For more than a century, the states have been exercising their power to protect the public health and safety by regulating the practice of certain professions. About 800 occupations are regulated in the United States, including physicians and physician assistants.
Each state writes its own laws and one should expect to find variation from state to state in the structure and content of most laws. The AAPA produced a model PA practice act in 1982. Because occupational regulation changes with the times, AAPA updates its model licensing law as necessary. The most recent revision was in 2006. The goal of the model law is to standardize certain provisions contained in PA practice acts. For example, licensing laws include requirements for education and examination. For PAs, graduation from an accredited PA program and passage of the national PA certifying examination are the two recommended requirements.
Great progress has been made in standardizing the regulation of PAs. All states, the District of Columbia, and the majority of U.S. territories have enacted statutes and regulations that define PAs, describe their scope of practice, discuss supervision, designate the agency that will administer the law, set application and renewal criteria, and establish disciplinary measures for violations of the law.
PA statutes are amplified by rules issued by the administering agency or board. Rules define and interpret the language of the law. For example, the law may require PAs to pass a national certifying examination to qualify for licensure. The rules would specify which examination; i.e., the one administered by the National Commission on Certification of PAs.
When evaluating a jurisdiction's practice climate, PAs are advised to read both the law and the licensing board's rules and regulations for PAs. It is also useful to review application forms and accompanying directions, which can provide insight into the expectations and detail required by the regulatory agency.
Contact the agency listed at the end of each summary for copies of the current PA laws and regulations. A detailed summary of all states is available by purchasing the latest edition of "Physician Assistants: State Laws and Regulations," published by the AAPA. State law summaries are updated as changes to laws and regulations are made. Updated detailed summaries are available on the AAPA Web site.
Ann Davis, PA-C, Director
State Government Advocacy and Outreach
American Academy of Physician Assistants
ALABAMA
Qualifications: Graduation from accredited PA program and NCCPA examination.
Application: By PA for license. PA must be registered to licensed physician prior to practice. Job description must be approved by the board.
Scope of practice: Obtaining histories, performing physical exams, ordering and/or performing diagnostic and therapeutic procedures, formulating a working diagnosis, developing and implementing a treatment plan, monitoring the effectiveness of therapeutic interventions, assisting at surgery, offering counseling and education, making referrals. PA may not perform any medical service, procedure, function or activity which is not approved by the board.
Prescribing/dispensing: PAs may prescribe, administer, authorize for administration, or dispense controlled substances listed in Schedule III-V (regulations necessary to implement the law have not yet been adopted), and non-controlled drugs from board-approved formulary.
Supervision: Oversight and direction but not direct, on-site physician supervision.
Participation in regulation: Four PAs serve on an eight- member Physician Assistant Advisory Committee.
Alabama State Board of Medical Examiners, P.O. Box 946, Montgomery, AL 36101-0946; (334) 242-4116.
ALASKA
Qualifications: Graduation from accredited PA program and current NCCPA certificate.
Application: PA applies for license. Licensed PA applies on board forms for authorization to practice; must have file documentation of established collaborative relationship(s) with the board within 14 days of commencing practice.
Scope of practice: Medical diagnosis and treatment within the scope of practice of the collaborating physician.
Prescribing/dispensing: PA may prescribe and dispense non-controlled drugs and Schedules II-V controlled drugs. Prescriptions for controlled medications must include collaborating physician's name and Drug Enforcement Administration (DEA) number and PA's name and DEA number.
Supervision: Periodic assessment by physician and at least monthly telephone or radio review of patient care and records. PAs in remote locations with less than two years of experience must first work 160 hours in direct patient care under immediate, direct supervision of collaborating or alternate collaborating physician within 90 days of starting practice in remote location. First 40 hours must be completed before PA works in remote location. Periodic assessment for PAs with less than two years of experience must include at least one direct personal contact visit from supervising physician at least every four months for at least four hours.
Participation in regulation: One PA serves on medical board.
Alaska Division of Occupational Licensing, 550 West 7th Avenue, Suite 1500, Anchorage, AK 99501; (907) 269-8163.
ARIZONA
Qualifications: Graduation from accredited PA program and passage of NCCPA examination.
Application: PA applies for license. Interview, physical examination, mental evaluation, and oral competency examination may be required. PA and supervising physician must submit notification of supervision.
Scope of practice: Histories and physicals; diagnostic and therapeutic procedures; treatment plans; assisting in surgery; patient education and counseling; referrals; minor surgery (not including surgical abortion) and other non-surgical tasks as approved by the board.
Prescribing/dispensing: PA may prescribe non-controlled and controlled drugs. Schedules II and III limited to 72-hour supply or an NCCPA certified PA or a PA with 45 hours of pharmacology in the preceding 3 years may prescribe a Schedule II or III for up to 14 days; Schedules IV and V drugs may not be prescribed more than five times in a six-month period for an individual patient. No refills of Schedules II and III drugs. Except for samples, dispensed drugs must be prepackaged by physician or pharmacist.
Supervision: Physician need not be present on-site; weekly meeting required. Board may approve PA utilization in a location geographically separate from supervising physician; specific supervision provisions required.
Participation in regulation: Four PAs serve on ten-member PA regulatory board.
Arizona Regulatory Board of Physician Assistants, 9545 E. Doubletree Ranch Rd., Scottsdale, AZ 85258, (480) 551-2700.
ARKANSAS
Qualifications: Graduation from accredited PA program, passage of NCCPA examination and bachelor's degree (some exceptions apply).
Application: PA applies for license. Physician notifies board of intent to supervise. Personal interview of PA and physician required. Board must approve protocol describing PA scope of practice and supervision. Must pass jurisprudence exam on PA laws and regulations.
Scope of Practice: Duties and responsibilities assigned by supervising physician.
Prescribing/dispensing: PA may prescribe non-controlled and Schedules III-V controlled medications as delegated by supervising physician. PAs authorized to prescribe controlled medications must register with the DEA. All PA prescriptions and orders must identify the supervising physician.
Supervision: Constant physical presence of supervising physician not required as long as PA and supervising physician can be in contact via telecommunication.
Participation in Regulation: Two PAs serve on six-member advisory committee.
Arkansas State Medical Board, 2100 Riverfront Drive, Suite 200, Little Rock, Arkansas 72202-1793; (501) 296-1802.
