Bill Text: NJ S4114 | 2026-2027 | Regular Session | Introduced
Bill Title: Authorizes physician assistants in behavioral health care to provide procedures and services without supervision.
Sponsorship: Partisan Bill (Democrat 1)
Status: (Introduced) 2026-05-11 - Introduced in the Senate, Referred to Senate Commerce Committee [S4114 Detail]
Download: New_Jersey-2026-S4114-Introduced.html
Sponsored by:
Senator JOSEPH A. LAGANA
District 38 (Bergen)
SYNOPSIS
Authorizes physician assistants in behavioral health care to provide procedures and services without supervision.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning supervision of certain physician assistants and supplementing P.L.1991, c.378 and amending various parts of the statutory law.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 2 of P.L.1991, c.378 (C.45:9-27.11) is amended to read as follows:
2. As used in this act:
"Accredited program" means an education program for physician assistants which is accredited by the Accreditation Review Commission on Education for the Physician Assistant or its predecessor or successor agency.
"Behavioral health care" means procedures or services rendered by a physician assistant to a patient for the treatment of a mental illness, emotional disorder, or drug or alcohol use disorder.
"Board" means the State Board of Medical Examiners created pursuant to R.S.45:9-1.
"Committee" means the Physician Assistant Advisory Committee established pursuant to section 11 of P.L.1991, c.378 (C.45:9-27.20).
"Director" means the Director of the Division of Consumer Affairs.
"Health care facility" means a health care facility as defined in section 2 of P.L.1971, c.136 (C.26:2H-2).
"Institution" means any of the charitable, hospital, relief and training institutions, noninstitutional agencies, and correctional institutions enumerated in R.S.30:1-7.
"Physician assistant" means a health professional who meets the qualifications under P.L.1991, c.378 (C.45:9-27.10 et seq.) and holds a current, valid license issued pursuant to section 4 of P.L.1991, c.378 (C.45:9-27.13).
"Physician" means a person licensed to practice medicine and surgery pursuant to chapter 9 of Title 45 of the Revised Statutes.
"Veterans' home" means the New Jersey Veterans' Memorial Home - Menlo Park, the New Jersey Veterans' Memorial Home - Vineland, and the New Jersey Veterans' Memorial Home - Paramus.
(cf: P.L.2015, c.224, s.1)
2. Section 11 of P.L.2015, c.224 (C.45:9-27.13a) is amended to read as follows:
11. a. A physician assistant who engages in clinical practice, including providing behavioral health care pursuant to section 9 of P.L. , c. (C. ) (pending before the Legislature as this bill), in this State is required to be covered by medical malpractice liability insurance, or if such liability coverage is not available, by a letter of credit. The board shall establish by regulation the minimum amount for medical malpractice liability insurance coverage or lines of credit.
b. The physician assistant shall include, on the physician assistant's license renewal form, the name and address of the insurance carrier or the institution issuing the letter of credit to the physician assistant.
c. A physician assistant who is in violation of this section is subject to disciplinary action and civil penalties pursuant to sections 8, 9, and 12 of P.L.1978, c.73 (C.45:1-21 to 22 and 45:1-25).
d. The board shall notify all licensed physician assistants of the requirements of this section within 30 days of the date of enactment of [P.L.2015, c.224 (C.45:9-27.13a et al.)] P.L. , c. (C. ) (pending before the Legislature as this bill).
