or omissions of a physician assistant employed
by health care facilities providing inpatient or outpatient
services shall be the legal responsibility of said facilities.
Physician assistants employed by such facilities in staff
positions shall be supervised by a permanently licensed
physician.
(j) A health care facility shall report in writing to the
board within sixty days after the completion of the facility's
formal disciplinary procedure, and also after the commencement,
and again after the conclusion, of any resulting legal action,
the name of any physician assistant practicing in the facility
whose privileges at the facility have been revoked, restricted,
reduced or terminated for any cause including resignation,
together with all pertinent information relating to such action.
The health care facility shall also report any other formal disciplinary action taken against any physician assistant by the
facility relating to professional ethics, medical incompetence,
medical malpractice, moral turpitude or drug or alcohol abuse.
Temporary suspension for failure to maintain records on a timely
basis or failure to attend staff or section meetings need not be
reported.
(k) When functioning as a physician assistant, the physician
assistant shall wear a name tag that identifies him or her as a
physician assistant. A two and one-half by three and one-half
inch card of identification shall be furnished by the board upon
licensure of the physician assistant.
(l) A physician assistant may write or sign prescriptions or
transmit prescriptions by word of mouth, telephone or other means
of communication at the direction of his or her supervising
physician. The board shall promulgate rules governing the
eligibility and extent to which such a physician assistant may
prescribe at the direction of the supervising physician. The
rules shall provide for a state formulary classifying
pharmacologic categories of drugs which may be prescribed by such
a physician assistant. In classifying such pharmacologic categories, those categories of drugs which shall be excluded
shall include, but not be limited to, Schedules I and II of
the Uniform Controlled Substances Act, anticoagulants,
antineoplastics, radiopharmaceuticals, general anesthetics, and
radiographic contrast materials. Drugs listed under Schedule III
shall be limited to a seventy-two hour supply without refill.
The regulations shall provide that all pharmacological categories
of drugs to be prescribed by a physician assistant shall be
listed in each job description submitted to the board as required
in subsection (g) of this section. The rules shall provide the
maximum dosage a physician assistant may prescribe. The rule
shall also provide that to be eligible for such prescription
privileges, a physician assistant shall have performed patient
care services for a minimum of two years immediately preceding
the submission to the board of the job description containing
prescription privileges and shall have successfully completed an
accredited course of instruction in clinical pharmacology
approved by the board. The regulations shall also provide that
to maintain prescription privileges, a physician assistant shall
continue to maintain national certification as a physician assistant, and in meeting such national certification
requirements shall complete a minimum of ten hours of continuing
education in rational drug therapy in each certification period.
Nothing in this subsection shall be construed to permit a
physician assistant to independently prescribe or dispense drugs.
(m) A supervising physician shall not supervise at any one
time more than two four physician assistants. except that a
physician may supervise up to four hospital-employed physician
assistants
A physician assistant shall not sign any prescription,
except in the case of an authorized physician assistant at the
direction of his or her supervising physician in accordance with
the provisions of subsection (l) of this section. A physician
assistant shall not perform any service that his or her
supervising physician is not qualified to perform. A physician
assistant shall not perform any service that is not included in
his or her job description and approved by the board as provided
for in this section.
The provisions of this section do not authorize any
physician 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.
(n) Each application for licensure submitted by a licensed
supervising physician under this section shall be accompanied by
a fee of one hundred dollars in the same amount as that
established by the board for physicians pursuant to subdivision
(1), subsection (b), section ten of this article. A fee of fifty
dollars in the same amount as that established by the board for
physicians under subsection (a), section twelve of this article
shall be charged for the biennial renewal of the license. A fee
of twenty-five dollars shall be charged for any change of
supervising physician.
(o) Beginning with the biennial renewal forms completed by
physician assistants and submitted to the board in one thousand
nine hundred ninety-three, as a condition of renewal of physician
assistant license, each physician assistant shall provide written
documentation pursuant to rules promulgated by the board in
accordance with chapter twenty-nine-a of this code of
participation in and successful completion during the preceding two-year period of a minimum of forty hours of continuing
education designated as Category I by the American Medical
Association, American Academy of Physician Assistants or the
Academy of Family Physicians, and sixty hours of continuing
education designated as Category II by such association or either
academy. Notwithstanding any provision of this chapter to the
contrary, failure to timely submit such required written
documentation shall result in the automatic suspension of any
license as a physician assistant until such time as the written
documentation is submitted to and approved by the board.
(p) It is unlawful for any person who is not licensed by the
board as a physician assistant to use the title of "physician
assistant" or to represent to any other person that he or she is
a physician assistant. Any person who violates the provisions of
this subsection is guilty of a misdemeanor, and, upon conviction
thereof, shall be fined not more than two thousand dollars.
(q) It is unlawful for any physician assistant to represent
to any person that he or she is a physician, surgeon or
podiatrist. Any person who violates the provisions of this
subsection is guilty of a felony, and, upon conviction thereof, shall be imprisoned in the penitentiary for not less than one nor
more than two years, or be fined not more than two thousand
dollars, or both fined and imprisoned.
(r) All physician assistants holding valid certificates
issued by the board prior to the first day of July, one thousand
nine hundred ninety-two, shall be considered to be licensed under
this section.
NOTE: The purpose of this bill is to provide for approvals
of educational programs for physician assistants by the successor
organization to the committee on allied health education and
accreditation of the American Medical Association, and to
increase the number of physician assistants a physician may
supervise from 2 to 4; and to provide that license fees for
physician assistants will be the same as those established for
physicians by the West Virginia board of medicine.
Strike-throughs indicate language that would be stricken
from the present law, and underscoring indicates new language
that would be added.