CALIFORNIA
Qualifications: Graduation from accredited PA program and NCCPA examination.
Application: By PA for license.
Scope of practice: Medical services delegated in writing, within supervising physician's customary practice and within PA's competence. PA may take histories; perform physical examinations; perform or assist with laboratory, screening, and therapeutic procedures; counsel patients; and assist physician in institutional settings.
Prescribing/dispensing: PA may transmit orally or in writing on patient record or in a drug order, an order to a person who may lawfully furnish the medication. Authority limited by delegation from supervising physician. Physician must adopt a practice-specific formulary. "Drug order" means an order for medication which is dispensed to or for a patient issued and signed by a PA and is treated in the same manner as a prescription or order of the supervising physician. PA signing the drug order is deemed a prescriber. Schedules II-V medications administered, provided or for which a drug order is issued require a patient-specific order from a supervising physician (unless PA has taken an approved course). Drug orders for controlled medications require PA's DEA registration number. Medical record of patient receiving prescription for Schedule II medication must be countersigned by supervising physician within 7 days. PA may hand to a patient a properly labeled drug prepackaged by pharmacist, physician, or manufacturer.
Supervision: Physician must be available in person or by electronic communication at all times PA is caring for patients. Written guidelines for supervision must include one or more of the following: same-day examination of patient by physician; countersignature of all medical records within 30 days; protocols for some or all tasks. Supervising physician must review, countersign and date at least 5% of medical records within 30 days for patients treated by PA when PAs working under protocols.
Participation in regulation: Four PAs serve on nine-member PA regulatory body.
California Physician Assistant Committee, Medical Board of California, 2005 Evergreen Street, Suite 1100, Sacramento, CA 95815-3831, (916)561-8780.
COLORADO
Qualifications: Graduation from accredited PA program (or equivalent) and NCCPA examination.
Application: By PA for licensure; supervising physician must register with the board.
Scope of practice: PA may perform acts that constitute the practice of medicine, as delegated by the supervising physician. (After July 1, 1990, state-licensed Child Health Associates are eligible for licensure as PAs, but practice is restricted to patients under the age of 21 years.)
Prescribing/dispensing: PA may prescribe controlled (Schedules II-V) and non-controlled substances. Each prescription must include the name of the supervising physician as well as the PA's name. All drugs dispensed by PAs must be unit doses prepackaged by pharmacist or physician. PA prescribing controlled substances must be registered with DEA.
Supervision: PA must practice with personal and responsible supervision of physician. In acute care hospital PA may practice without physical presence of physician if physician regularly practices in hospital or if hospital is located in a health professional shortage area; physician must review medical records every two working days. In other settings, physician must be available via telecommunication. New graduate PAs require on-site presence of physician for first 1,000 working hours; for first six months of employment and a minimum of 500 patient encounters charts must be co-signed within 7 days. Experienced PAs new to practice require chart review within 14 days for first three months of employment and minimum of 500 patient encounters. All other PAs required to meet with supervising physician at least twice during each 12 month period for performance assessment.
Participation in regulation: none
Colorado Board of Medical Examiners, 1560 Broadway, Suite 1350, Denver, CO 80202; (303) 894-7690.
CONNECTICUT
Qualifications: Graduation from accredited PA program, current NCCPA certification, a bachelor's degree and documentation of 60 hours of pharmacology education.
Application: By PA for license.
Scope of practice: Medical functions delegated by supervising physician that are within the normal scope of the physician's practice and in accordance with written protocols.
Prescribing/dispensing: PA may be delegated the authority to prescribe and administer drugs, including controlled substances, in all settings. Supervising physician must document physician's approval of order for Schedule II or III drugs within 1 calendar day. Each prescription must include the name, license number, and address of the supervising physician and physician assistant.
Supervision: Includes but is not limited to the continuous availability of direct communication between PA and physician either in person or by radio, telephone, or telecommunication; at least weekly personal review of PA's practice, and face-to-face meetings between supervising physician and PA in non-hospital settings; regular chart review with documentation of review to be kept at practice site; existence of predetermined plan for emergency situations; and designation of an alternate physician in absence of supervisor.
Participation in regulation: One PA serves on medical examining board. One physician on medical board must supervise PAs.
Connecticut Division of Medical Quality Assurance, Dept. of Public Health - PA Licensing, 410 Capitol Ave., MS#12APP, P.O. Box 340308, Hartford, CT 06134-0308; (860) 509-7603.
DELAWARE
Qualifications: Graduation from accredited PA program and passage of national certifying exam.
Application: By PA for license.
Scope of practice: Medical acts delegated by supervising physician. PA may take histories, perform physicals, record progress notes in outpatient setting, relay, transcribe, or execute diagnostic and therapeutic orders (orders must be countersigned within 72 hours), and perform delegated medical acts of diagnosis and prescription of therapeutic drugs and treatments.
Prescribing/dispensing: PA may prescribe up to a six-month supply of non-controlled drugs and up to a three-month supply of controlled Schedules II-V drugs. PA must have both a state controlled substance number and a DEA number to prescribe controlled drugs.
Supervision: Physician need not be present as long as is readily accessible by electronic communication and can be present within 30 minutes if necessary. Patients seen by PA receiving controlled drugs should be seen by physician every three months, patients receiving other prescriptions should be seen by physician every six months.
Participation in regulation: Four PAs serve on PA Advisory Council.
Delaware Board of Medical Practice: Cannon Building, Ste 203, 861 Silver Lake Blvd., Dover, DE 19904-2467; (302) 744-4500.
DISTRICT OF COLUMBIA
Qualifications: Graduation from accredited PA program and NCCPA examination.
Application: PA applies for license; PA and supervising physician file delegation agreement with board prior to practice.
Scope of practice: Acts of medical diagnosis and treatment, prescription, preventive health care, and other functions authorized by the board.
Prescribing/dispensing: PA may prescribe Schedules II-V and non-controlled medications.
Supervision: Physician must be available in person or by communication device; need not be physically present on premises. Physician must countersign all outpatient medical orders and progress notes within 10 days. In hospitals, physician must countersign medical orders within 30 days.
Participation in regulation: One PA serves on three-member PA advisory committee.