(cf: P.L.2015, c.224, s.11)
3. Section 6 of P.L.1991, c.378 (C.45:9-27.15) is amended to read as follows:
6. a. A physician assistant may practice in all medical care settings, including, but not limited to, a physician's office, a health care facility, an institution, a veterans' home, or a private home, provided that:
(1) the physician assistant performs medical services within the physician assistant's education, training, and experience under the supervision of a physician pursuant to section 9 of P.L.1991, c.378 (C.45:9-27.18). A physician assistant providing behavioral health care pursuant to section 9 of P.L. , c. (C. ) (pending before the Legislature as this bill) shall be exempt from the requirement for supervision by a physician;
(2) the practice of the physician assistant is limited to those procedures enumerated under section 7 of P.L.1991, c.378 (C.45:9-27.16), and any other procedures that are delegated to the physician assistant by the supervising physician, as authorized under subsection d. of section 7 of P.L.1991, c.378 (C.45:9-27.16), and to those authorized in accordance with section 9 of P.L. , c. (C. ) (pending before the Legislature as this bill);
(3) (Deleted by amendment, P.L.2015, c.224)
(4) the supervising physician or physician assistant advises the patient at the time that services are rendered that they are to be performed by the physician assistant;
(5) the physician assistant conspicuously wears an identification tag using the term "physician assistant" or the designation, "PA-C" or "PA" whenever acting in that capacity; and
(6) any entry by a physician assistant in a clinical record is appropriately signed and followed by the designation, "PA-C" or "PA."
b. Any physician assistant who practices in violation of any of the conditions specified in subsection a. of this section shall be deemed to have engaged in professional misconduct in violation of subsection e. of section 8 of P.L.1978, c.73 (C.45:1-21).
(cf: P.L.2015, c.224, s.3)
4. Section 7 of P.L.1991, c.378 (C.45:9-27.16) is amended to read as follows:
7. a. A physician assistant may perform the following procedures:
(1) Approaching a patient to elicit a detailed and accurate history, perform an appropriate physical examination, identify problems, record information, and interpret and present information to the supervising physician;
(2) Suturing and caring for wounds including removing sutures and clips and changing dressings, except for facial wounds, traumatic wounds requiring suturing in layers, and infected wounds;
(3) Providing patient counseling services and patient education consistent with directions of the supervising physician;
(4) Assisting a physician in an inpatient setting by conducting patient rounds, recording patient progress notes, determining and implementing therapeutic plans jointly with the supervising physician, and compiling and recording pertinent narrative case summaries;
(5) Assisting a physician in the delivery of services to patients requiring continuing care in a private home, nursing home, extended care facility, or other setting, including the review and monitoring of treatment and therapy plans; and
(6) Referring patients to, and promoting their awareness of, health care facilities and other appropriate agencies and resources in the community.
(7) (Deleted by amendment, P.L.2015, c.224)
b. A physician assistant may perform the following procedures only when directed, ordered, or prescribed by the supervising physician, or when performance of the procedure is delegated to the physician assistant by the supervising physician as authorized under subsection d. of this section:
(1) Performing non-invasive laboratory procedures and related studies or assisting duly licensed personnel in the performance of invasive laboratory procedures and related studies;
(2) Giving injections, administering medications, and requesting diagnostic studies;
(3) Suturing and caring for facial wounds, traumatic wounds requiring suturing in layers, and infected wounds;
(4) Writing prescriptions or ordering medications in an inpatient or outpatient setting in accordance with section 10 of P.L.1991, c.378 (C.45:9-27.19);
(5) Prescribing the use of patient restraints; and
(6) Authorizing qualifying patients for the medical use of cannabis and issuing written instructions for medical cannabis to registered qualifying patients pursuant to P.L.2009, c.307 (C.24:6I-1 et al.).
c. A physician assistant may assist a supervising surgeon in the operating room when a qualified assistant physician is not required by the board and a second assistant is deemed necessary by the supervising surgeon.
d. A physician assistant may perform medical services beyond those explicitly authorized in this section, when such services are delegated by a supervising physician with whom the physician assistant has signed a delegation agreement pursuant to section 8 of P.L.1991, c.378 (C.45:9-27.17). The procedures delegated to a physician assistant shall be limited to those customary to the supervising physician's specialty and within the supervising physician's and the physician assistant's competence and training.
e. Notwithstanding subsection d. of this section, a physician assistant shall not be authorized to measure the powers or range of human vision, determine the accommodation and refractive states of the human eye, or fit, prescribe, or adapt lenses, prisms, or frames for the aid thereof. Nothing in this subsection shall be construed to prohibit a physician assistant from performing a routine visual screening.
f. A physician assistant shall be able to provide behavioral health care without the supervision of a physician if the physician assistant qualifies to provide the behavioral health care pursuant to section 9 of P.L. , c. (C. ) (pending before the Legislature as this bill).
