This document includes Senate 2nd Reading Floor Amendments incorporated into the bill on Fri, Feb 24, 2017 at 3:22 PM by lpoole.



Chief Sponsor: Brian E. Shiozawa

House Sponsor: Michael S. Kennedy


8     General Description:
9          This bill amends the Physician Assistant Act.
10     Highlighted Provisions:
11          This bill:
12          ▸     amends the requirements of a delegation of services agreement;
13          ▸     removes the requirement that a physician assistant obtain a co-signature Ŝ→ on a chart
13a               medical record of a prescription ←Ŝ from the
14     supervising physician to prescribe certain controlled substances;
15          ▸     amends requirements for licensure; and
16          ▸     makes technical changes.
17     Money Appropriated in this Bill:
18          None
19     Other Special Clauses:
20          None
21     Utah Code Sections Affected:
22     AMENDS:
23          58-70a-102, as enacted by Laws of Utah 1997, Chapter 229
24          58-70a-301, as enacted by Laws of Utah 1997, Chapter 229
25          58-70a-302, as last amended by Laws of Utah 2010, Chapter 37
26          58-70a-501, as last amended by Laws of Utah 1998, Chapter 38
27          58-70a-503, as last amended by Laws of Utah 2014, Chapter 72


29     Be it enacted by the Legislature of the state of Utah:
30          Section 1. Section 58-70a-102 is amended to read:
31          58-70a-102. Definitions.
32          In addition to the definitions in Section 58-1-102, as used in this chapter:
33          (1) "Board" means the Physician Assistant Licensing Board created in Section
34     58-70a-201.
35          (2) (a) "Delegation of services agreement" means written criteria jointly developed by a
36     physician assistant's supervising physician and [any] substitute supervising physicians and the
37     physician assistant, that permits a physician assistant, working under the direction or review of
38     the supervising physician, to assist in the management of common illnesses and injuries.
39          (b) The agreement defines the working relationship and delegation of duties between
40     the supervising physician and the physician assistant as specified by division rule and shall
41     include:
42          (i) the prescribing of controlled substances;
43          (ii) the degree and means of supervision;
44          (iii) the frequency and mechanism of [chart review] quality review, including the
45     mechanism for review of patient data and documentation of the review, as determined by the
46     supervising physician and the physician assistant;
47          (iv) procedures addressing situations outside the scope of practice of the physician
48     assistant; and
49          (v) procedures for providing backup for the physician assistant in emergency situations.
50          (3) "Direct supervision" means the supervising physician is:
51          (a) physically present at the point of patient treatment on site where the physician
52     assistant he is supervising is practicing; and
53          (b) immediately available for consultation with the physician assistant.
54          (4) "Practice as a physician assistant" means:
55          (a) the professional activities and conduct of a physician assistant, also known as a PA,
56     in diagnosing, treating, advising, or prescribing for any human disease, ailment, injury,
57     infirmity, deformity, pain, or other condition, dependent upon and under the supervision of a
58     supervising physician or substitute supervising physician in accordance with a delegation of

59     services agreement; and
60          (b) the physician assistant acts as the agent of the supervising physician or substitute
61     supervising physician when acting in accordance with a delegation of services agreement.
62          (5) "Substitute supervising physician" means an individual who meets the requirements
63     of a supervising physician under this chapter and acts as the supervising physician in the
64     absence of the supervising physician.
65          (6) "Supervising physician" means an individual who:
66          (a) is currently licensed to practice under Title 58, Chapter 67, Utah Medical Practice
67     Act, or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act;
68          (b) acts as the primary supervisor of a physician assistant and takes responsibility for
69     the professional practice and conduct of a physician assistant in accordance with this chapter;
70     and
71          (c) is not an employee of the physician assistant [he] whom the individual supervises.
72          (7) "Supervision" means the supervising physician is available for consultation with
73     the physician assistant, either personally or by other means permitting direct verbal
74     communication between the physician and the physician assistant.
75          (8) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-70a-502.
76          (9) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-70a-503 and as
77     may be further defined by rule.
78          Section 2. Section 58-70a-301 is amended to read:
79          58-70a-301. Licensure required -- License classifications.
80          (1) A license is required to engage in practice as a physician assistant, except as
81     specifically provided in Section 58-70a-305 or 58-1-307.
82          (2) The division shall issue to [a person] an individual who qualifies under this chapter
83     a license in the classification of physician assistant.
84          Section 3. Section 58-70a-302 is amended to read:
85          58-70a-302. Qualifications for licensure.
86          Each applicant for licensure as a physician assistant shall:
87          (1) submit an application in a form prescribed by the division;
88          (2) pay a fee determined by the department under Section 63J-1-504;
89          (3) be of good moral character;