District of Columbia Board of Medicine: 717 14th St. NW, Ste 600, Washington, DC 20005; (877) 672-2174.
FLORIDA
Qualifications: Graduation from accredited PA program and NCCPA examination; two letters of recommendation from physicians.
Application: By PA for license; includes information about supervising physician.
Scope of practice: PA may perform delegated tasks and procedures for which he or she is skilled that are within supervising physician's scope of practice. Some duties may only be performed if the physician is on the premises, such as insertion of chest tubes and monitoring cardiac stress tests. Final diagnoses may not be delegated.
Prescribing/dispensing: Negative formulary; PAs may prescribe or dispense drugs not listed on the formulary established by Council on PAs and adopted by medical and osteopathic boards. PAs may not prescribe controlled substances. Medical record of prescription or dispensing must be countersigned by supervising physician. Prior to prescribing, PA must complete a three-hour course in prescriptive practice, three months of clinical experience in the specialty area of the supervising physician, and 10 hours of CME in the specialty area of practice. The Board issues a prescriber number to the PA.
Supervision: Physical presence or easy availability (by telecommunications) of physician is required.
Participation in regulation: One PA serves on five-member PA Council.
Florida Board of Medicine, 4052 Bald Cypress Way, Bin #C03, Tallahassee, FL 32399; (850) 488-0595.
Florida Board of Osteopathic Medical Examiners, 4052 Bald Cypress Way, Bin #C06, Tallahassee, FL 32399; (850) 245-4161.
GEORGIA
Qualifications: Graduation from accredited PA program and NCCPA examination. Personal interview may be required.
Application: By PA for license; by physician for approval to utilize PA (includes job description and description of locations where PA will practice).
Scope of practice: Delegated medical tasks contained in job description and approved by board.
Prescribing/dispensing: PAs may issue a prescription drug order for Schedules III-V and non-controlled drugs as delegated by physician. Dispensing authorized in public or nonprofit health facilities. PAs who are authorized to prescribe controlled medications must register with the DEA.
Supervision: Supervising physician must be readily available. Board approval required for utilization of PA in satellite clinic where there is a shortage of health care professionals.
Participation in regulation: Four PAs serve on eight-member PA advisory committee. Committee appoints PA to serve as nonvoting medical board member.
Georgia Composite Medical Board, 2 Peachtree St. NW, 36th floor, Atlanta, GA 30303-3465; (404) 656-3913.
HAWAII
Qualifications: Graduation from accredited PA program and NCCPA examination; current NCCPA certificate required for biennial renewal.
Application: By PA for license. Must include signed statement from supervising physician(s) that will direct and supervise PA.
Scope of practice: Medical services including histories and physicals, ordering, interpreting or performing diagnostic and therapeutic procedures, formulating a diagnosis, implementing a treatment plan, patient counseling, making referrals and assisting at surgery.
Prescribing/dispensing: PAs may prescribe Schedules III-V controlled drugs and all legend drugs as delegated by supervising physician. Dispensing activities must comply with federal and state regulations. PA prescribers of controlled medications must register with DEA. Prescription must include both the PA's DEA number and the physician's DEA number. Medical record of controlled substance prescription must be initialed by the physician within seven working days. PAs employed or extended privileges by hospital or extended care facility may write orders for Schedules II-V medications as allowed by facility policy.
Supervision: Physical presence of physician or physician availability via telecommunication. Physician must review PA records within seven working days and must designate a supervising physician in his or her absence.
Participation in regulation: Five PAs serve on advisory committee.
Hawaii Board of Medical Examiners, Dept. of Commerce and Consumer Affairs, Division of Professional Licensing, P.O. Box 3469, Honolulu, HI 96801; (808) 586-3000.
IDAHO
Qualifications: Graduation from accredited PA program, baccalaureate degree, and NCCPA examination.
Application: By PA for license. Delegation of Services agreement with supervising physician required for practice. Personal interview of PA, supervising physician, or both may be required.
Scope of practice: PA may take histories, do physical examinations, initiate and interpret laboratory and diagnostic tests, and perform other duties that are included in the supervising physician's scope of practice and are delineated in the Delegation of Services Agreement.
Prescribing/dispensing: PA may apply for approval to prescribe Schedules II-V and non-controlled medications. Application to prescribe must include documentation of all pharmacology course content completed (at least 30 hours). PAs who are authorized to prescribe controlled medications must register with the DEA and Idaho Board of Pharmacy. Dispensing limited to times when pharmacist is not available. PAs in family planning, communicable disease or chronic disease clinics under government contract or grant may also dispense medications.
Supervision: Supervising physician must conduct on-site visit at least monthly. Must be available by phone or in person; hold regularly scheduled conferences; review sampling of charts. Supervising physician must designate an alternate supervising physician in his or her temporary absence.
Participation in regulation: Three PAs serve on PA advisory committee.
Idaho Board of Medicine, P.O. Box 83720, Boise, ID 83720; (208) 327-7000.
ILLINOIS
Qualifications: Completion of approved program or verification from NCCPA that applicant has substantially equivalent training and experience. NCCPA examination; current NCCPA certificate required for renewal. No one holding medical degree eligible.
Application: By PA for license. Physician must file notice of supervision.
Scope of practice: Delegated medical duties within the supervising physician's scope of practice, consistent with the PA's education and experience.
Prescribing/dispensing: Physician may delegate prescriptive authority for non-controlled and Schedules III-V medications to PA. Physician may delegate limited Schedule II prescribing authority to PA (effective 8/17/09; rules to implement law not yet adopted). Medication orders issued by PA must be periodically reviewed by supervising physician. Physician must file notice of delegation of prescriptive authority to PA with Department of Professional Regulation. Physician and PA must include prescribing authority within a written supervision agreement. PAs who prescribe controlled medications must register with state controlled substance authority and the DEA.
Supervision: PAs shall practice in accordance with a written supervision agreement that is kept on file at the practice site (effective 8/17/09; rules to implement law not yet adopted). Physician need not be physically present at all times provided consultation available by radio, telephone, or telecommunications. Supervising physician may designate alternate supervising physician in accordance with statute. Physicians within a practice group of the supervising physician may supervise the PA with respect to their patients without being deemed an alternate supervising physician.
Participation in regulation: Three PAs serve on seven-member PA advisory committee.