(cf: P.L.2019, c.153, s.45)
5. Section 9 of P.L.1991, c.378 (C.45:9-27.18) is amended to read as follows:
9. a. A physician assistant shall be under the supervision of a physician at all times during which the physician assistant is working in an official capacity, unless a physician assistant practices behavioral health care pursuant to section 9 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. Supervision of a physician assistant shall be continuous but shall not be construed as necessarily requiring the physical presence of the supervising physician, provided that the supervising physician and physician assistant maintain contact through electronic, or other means of, communication.
(1) (Deleted by amendment, P.L.2015, c.224)
(2) (Deleted by amendment, P.L.2015, c.224)
(3) (Deleted by amendment, P.L.2015, c.224)
c. (Deleted by amendment, P.L.2015, c.224)
(1) (Deleted by amendment, P.L.2015, c.224)
(2) (Deleted by amendment, P.L.2015, c.224)
(3) (Deleted by amendment, P.L.2015, c.224)
d. (Deleted by amendment, P.L.2015, c.224)
(1) (Deleted by amendment, P.L.2015, c.224)
(2) (Deleted by amendment, P.L.2015, c.224)
(3) (Deleted by amendment, P.L.2015, c.224)
e. It is the obligation of each supervising physician and physician assistant to ensure that: (1) the physician assistant's scope of practice is identified; (2) delegation of medical tasks is appropriate to the physician assistant's level of competence; (3) the relationship of, and access to, the supervising physician is defined; and (4) a process for evaluation of the physician assistant's performance is established.
(cf: P.L.2015, c.224, s.6)
6. Section 10 of P.L.1991, c.378 (C.45:9-27.19) is amended to read as follows:
10. A physician assistant may order, prescribe, dispense, and administer medications and medical devices and issue written instructions to registered qualifying patients for medical cannabis to the extent delegated by a supervising physician, unless a physician assistant provides behavioral health care in accordance with section 9 of P.L. , c. (C. ) (pending before the Legislature as this bill).
a. Controlled dangerous substances may only be ordered or prescribed if:
(1) a supervising physician has authorized a physician assistant to order or prescribe Schedule II, III, IV, or V controlled dangerous substances in order to:
(a) continue or reissue an order or prescription for a controlled dangerous substance issued by the supervising physician;
(b) otherwise adjust the dosage of an order or prescription for a controlled dangerous substance originally ordered or prescribed by the supervising physician, provided there is prior consultation with the supervising physician;
(c) initiate an order or prescription for a controlled dangerous substance for a patient, provided there is prior consultation with the supervising physician if the order or prescription is not pursuant to subparagraph (d) of this paragraph; or
(d) initiate an order or prescription for a controlled dangerous substance as part of a treatment plan for a patient with a terminal illness, which for the purposes of this subparagraph means a medical condition that results in a patient's life expectancy being 12 months or less as determined by the supervising physician;
(2) the physician assistant has registered with, and obtained authorization to order or prescribe controlled dangerous substances from, the federal Drug Enforcement Administration and any other appropriate State and federal agencies; and
(3) the physician assistant complies with all requirements which the board shall establish by regulation for the ordering, prescription, or administration of controlled dangerous substances, all applicable educational program requirements, and continuing professional education programs approved pursuant to section 16 of P.L.1991, c.378 (C.45:9-27.25).
