H. B. 3239
(By Delegates Douglas and Kuhn)
(Originating in the Committee on Government Organization)
[April 2, 2001]
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 changing the number of
hours of continuing education required to be completed by a
physician assistant.
Be it enacted by the Legislature of West Virginia:
That section sixteen, chapter three, article 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.
§30-3-16. 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; 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) of
this subsection and fulfills the requirements set forth in
subsection (d) of this section; 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 pursuant to the
provisions of article three, chapter twenty-nine-a of this code
governing the extent to which physician assistants may function in
this state. The 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
that 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 may not be
established. In promulgating the 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 this
section. Certain authorized physician assistants may pronounce
death in accordance with the rules proposed by the board which
receive legislative approval. The board shall compile and publish
an annual report that includes a list of currently licensed
physician assistants and their employers and location in the state.
(c) The board shall license as a physician assistant any
person who files an application together with a proposed job
description 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 certifying examination for a
primary care physician assistant administered by the national
commission on certification of physician assistants and has
maintained certification by that 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 together with a proposed job description
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 certifying examination for a physician assistant administered
by the national commission on certification of physician assistants
and has maintained certification by that commission so as to be
currently certified; 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 submits an
application to the board for a physician assistant license,
accompanied by a job description as referenced by this section, the
board shall issue to that applicant a temporary license allowing
that applicant to function as a physician assistant until the
applicant successfully passes the national commission on
certification of physician assistants' certifying examination:
Provided, That the applicant shall sit for and obtain a passing
score on the examination next offered following graduation from the
approved program. No applicant shall receive a temporary license
who, following graduation from an approved program, has sat for and
not obtained a passing score on the examination. A physician
assistant who has not been certified 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.
A physician assistant who has been issued a temporary license
shall, within thirty days of receipt of written notice from the
national commission on certification of physician assistants of his or her performance on the certifying examination, notify the board
in writing of his or her results. In the event of failure of that
examination, the temporary license shall expire and terminate
automatically, and the board shall so notify the physician
assistant in writing.
(g) Any physician applying to the board to supervise a
physician assistant shall affirm that the range of medical services
set forth in the physician assistant's job description are
consistent with the skills and training of the supervising
physician and the physician assistant. Before a physician
assistant can be employed or otherwise use his or her skills, the
supervising physician and the physician assistant 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 that assistant an opportunity to be heard in
the manner provided by article five, 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 the facilities. Physician
assistants employed by 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 the 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 pursuant to the
provisions of article three, chapter twenty-nine-a of this code
governing the eligibility and extent to which a physician assistant
may prescribe at the direction of the supervising physician. The
rules shall include, but not be limited to, the following:
(1) Provisions for approving a state formulary classifying
pharmacologic categories of drugs that may be prescribed by a
physician assistant:
(A) The following categories of drugs shall be excluded from the formulary: Schedules I and II of the uniform controlled
substances act, anticoagulants, antineoplastic,
radiopharmaceuticals, general anesthetics and radiographic contrast
materials;
(B) Drugs listed under Schedule III shall be limited to a
seventy-two hour supply without refill;
(C) Categories of other drugs may be excluded as determined by
the board;
(2) 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;
(3) The maximum dosage a physician assistant may prescribe;
(4) A requirement that to be eligible for 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; and
(5) A requirement that to maintain prescription privileges, a
physician assistant shall continue to maintain national
certification as a physician assistant, and in meeting the 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 may not supervise at any one time
more than three full-time physician assistants or their equivalent,
except that a physician may supervise up to four hospital-employed
physician assistants. No physician shall supervise more than four
physician assistants at any one time.
A physician assistant may 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 may not
perform any service that his or her supervising physician is not
qualified to perform. A physician assistant may 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 is to be accompanied by a
fee of one hundred dollars. A fee of fifty dollars is to be
charged for the biennial renewal of the license. A fee of
twenty-five dollars is to 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 the year 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, in the number
of hours specified by the board by rule, 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, in the number of hours specified by the board
by rule
, designated as Category II by the association or either
academy. Notwithstanding any provision of this chapter to the
contrary, failure to timely submit the required written
documentation shall result in the automatic suspension of any
license as a physician assistant until the written documentation is
submitted to and approved by the board.
(p) 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.
(q) 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.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.