Illinois Division of Professional Regulation, 320 W. Washington St., Springfield, IL 62786; (217) 785-0800.
INDIANA
Qualifications: Graduation from accredited PA program and current NCCPA certificate.
Application: By PA for license by the committee. Supervising physician must file supervisory agreement to the board for approval.
Scope of practice: Medical tasks delegated by supervising physician.
Prescribing/Dispensing: PA may apply for approval to prescribe Schedules III-V and non-controlled medications. Application to prescribe must include documentation of all pharmacology course content completed (at least 30 contact hours), and proof that PA has practiced for at least 1 year. Supervisory agreement to include medications PA is authorized to prescribe, and protocol PA must follow when prescribing. PAs who prescribe controlled medications must register with the state and the DEA.
Supervision: Must be continuous but does not require the physical presence of the physician. Physician shall review all patient encounters within 24 hours. Supervision must meet either of the following requirements: 1) supervising physician is physically present at the location which PA practices; 2) supervising physician is immediately available for consultation and is in the same county or a county adjacent to the location in which PA practices; or 3) PA (or physician) is practicing at a hospital or other health care facility or is traveling to or from the facility.
Participation in regulation: Three PAs serve on a five-member PA committee.
Indiana Health Professions Bureau, Attn: PA Committee, Professional Licensing Board, 402 West Washington Street, Suite W072, Indianapolis, IN 46204; (317) 234-2060.
IOWA
Qualifications: Graduation from accredited PA program (or equivalent education and training) and NCCPA examination.
Application: By PA for license. PA must supply information on supervising physician to PA board prior to beginning practice.
Scope of practice: Medical services that are within the supervising physician's scope of practice and for which the PA is qualified by training to perform that are delegated by the supervising physician.
Prescribing/dispensing: PA may prescribe non-controlled and controlled substances (except Schedule II depressants). May dispense under certain conditions. PAs who prescribe controlled medications must register with the DEA.
Supervision: Physician need not be physically present, but must be readily available by telecommunication.
Participation in regulation: Five PAs serve on nine-member PA regulatory board.
Iowa Board of Physician Assistants, Bureau of Professional Licensure, Lucas State Office Building, 321 East 12th Street, Capitol Complex, Des Moines, IA 50319-0075; (515) 281-4401.
KANSAS
Qualifications: Graduation from an accredited PA program (or military experience that meets medical board requirements) and NCCPA examination.
Application: By PA for license, including designation of the responsible physician.
Scope of practice: Delegated acts constituting the practice of medicine and surgery that can be competently performed by the PA, based on his or her education, skill, and experience. Physician required to submit utilization plan.
Prescribing/dispensing: PAs may prescribe Schedules II-V and non-controlled medications as authorized in a written protocol with a supervising physician. PA prescribers of controlled medications must register with the DEA.
Supervision: Physician need not be physically present, but must be immediately available for consultation by telecommunication. Biweekly review of patient records and annual evaluation of PA performance and protocols required. PA may work in different practice location after completing at least 80 hours of on-site supervision with supervising physician, physician periodically sees patients at the same location, and a notice is posted.
Participation in regulation: Three PAs serve on a five- member advisory council.
Kansas State Board of Healing Arts, 235 SW Topeka Blvd., Topeka, KS 66603-3068; (785) 296-7413 or (888)886-7205.
KENTUCKY
Qualifications: Graduation from board-approved or accredited PA program and NCCPA examination; current NCCPA certificate required for biennial renewal.
Application: By PA for license; by physician for approval to supervise (includes job description).
Scope of practice: PA considered to practice medicine or osteopathy with physician supervision. PA may perform duties and responsibilities described in the initial application or supplemental application received by the board. PA may initiate evaluation and treatment in emergency situations without specific approval. PA may not practice in hospitals or other facilities without permission of facility's governing body.
Prescribing/Dispensing: PAs may prescribe non-controlled medications as delegated to do so by supervising physician.
Supervision: Physician need not be physically present provided there is reliable means of direct communication. All records of service must be cosigned by physician in a timely manner. Newly graduated PAs must practice with on-site physician supervision for 18 months before they may practice in location separate from supervising physician. Certain exceptions apply.
Participation in regulation: Five PAs serve on nine-member PA advisory committee.
Kentucky State Board of Medical Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222; (502) 429-7150.
LOUISIANA
Qualifications: Graduation from accredited PA program and current NCCPA certification.
Application: By PA for license; by physician for approval to supervise. Possible interview for initial license if discrepancies exist.
Scope of practice: Medical services within the PA's education, training and experience which are delegated by the supervising physician.
Prescribing/dispensing: PAs may prescribe Schedule III-V and non-controlled medications if delegated by supervising physician to do so and approved by the board. To be approved for prescribing PA must have had a minimum of one year of clinical rotations during training and have practiced for a minimum of one year (PAs with less than a full year of clinical rotations may substitute two years of practice.) In order to prescribe controlled medications PA must register with state controlled drug agency and DEA.
Supervision: Continuous but does not require the physical presence of supervisor at time and place services are rendered. All written entries by PAs shall be cosigned by physician within 24 hours for inpatients, acute care settings, and hospital EDs; 48 hours for nursing home patients; 72 hours in all other cases.
Participation in regulation: Three PAs serve on a five- member PA advisory committee.
Louisiana State Board of Medical Examiners, P.O. Box 30250, New Orleans, LA 70190-0250; (504) 568-6820.
MAINE
Qualifications: Graduation from accredited PA program and/or passage of NCCPA exam.
Application: By PA for license. Supervising physician must submit affidavit stating written plan of supervision is on file in practice setting.
Scope of practice: Delegated medical services within supervising physician's proficiency and scope of practice.
Prescribing/dispensing: PA may prescribe and dispense drugs and medical devices, including non-controlled and Schedules III-V controlled substances. PA and physician may request authorization to prescribe Schedule IIs under specific individual guidelines. Registration with DEA required. PAs supervised by osteopathic physicians can prescribe non-controlled and Schedules III-V controlled drugs.
Supervision: Physician must be available by radio, telephone or telecommunication device. PA and physician establish supervision plan.
Participation in regulation: Two PAs serve on four-member PA Advisory Committee to the Board of Licensure in Medicine.