b. (Deleted by amendment, P.L.2015, c.224)
c. (Deleted by amendment, P.L.2015, c.224)
d. In the case of an order or prescription for a controlled dangerous substance or written instructions for medical cannabis, the physician assistant shall print on the order or prescription or the written instructions the physician assistant's Drug Enforcement Administration registration number.
e. The dispensing of medication or a medical device by a physician assistant shall comply with relevant federal and State regulations, and shall occur only if: (1) pharmacy services are not reasonably available; (2) it is in the best interest of the patient; or (3) the physician assistant is rendering emergency medical assistance.
f. A physician assistant may request, receive, and sign for prescription drug samples and may distribute those samples to patients.
g. A physician assistant may issue written instructions to a registered qualifying patient for medical cannabis pursuant to section 10 of P.L.2009, c.307 (C.24:6I-10) only if:
(1) a supervising physician has authorized the physician assistant to issue written instructions to registered qualifying patients;
(2) the physician assistant verifies the patient's status as a registered qualifying patient; and
(3) the physician assistant complies with the requirements for issuing written instructions for medical cannabis established pursuant to P.L.2009, c.307 (C.24:6I-1 et al.).
(cf: P.L.2019, c.153, s.46)
7. Section 12 of P.L.2017, c.341 (C.45:9-27.19b) is amended to read as follows:
12. a. Notwithstanding any other provision of law to the contrary, a physician assistant who is otherwise authorized to order, prescribe, and dispense controlled dangerous substances pursuant to P.L.1991, c.378 (C.45:9-27.10 et seq.) may dispense narcotic drugs for maintenance treatment or detoxification treatment if the physician assistant has met the training and registration requirements set forth in subsection (g) of 21 U.S.C. s.823. A physician assistant who is authorized to dispense such drugs may do so regardless of whether the physician assistant's supervising physician has met the training and registration requirements set forth in subsection (g) of 21 U.S.C. s.823, provided that the written delegation agreement between the supervising physician and the physician assistant executed pursuant to subsection d. of section 8 of P.L.1991, c.378 (C.45:9-27.17) included the supervising physician's written approval for the physician assistant to dispense the drugs or the physician assistant practices behavioral health care in accordance with section 9 of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. Notwithstanding any other provision of law to the contrary, a physician assistant under the direct supervision of a licensed physician or practicing behavioral health care pursuant to section 9 of P.L. , c. (C. ) (pending before the Legislature as this bill) may make the determination as to the medical necessity for services for the treatment of substance use disorder, as provided in P.L.2017, c.28 (C.17:48-6nn et al.), and may prescribe such services.
(cf: P.L.2017, c.341, s.12)
8. Section 17 of P.L.1991, c.378 (C.45:9-27.26) is amended to read as follows:
17. In consultation with the committee, the board shall, in addition to such other powers and duties as it may possess by law:
a. Administer and enforce the provisions of P.L.1991, c.378 (C.45:9-27.10 et seq.) and P.L. , c. (C. ) (pending before the Legislature as this bill);
b. Adopt and promulgate rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to effectuate the purposes of P.L.1991, c.378 (C.45:9-27.10 et seq.) and P.L. , c. (C. ) (pending before the Legislature as this bill;
c. Establish professional standards for persons licensed under P.L.1991, c.378 (C.45:9-27.10 et seq.) and providing behavioral health care pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill);
d. Conduct hearings pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), except that the board shall have the right to administer oaths to witnesses, and shall have the power to issue subpoenas for the compulsory attendance of witnesses and the production of pertinent books, papers, or records;
e. Conduct proceedings before any board, agency, or court of competent jurisdiction for the enforcement of the provisions of P.L.1991, c.378 (C.45:9-27.10 et seq.);
f. Evaluate and pass upon the qualifications of candidates for licensure;
g. (Deleted by amendment, P.L.2015, c.224)
h. (Deleted by amendment, P.L.2015, c.224)
i. Subject to the requirements of section 16 of P.L.1991, c.378 (C.45:9-27.25) and section 9 of P.L. , c. (C. ) (pending before the Legislature as this bill), establish standards for and approve continuing education programs; and
j. Have the enforcement powers provided pursuant to P.L.1978, c.73 (C.45:1-14 et seq.).