90          (4) have successfully completed a physician assistant program accredited by the:
91          (a) Accreditation Review Commission on Education for the Physician Assistant; or
92          (b) if prior to January 1, 2001, either the:
93          (i) Committee on Accreditation of Allied Health Education Programs; or
94          (ii) Committee on Allied Health Education and Accreditation;
95          (5) have passed the licensing examinations required by division rule made in
96     collaboration with the board;
97          (6) meet with the board and representatives of the division, if requested, for the
98     purpose of evaluating the applicant's qualifications for licensure; and
99          (7) (a) if the applicant desires to practice in Utah, complete a form provided by the
100     division indicating:
101          (i) the applicant has completed a delegation of services agreement signed by the
102     physician assistant[,] and the supervising physician[, and substitute supervising physicians];
103     and
104          (ii) the agreement is on file at the Utah practice sites; or
105          (b) complete a form provided by the division indicating the applicant is not practicing
106     in Utah and, prior to practicing in Utah, the applicant will meet the requirements of Subsection
107     (7)(a).
108          Section 4. Section 58-70a-501 is amended to read:
109          58-70a-501. Scope of practice.
110          (1) A physician assistant may provide any medical services that are not specifically
111     prohibited under this chapter or rules adopted under this chapter, and that are:
112          (a) within the physician assistant's skills and scope of competence;
113          (b) within the usual scope of practice of the physician assistant's supervising physician;
114     and
115          (c) provided under the supervision of a supervising physician and in accordance with a
116     delegation of services agreement.
117          (2) A physician assistant, in accordance with a delegation of services agreement, may
118     prescribe or administer an appropriate controlled substance if:
119          (a) the physician assistant holds a Utah controlled substance license and a DEA
120     registration; and

121          (b) the prescription or administration of the controlled substance is within the
122     prescriptive practice of the supervising physician and also within the delegated prescribing
123     stated in the delegation of services agreement[; and].
124          [(c) the supervising physician cosigns any medical chart record of a prescription of a
125     Schedule 2 or Schedule 3 controlled substance made by the physician assistant.]
126          (3) A physician assistant shall, while practicing as a physician assistant, wear an
127     identification badge showing [his] the physician assistant's license classification as a
128     [practicing] physician assistant.
129          (4) A physician assistant may not:
130          (a) independently charge or bill a patient, or others on behalf of the patient, for services
131     rendered;
132          (b) identify himself or herself to any person in connection with activities allowed under
133     this chapter other than as a physician assistant; or
134          (c) use the title "doctor" or "physician," or by any knowing act or omission lead or
135     permit anyone to believe [he] the physician assistant is a physician.
136          Section 5. Section 58-70a-503 is amended to read:
137          58-70a-503. Unprofessional conduct.
138          "Unprofessional conduct" includes:
139          (1) violation of a patient confidence to any person who does not have a legal right and
140     a professional need to know the information concerning the patient;
141          (2) knowingly prescribing, selling, giving away, or directly or indirectly administering,
142     or offering to prescribe, sell, furnish, give away, or administer any prescription drug except for
143     a legitimate medical purpose upon a proper diagnosis indicating use of that drug in the amounts
144     prescribed or provided;
145          (3) prescribing prescription drugs for [himself] oneself or administering prescription
146     drugs to [himself] oneself, except those that have been legally prescribed for [him] the
147     physician assistant by a licensed practitioner and that are used in accordance with the
148     prescription order for the condition diagnosed;
149          (4) failure to maintain at the practice site a delegation of services agreement that
150     accurately reflects current practices;
151          (5) failure to make the delegation of services agreement available to the division for

152     review upon request;
153          (6) in a practice that has physician assistant ownership interests, failure to allow the
154     supervising physician the independent final decision making authority on patient treatment
155     decisions, as set forth in the delegation of services agreement or as defined by rule; and
156          (7) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
157     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable.

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