Maine Board of Licensure in Medicine, 137 State House Station, 161Capitol Avenue., Augusta, ME 04333; (207) 287-3601.
Board of Osteopathic Examiners, 142 State House Station, 161 Capitol Avenue., Augusta, ME 04333, (207) 287-2480.
MARYLAND
Qualifications: Graduation from accredited PA program and NCCPA examination. Applicant who graduates from PA program after Oct. 1, 2003 must have bachelor's degree or equivalent.
Application: By PA for certification; PA and physician apply for approval of delegation agreement.
Scope of Practice: Delegated medical acts within the physician's customary practice, appropriate to the PA's education, training and experience, and consistent with delegation agreement submitted to board.
Prescribing/dispensing: Physician may delegate prescriptive authority including Schedules II-V and non-controlled medications to PA. Must be consistent with delegation agreement. PAs prescribing controlled medications must register with the DEA and state controlled substance agency. Prescribing PAs must have passed NCCPA exam within previous two years or have completed eight hours of Category I pharmacology CME within previous two years and have bachelor's degree or its equivalent or two years work experience as a PA.
Supervision: Physician oversight of patient services rendered by PA, including continuous availability to PA in person, through written instructions, or by electronic means.
Participation in regulation: PA serves on medical board. Three PAs serve on 7-member PA advisory committee.
Maryland Board of Physicians, 4201 Patterson Ave., Baltimore, MD 21215-0095; (410) 764-4777 or (800) 492-6836.
MASSACHUSETTS
Qualifications: Graduation from accredited PA program, baccalaureate degree, NCCPA exam.
Application: By PA to PA board for registration.
Scope of practice: Medical services delegated by the supervising physician.
Prescribing/dispensing: PA may prescribe non-controlled drugs and controlled substances (Schedules II-V). Prescriptions or orders for Schedule IIs must be reviewed by the physician within 96 hours.
Supervision: Physician need not be physically present when PA renders medical services; patient records must be reviewed in a timely manner.
Participation in regulation: Four PAs and one PA educator serve on the nine-member PA board.
Massachusetts Board of Registration of Physician Assistants, Division of Registration, 239 Causeway St., Suite 200, Boston, MA 02114; (617) 973-0806 or (800) 414-0168.
MICHIGAN
Qualifications: Graduation from accredited PA program and NCCPA examination.
Application: By PA for license.
Scope of practice: Medical care services delegated by the supervising physician, within the physician's usual scope of practice, and approved by the board.
Prescribing/dispensing: PA may prescribe non-controlled and Schedules III-V medications as delegated by supervising physician. PA may prescribe seven-day supply of Schedule II drugs as discharge medications. Supervising physician's and PA's names must be indicated on prescription. PA prescribers of controlled medications must register with the DEA.
Supervision: Physician must be continuously available for direct communication in person or by radio, telephone, or telecommunication and must regularly review PA performance and patient records, consult, and educate.
Participation in regulation: Five PAs serve on nine-member PA regulatory task force. Task force sends one PA to serve as member of medical board and one PA to serve on osteopathic board.
Michigan Task Force on Physician Assistants, Bureau of Health Professions, P.O. Box 30670, Lansing, MI 48909-7518; (517) 335-0918.
MINNESOTA
Qualifications: Current NCCPA certification.
Application: By PA for license; by PA and supervising physician for approval of their practice agreement. Effective 8/10/09, PA and supervising physician will not need approval of practice agreement, but PA to file a notice of intent to practice prior to beginning practice.
Scope of practice: Effective 8/10/09, physician and PA must maintain a delegation agreement outlining delegated patient services within supervising physician's customary practice consistent with PA's training or experience. Specifically allowed are taking histories, doing physical examinations, data interpretation and evaluation to determine treatment, ordering or performing diagnostic and therapeutic procedures, patient counseling, assisting in surgery, and assisting physician in health care institutions and patient homes.
Prescribing/dispensing: NCCPA-certified PAs may prescribe controlled (Schedules II-V) and non-controlled drugs. Delegation of prescribing authority must be outlined in delegation agreement (effective 8/10/09). PAs authorized to prescribe controlled medications must register with DEA.
Supervision: Constant presence of supervising physician is not required so long as the PA and supervising physician can be in touch via telecommunication.
Participation in regulation: Three PAs serve on seven-member PA advisory council.
Minnesota Board of Medical Practice, 2829 University Ave. SE, Suite 500, Minneapolis, MN 55414-3246; (612) 617-2130.
MISSISSIPPI
Qualifications: Graduation from accredited PA program, current NCCPA certificate, and bachelor's degree until 12/31/04; master's degree in a science or health related field required as of 1/1/05. Temporary licensure available for PA applicants seeking masters degree.
Application: By PA for license. Board approval of protocol submitted by PA and supervising physician required prior to PA beginning practice. Interview and passage of jurisprudence exam required.
Scope of practice: Any delegated medical service within the PA's training and skills that forms a component of the physician's scope of practice and is provided with supervision. Board must approve protocol outlining delegated duties.
Prescribing/dispensing: PA may prescribe those non-controlled medications outlined in board-approved protocol. PA must apply to board for authority to prescribe controlled substances (Schedules II-V); must complete board approved educational program prior to application; must comply with physician regulations on maintenance of records, prescription of diet medication, prescription of controlled substances for chronic pain and prescription guidelines. PAs authorized to prescribe controlled medications must register with DEA.
Supervision: On-site presence of physician required for first 120 days. Thereafter supervision must be continuous but does not require physical presence of supervising physician. Supervising physician must review and initial 10% of PA charts monthly.
Participation in regulation: Any board-appointed task force or committee must include at least one PA.
Mississippi State Board of Medical Licensure, 1867 Crane Ridge Dr., Ste 200B, Jackson, MS 39216; (601) 987-3079.
MISSOURI
Qualifications: Graduation from accredited PA program and current NCCPA certification. Person employed as PA for three years prior to August 28, 1989, who has passed NCCPA exam and has current certification also eligible. Applicants for licensure who have graduated from a PA program after January 1, 2008, must have a master's degree from a PA program.
Application: By PA for license, includes form signed by supervising physician. Personal appearance may be required.
Scope of practice: Histories and physicals; routine office laboratory and screening procedures; routine therapeutic procedures; counseling; assisting at surgery; writing orders; other delegated tasks.