(cf: P.L.2015, c.224, s.10)
9. (New section) a. A physician assistant shall be authorized to provide behavioral health care without a supervising physician if the physician assistant:
(1) has completed more than 5,000 hours of licensed, active work as a licensed physician assistant in behavioral health care; and
(2) each licensure renewal period, demonstrates completion of at least 10 contact hours of continuing education in pharmacology.
b. A physician assistant who practices independently shall be held to the same standard of care as other independent health care practitioners.
c. A physician assistant shall immediately notify the Physician Assistant Advisory Committee if the physician assistant:
(1) is incapable, for medical or any other good cause, of discharging the functions of a physician assistant in a manner consistent with the public's health, safety and welfare;
(2) is indicted or convicted of a crime involving moral turpitude or a crime adversely relating to the physician assistant's practice;
(3) is named as a defendant or respondent in a civil, criminal or administrative investigation, complaint or judgment involving alleged malpractice, negligence or misconduct relating to the physician assistant's practice;
(4) is the subject of any voluntary license or certification surrender or any disciplinary action or order by any state or Federal agency, board or commission, including any order of limitation or preclusion; or
(5) fails to maintain or renew any certification which is required by law as a condition of practice or as a condition of license renewal.
d. Any provision of State law or regulation that requires the signature, stamp, verification, affidavit, or endorsement of a physician shall be deemed to require the signature, stamp, verification, affidavit, or endorsement of a physician or a physician assistant providing behavioral health care, to the extent consistent with the scope of practice of the physician assistant providing behavioral health care.
e. If the physician assistant does not provide services to beneficiaries of the Medicare program established pursuant to section 1801 of the Social Security Act (42 U.S.C. s.1395 et seq.), the physician assistant shall, if applicable, prominently display in the office of the physician assistant an appropriate notice, and inform, in writing, the Physician Assistant Advisory Committee.
10. This act shall take effect on the first day of the thirteenth month next following the date of enactment except that the State Board of Medical Examiners may take any anticipatory action as necessary to implement the provisions of the act.
STATEMENT
This bill authorizes physician assistants to provide behavioral health care without supervision. "Behavioral health care" is defined in the bill to mean procedures or services rendered by a physician assistant to a patient for the treatment of a mental illness, emotional disorder, or drug or alcohol use disorder.
Under the bill, a physician assistant may provide behavioral health care without supervision if the physician assistant has completed more than 5,000 hours of licensed, active work as a licensed physician assistant in behavioral health care and, for each licensure renewal period, demonstrate completion of at least 10 contact hours of continuing education in pharmacology.
The bill further stipulates that a physician assistant who practices independently is 1) to be held to the same standard of care as other independent health care practitioners and 2) is to report on a variety of matters to the Physician Assistant Advisory Committee if certain circumstances arise, including if the physician assistant is incapable, for medical or any other good cause, of discharging the functions of a physician assistant in a manner consistent with the public's health, safety and welfare. Additionally, the bill allows that any provision of State law or regulation that requires the signature, stamp, verification, affidavit, or endorsement of a physician is to be deemed to require the signature, stamp, verification, affidavit, or endorsement of a physician or a physician assistant providing behavioral health care, to the extent consistent with the scope of practice of the physician assistant providing behavioral health care.
The bill incorporates physician assistants providing behavioral health care independently into the statute governing physician assistants, including as part of the requirement for malpractice insurance or a letter of credit.
Lastly, a physician assistant independently providing behavioral health care is to, if applicable, prominently display in the office of the physician assistant an appropriate notice if the physician assistant does not provide services to Medicare beneficiaries. The physician assistant is to also inform, in writing, the Physician Assistant Advisory Committee.
