Bill Text: IN HB1099 | 2013 | Regular Session | Enrolled
Bill Title: Physician assistants.
Spectrum: Slight Partisan Bill (Republican 3-1)
Status: (Passed) 2013-05-13 - Public Law 102 [HB1099 Detail]
Download: Indiana-2013-HB1099-Enrolled.html
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AN ACT to amend the Indiana Code concerning professions and occupations.
(1) The supervising physician or the physician designee is physically present at the location at which services are rendered or tasks are performed by the physician assistant.
(2) Both of the following apply:
(A) The supervising physician or the physician designee is immediately available:
(i) through the use of telecommunications or other electronic means; and
(ii) for consultation, including being able to see the patient in person within twenty-four (24) hours if requested by the patient or the physician assistant.
(B) If the supervising physician or the physician designee is
state, of the county containing the onsite location in which
services are rendered or tasks are performed by the
physician assistant.
The medical licensing board may permit an exception to the
requirements of this clause after receiving an exceptional
circumstance waiver request with the filed supervising
agreement for each individual physician assistant and practice
location. An exception must be approved by the board before
the commencement of the physician assistant's practice in the
county that requires the exceptional circumstance waiver
request. not present in the same facility as the physician
assistant, the supervising physician or physician designee
must be within a reasonable travel distance from the
facility to personally ensure proper care of the patients.
(b) The term includes the use of protocols, guidelines, and standing
orders developed or approved by the supervising physician.
(b) A physician assistant may not prescribe, dispense, or administer ophthalmic devices, including glasses, contact lenses, and low vision devices.
(c) A physician assistant may use or dispense only drugs prescribed or approved by the supervising physician. A physician assistant may not prescribe or dispense
(d) A physician assistant may request, receive, and sign for professional samples and may distribute professional samples to patients if the samples are within the scope of the physician assistant's prescribing privileges delegated by the supervising physician.
(e) A physician assistant may not prescribe drugs unless the physician assistant has successfully completed at least thirty (30) contact hours in pharmacology from an educational program that is approved by the committee.
(f) A physician assistant may not prescribe, administer, or monitor
general anesthesia, regional anesthesia, or deep sedation as defined by
the board. A physician assistant may not administer moderate sedation:
(1) if the moderate sedation contains agents in which the
manufacturer's general warning advises that the drug should be
administered and monitored by an individual who is:
(A) experienced in the use of general anesthesia; and
(B) not involved in the conduct of the surgical or diagnostic
procedure; and
(2) during diagnostic tests, surgical procedures, or obstetric
procedures unless the following conditions are met:
(A) A physician is physically present in the area, is
immediately available to assist in the management of the
patient, and is qualified to rescue patients from deep sedation.
(B) The physician assistant is qualified to rescue patients from
deep sedation and is competent to manage a compromised
airway and provide adequate oxygenation and ventilation by
reason of meeting the following conditions:
(i) The physician assistant is certified in advanced
cardiopulmonary life support.
(ii) The physician assistant has knowledge of and training in
the medications used in moderate sedation, including
recommended doses, contraindications, and adverse
reactions.
(g) Before a physician assistant may prescribe drugs, a controlled
substance, the physician assistant must have practiced as a physician
assistant:
(1) for at least one (1) year after graduating from a physician
assistant program approved by the committee; and
(2) for at least one thousand eight hundred (1,800) hours.
(1) legend drugs except as provided in section 4(c) of this chapter; and
(2) medical devices (except ophthalmic devices, including glasses, contact lenses, and low vision devices).
(b) Any prescribing authority delegated to a physician assistant must be expressly delegated in writing by the physician assistant's supervising physician, including:
(1) the name of the drug or drug classification being delegated by
the supervising physician; and
(2) the protocols the physician assistant shall use when
prescribing the drug.
(c) A physician assistant who is delegated the authority to prescribe
legend drugs or medical devices must do the following:
(1) Enter the following on each prescription form that the
physician assistant uses to prescribe a legend drug or medical
device:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to the
physician assistant by the NCCPA.
(C) The physician assistant's state license number.
(2) Comply with all applicable state and federal laws concerning
prescriptions for legend drugs and medical devices.
(d) A supervising physician may delegate to a physician assistant
the authority to prescribe only legend drugs and medical devices that
are within the scope of practice of the licensed supervising physician
or the physician designee.
(e) A physician assistant who is delegated the authority to prescribe
controlled substances under subsection (a) and in accordance with the
limitations specified in section 4(c) of this chapter must do the
following:
(1) Obtain an Indiana controlled substance registration and a
federal Drug Enforcement Administration registration.
(2) Enter the following on each prescription form that the
physician assistant uses to prescribe a controlled substance:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to the
physician assistant by the NCCPA.
(C) The physician assistant's state license number.
(D) The physician assistant's federal Drug Enforcement
Administration (DEA) number.
(3) Comply with all applicable state and federal laws concerning
prescriptions for controlled substances.
(f) A supervising physician may only delegate to a physician
assistant the authority to prescribe controlled substances:
(1) that may be prescribed within the scope of practice of the
licensed supervising physician or the physician designee;
(2) in an aggregate amount that does not exceed a one (1) thirty
(30) day supply; however, any refills or subsequent
prescriptions beyond the thirty (30) day supply must be
authorized by the supervising physician and recorded in the
patient's medical record; and
(3) in accordance with the limitations set forth in section 4(c) of
this chapter.
If an additional prescription for the controlled substance is necessary
after the one (1) time thirty (30) day supply described in subdivision
(2) has been prescribed, the additional prescription may be prescribed
only by a physician.
(b) A supervising physician or physician designee shall review all patient encounters not later than seventy-two (72) hours after the physician assistant has seen the patient.
(c) Subject to subsection (d), the supervising physician or physician designee shall review within seventy-two (72) hours after a patient encounter at least the following percentages of the patient charts:
(1) For the first year of employment of the physician assistant, one hundred percent (100%).
(2) For the second year of employment of the physician assistant, fifty percent (50%).
(3) For the third year of employment of the physician assistant and thereafter, twenty-five percent (25%).
(4) For the first year in which a physician assistant obtains authority to prescribe a controlled substance under IC 25-27.5-5-4, one hundred percent (100%) of the patient records for which a controlled substance is being dispensed or prescribed.
(d) If a physician assistant changes supervising physicians but remains in the same practice specialty, the schedule of chart review in subsection (c) does not start over. However, if the physician assistant is employed in a different practice specialty, the full schedule of chart review in subsection (c) must be followed.
(1) Be licensed under IC 25-22.5.
(2) Register with the board the physician's intent to supervise a physician assistant.
(3) Submit a statement to the board that the physician will exercise supervision over the physician assistant in accordance with rules adopted by the board and retain professional and legal responsibility for the care rendered by the physician assistant.
(4) Not have a disciplinary action restriction that limits the physician's ability to supervise a physician assistant.
(5) Maintain a written agreement with the physician assistant that states the physician will:
(A) exercise supervision over the physician assistant in accordance with any rules adopted by the board; and
(B) retain responsibility for the care rendered by the physician assistant.
The agreement must be signed by the physician and physician assistant, updated annually, and made available to the board upon request.
(6) Submit to the board a list of locations that the supervising physician and the physician assistant may practice. The board may request additional information concerning the practice locations to assist the board with considering the written agreement described in subdivision (5).
(b) Except as provided in this section, this chapter may not be construed to limit the employment arrangement with a supervising physician under this chapter.
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