Prescribing/dispensing: Physician assistants shall not prescribe nor dispense any drug, medicine, device or therapy independent of consultation with the supervising physician. PAs may prescribe Schedule III-V and non-controlled medications pursuant to supervision agreement with supervising physician (changes to laws pertaining to controlled medication effective 8/28/2009). Prescriptions shall include name, address, and telephone number of PA and supervising physician. Dispensing is limited to 72-hour starter dose supply of medication.
Supervision: PA must practice in same facility as supervising physician. Supervising physician must be present 66% of the time (per calendar quarter) PA is providing patient care. Physician must be immediately available in person or via telecommunication for consultation, assistance, and intervention. PA is limited to practicing in locations where the supervising physician is no further than 30 miles away. PA and physician practicing in certain settings may apply for a waiver for alternative supervision and distance requirements.
Participation in regulation: Two PAs serve on a five-member Advisory Commission for Physician Assistants.
Missouri Board of Registration for the Healing Arts, State Advisory Commission for Physician Assistants, P.O. Box 4, Jefferson City, MO 65102; (573) 751-0098 or (866) 289-5753.
MONTANA
Qualifications: Graduation from accredited PA program and current NCCPA certificate.
Application: By PA for license; PA submits physician supervision agreement prior to beginning practice. Interview may be required.
Scope of practice: Duties delegated by the supervising physician that are within his or her scope of practice and the PA's training and experience.
Prescribing/dispensing: PA may prescribe and dispense drugs, including Schedules II-V controlled substances, as delegated by physician. Schedule II prescriptions may be up to a 34-day supply.
Supervision: Onsite supervision of PA not required if supervising physician has provided a means of communication or an alternate means of supervision. PA and supervising physician must meet in person once every 30 days. Physician must review and sign 10% of PA charts; greater percentage in specific circumstances.
Participation in regulation: One PA appointed to medical board; one non-voting PA acts as liaison to the Board of Medical Examiners.
Montana State Board of Medical Examiners, P.O. Box 200513, Helena, MT 59620-0513; (406) 841-2364.
NEBRASKA
Qualifications: Graduation from accredited PA program and NCCPA examination.
Application: By PA for state licensure; by physician for approval to supervise (physician approval not required after 9/30/09).
Scope of practice: Medical services that are delegated by and provided under the supervision of a licensed physician, appropriate to the level of competence of the physician assistant, form a component of the supervising physician's scope of practice, and are not otherwise prohibited by law (effective 9/30/09).
Prescribing/dispensing: PA may prescribe medications as delegated to do so by supervising physician. Delegated authority may include legend drugs and Schedules II-V controlled medications. PAs authorized to prescribe controlled medications must register with the DEA.
Supervision: Supervision should be continuous but not require the personal presence of the supervising physician. Board may place limitations on amount of on-site supervision required for PAs with less than 2 years of experience; may apply for a waiver for this requirement (effective 9/30/09; rules to implement this law not yet adopted).
Participation in regulation: Two PAs serve on five-member PA committee.
Nebraska Health Department, Board of Examiners in Medicine and Surgery, P.O. Box 94986, Lincoln, NE 68509-4986; (402) 471-2118.
NEVADA
Qualifications: Graduation from accredited PA program and current NCCPA certificate.
Application: By PA for license (PA must send in supervision form signed by physician prior to initiating practice).
Scope of practice: Medical services delegated by the supervising physician; within his or her specialty; within the PA's training, experience, and competence; and approved by the board.
Prescribing/dispensing: With board approval, PA may prescribe and dispense drugs and devices, including Schedules II-V controlled substances, as delegated by the supervising physician. Registration with pharmacy board and pharmacy law exam required. PAs who prescribe controlled medications must register with the DEA.
Supervision: Supervising physician must be available at all times for consultation, which may be indirect (by telecommunication); physician shall regularly review and initial selected patient records. Supervising physician shall spend part of a day at least once a month at any location where PA provides medical services to act as consultant to PA and to monitor quality of care.
Participation in regulation: Three PAs serve on PA advisory committee.
Nevada State Board of Medical Examiners, P.O. Box 7238, Reno, NV 89510; (775) 688-2559 or (888) 890-8210.
Nevada State Board of Osteopathic Medicine, 2860 E. Flamingo Rd., Suite D, Las Vegas, NV 89121-5208, (702) 732-2147.
NEW HAMPSHIRE
Qualifications: Graduation from accredited PA program and current NCCPA certificate.
Application: By PA for license, must include statement from supervising physician that he/she accepts supervisory responsibility for PA.
Scope of practice: PA's scope of practice is defined by agreement with the registered supervising physician. Scope of practice is limited to and no broader than the scope of practice and privileges of the supervising physician.
Prescribing/dispensing: PA may prescribe and dispense legend drugs and controlled substances (Schedules II-V);
Supervision: Supervising physician(s) must file a written acceptance of supervisory responsibility with the board. Physician must be available for consultation at all times in person or via electronic communications device; provide regular ongoing evaluation of representative sample of charts. Alternate designated by supervising physician assumes responsibility for PA when supervising physician unavailable.
Participation in regulation: One PA serves on eight-member medical board.
New Hampshire Board of Medicine, 2 Industrial Park Dr., Suite 8, Concord, NH 03301-8520; (603) 271-1203.
NEW JERSEY
Qualifications: Graduation from accredited PA program and NCCPA exam.
Application: By PA for license; file notice of employment within 10 days of commencing employment.
Scope of practice: Delegated tasks such as histories and physicals, assisting at surgery, patient education, determining and implementing therapeutic plans.
Prescribing/dispensing: PAs may prescribe non-controlled drugs as delegated by supervising physician. PAs may order or prescribe controlled medications in Schedules II-V if authorized by supervising physician and controlled drug is to continue or reissue order or prescription of controlled drug issued by supervising physician; adjust dose of controlled drug prescribed by physician with prior consultation; initiate order or prescription for controlled drug with prior consultation with supervising physician; or initiate order or prescription for controlled drug as part of treatment plan for patient with terminal illness.
Supervision: Constant availability through electronic communication; intermittent physical presence; regular review of records. 24 hour countersignature of inpatient medical orders. Outpatient chart countersignature in seven days; 48 hours if chart has medication order or prescription.
Participation in regulation: Three PAs named to five-member PA advisory committee; one PA on medical board.
New Jersey Board of Medical Examiners, PA Advisory Committee, P.O. Box 45035, Newark, New Jersey 07101; (973) 504-6580.
NEW MEXICO
Qualifications: Graduation from accredited PA program; current NCCPA certificate.
Application: By PA for license; by supervising physician for approval. Personal interview with board member or designee and attendance at orientation required. PAs supervised by DOs must attend board meeting when application is discussed.
Scope of practice: Medical services delegated by supervising physician within PA's skills and forming a usual component of physician's practice. Written utilization plan must be developed.
Prescribing/dispensing: PA may prescribe, administer, and distribute non-controlled medications and Schedules II-V under direction of supervising physician and within parameters of board-approved formulary and guidelines. PA prescribers of controlled medications must register with the DEA.
Supervision: Must be immediate communication between physician and PA, can be through telecommunication. Quality assurance program must be in place and reviewed on an ongoing basis.
Participation in regulation: One PA serves on medical board.
New Mexico Medical Board, 2055 South Pacheco St., Bldg. 400, Santa Fe, NM 87505; (505) 476-7220 or (800) 945-5845.
Board of Osteopathic Medical Examiners, 2550 Cerrillos Rd., Santa Fe, NM 87505; (505) 476-4695.
NEW YORK
Qualifications: Graduation from approved PA program and NCCPA examination.
Application: By PA for state registration.
Scope of practice: Medical acts and duties delegated by the supervising physician, within the physician's scope of practice and appropriate to the PA's education, training, and experience.
Prescribing/dispensing: PA may prescribe Schedules II-V and non-controlled medications.
Supervision: Physician not required to be physically present at time and place where PA performs services.
Participation in regulation: At least two PAs appointed to medical examining board.
New York State Board for Medicine, Office of the Professions, 89 Washington Avenue, Albany, NY 12234; (518) 474-3817 ext. 560.
NORTH CAROLINA
Qualifications: Graduation from accredited PA program and NCCPA exam.
Application: By PA for license; physician submits statement of supervision.
Scope of practice: Medical acts and tasks delegated by supervising physician and within the PA's training.
Prescribing/dispensing: PA may prescribe non-controlled and controlled drugs in Schedules II-V (Sch. II and III limited to 30-day supply). Pharmacy Board approval required for compounding and dispensing drugs. PA prescribers of controlled medications must register with the DEA.
Supervision: Supervision continuous but physical presence of physician not required at all times. PA must meet with supervising physician monthly for first six months of employment and every six months thereafter to discuss clinical problems and quality improvement measures.
Participation in regulation: Physician extender (PA or NP) serves on medical board. PAs serve in the majority on a 15-member PA Advisory Council.
North Carolina Medical Board, P.O. Box 20007, Raleigh, NC 27619-0007; (919) 326-1100 or (800) 253-9653.
NORTH DAKOTA
Qualifications: Current NCCPA certification.
Application: By PA for license; includes copy of contract.
Scope of practice: Patient services delegated by supervising physician and approved by board.
Prescribing/dispensing: PAs may prescribe non-controlled drugs and Schedules II-V controlled substances (Schedule II effective 8/1/09). PA may dispense prepackaged medications (Schedules IV and V and non-controlled substances) prepared by pharmacist acting on physician's written order and labeled to show names of PA and physician. Dispensing must be authorized by and within preestablished guidelines of supervising physician. PA prescribers of controlled drugs must register with the DEA.
Supervision: Physician must be continuously available for contact personally or by telephone or radio.
North Dakota State Board of Medical Examiners, 418 E. Broadway Ave., Suite 12, Bismarck, ND 58501; (701) 328-6500.
OHIO
Qualifications: Current NCCPA certificate needed for initial registration and for change of employment and renewal. After January 1, 2008, PAs are required to possess a master's degree in a health-related field. Those already licensed as PAs in any jurisdiction are exempt from this requirement.
Application: By PA for certificate of registration (license); by physician for approval.
Scope of practice: Taking histories and performing physical examinations, assisting in surgery, and other tasks approved by the board in a physician supervisory plan. Scope of practice in a licensed health facility is determined by physician delegation and the policies of the health facility.
Prescribing/Dispensing: PAs may prescribe non-controlled and controlled drugs in Schedules III-V. PA prescribers must apply for a certificate to prescribe, issued by the state medical board. PA prescribers of controlled medications required to register with the DEA.
Supervision: Physician not required to be physically present but must be available for consultation and within 60 minutes travel time of PA's location. Physician to develop a quality assurance plan to ensure proper PA supervision. During first 500 hours of the provisional prescribing period, physician provides on-site supervision of PA prescribing.
Participation in regulation: Three PAs serve on seven-member PA policy committee.
Ohio State Medical Board, 77 S. High St., 17th Floor, Columbus, OH 43215-6127; (614) 466-3934.
OKLAHOMA
Qualifications: Graduation from accredited PA program, which for graduates after July 1, 2007, must include minimum of 1year of classroom instruction and 1 year of clinical experience (including at least 1month rotations each in family medicine, emergency medicine, and surgery). Passage of NCCPA examination required.
Application: By PA for license. Board must approve PA and physician (includes job description). Passage of jurisprudence exam required.
Scope of practice: Diagnostic and therapeutic procedures common to the physician's practice.
Prescribing/dispensing: PAs may prescribe non-controlled and Schedules III-V drugs on board-approved formulary. Schedule III-V drugs are limited to 30-day supply or 40 dosage units with one refill, whichever is smaller. PAs who prescribe controlled medications must register with the DEA and the Oklahoma Bureau of Narcotics and Dangerous Drugs.
Supervision: Physician not required to be physically present when, nor specifically consulted before, PA performs delegated task. Board approval required for PA utilization in remote site. In the remote setting, physician shall be present at least half a day each week.
Participation in regulation: Two PAs serve on seven-member PA committee.
Oklahoma State Board of Medical Licensure and Supervision, P.O. Box 18256, Oklahoma City, OK 73154-0256; (405) 848-6841.
OREGON
Qualifications: Graduation from accredited PA program and NCCPA examination. New graduate PAs, PAs new to the state, and supervising physicians not previously approved must pass an open-book exam on the Medical Practice Act.
Application: By PA and physician (includes job description). Interview may be required.
Scope of practice: Medical services delegated by the physician and included in the board-approved job description.
Prescribing/dispensing: PA may prescribe medications, including Schedules II-V controlled substances, as determined by physician and approved by board. PAs prescribing Schedule IIs must have current NCCPA certification. DEA registration required. PA may apply for emergency dispensing authority for medications prepackaged by pharmacist.
Supervision: Physician must always be available for verbal communication. Board approval required for PA utilization at remote site. Supervising physician must provide four hours of on-site supervision every two weeks.
Participation in regulation: Three PAs serve on five-member PA committee.
Oregon Board of Medical Examiners, 1500 SW First Ave., Suite 620, Portland, OR 97201; (971) 673-2700 or (877) 254-6263.
PENNSYLVANIA
Qualifications: Graduation from accredited PA program and NCCPA examination (current NCCPA certificate required for renewal), baccalaureate or higher degree from a college or university and not less than 60 clock hours of didactic instruction in pharmacology or other related courses as the board may approve by regulation.
Application: By PA for license; supervising physician must register with board.
Scope of practice: Medical procedures delegated by supervising physician, within normal scope of physician's practice and within the training and expertise of the PA.
Prescribing/dispensing: PAs may prescribe and dispense drugs including Schedule II-V controlled substances. Schedule II drugs are limited to a 72-hour supply for initial therapy, 30-day supply if given prior approval by supervising physician. Written agreement specifying PA prescribing and dispensing privileges, and categories of drugs which the PA is not permitted to prescribe, must be kept on file and available for review.
Supervision: Physician's constant physical presence not required as long as contact available through radio, telephone or telecommunication. Board approval required for satellite office. Supervising physician must review and sign medical record of patient cared for by PA within 10 days. If at a satellite location, supervising physician must visit location at least weekly to provide supervision.
Participation in regulation: One medical board seat reserved for, and rotates among, PA, nurse practitioner, respiratory care practitioner, acupuncturist, and nurse midwife. One PA, certified athletic trainer or respiratory care practitioner on osteopathic board.
Pennsylvania State Board of Medicine, P.O. Box 2649, Harrisburg, PA 17105-2649; (717) 783-1400.
Pennsylvania State Board of Osteopathic Medicine, same address; (717) 783-4858.
RHODE ISLAND
Qualifications: Graduation from accredited PA program and NCCPA examination.
Application: By PA for license.
Scope of practice: Health care services delegated by supervising physician consistent with the physician's and the PA's expertise.
Prescribing/dispensing: PAs may prescribe legend and Schedules II-V drugs. PA prescribers of controlled medications must register with state drug control office and DEA.
Supervision: Physician not required to be physically present but must be available for easy communication.
Participation in regulation: Two PAs serve on seven-member PA regulatory board.
Rhode Island Board of Physician Assistants, Division of Health Services Regulation, Health Professionals, 3 Capitol Hill, Room #104, Providence, RI 02908; (401) 222-3855.
SOUTH CAROLINA
Qualifications: Graduation from accredited PA program; current NCCPA certificate required for licensure and license renewal. Must pass examination on state laws governing PA practice.
Application: By PA for license; interview of PA and supervising physician by board member or board designee required.
Scope of practice: Medical acts, tasks or functions delegated by supervising physician in written scope of practice guidelines.
Prescribing/dispensing: PA may prescribe non-controlled and Schedules III-V medications as delegated by supervising physician in scope of practice guidelines. PAs who prescribe controlled drugs must register with the DEA. PA and supervising physician must read and sign a document approved by the board describing the management of expanded controlled substances prescriptive authority for PAs, which must be kept on file for review.
Supervision: Supervising physician must be available by telecommunication. Supervising physician must be present at least 75% of the time PA is providing services; PA must have six months clinical experience with supervising physician before off-site supervision authorized; PA may not provide services in the absence of supervising physician for more than seven consecutive days per month.PA may not practice in any location more than 45 miles or 60 minutes from supervising physician without board approval, and supervising physician must be physically present at least 20% of the time PA is providing services. Supervising physician must review, initial, and date the off-site physician assistant's charts not later than five working days from the date of service, as proportionate to the acuity of care and practice setting (board may authorize exceptions to these provisions).
Participation in regulation: Three PAs serve on a nine-member PA committee.
South Carolina Board of Medical Examiners, P.O. Box 11289, Columbia, SC 29211-1289; (803) 896-4500.
SOUTH DAKOTA
Qualifications: Graduation from an accredited PA program and NCCPA examination.
Application: By PA for license; includes copy of practice agreement and personal interview. Physician interviewed in person or by telephone.
Scope of practice: PA may perform delegated tasks which are within the PA's skills and the supervising physician's scope of practice.
Prescribing/dispensing: PA may prescribe medication including Schedules II-V, limited to 30 days for Schedule II. PAs who prescribe controlled medications must register with the state and the DEA.
Supervision: May be by personal contact or contact via telecommunication. If PA utilized in satellite office, physician must provide intermittent on-site personal supervision. PA and supervising physician must maintain jointly written and signed supervisory agreement, which is filed with the board prior to commencing practice.
Participation in regulation: Board has established PA advisory committee with three PA members.
South Dakota Board of Medical and Osteopathic Examiners, 125 South Main Ave., Sioux Falls, SD 57104; (605) 367-7781.
TENNESSEE
Qualifications: Graduation from accredited PA program and NCCPA examination.
Application: By PA for license; includes name of supervising physician.
Scope of practice: Medical services delegated in writing by supervising physician and form a usual component of the physician's scope of practice.
Prescribing/dispensing: PAs may prescribe non-controlled and Schedules II-V medications. PA prescribers of controlled drugs must register with the DEA. Supervising physician must review all controlled substance prescriptions within 30 days.
Supervision: Active and continuous overview, but physician not required to be physically present at all times. Physician shall review 20% of chart notes written by PA every 30 days and must visit remote site once every 30 days.
Participation in regulation: Five PAs serve on five-member PA regulatory committee.
Tennessee Committee on Physician Assistants, Department of Health-Related Boards, 227 French Landing, Suite 300, Nashville, TN 37243, (615) 532-3202 or (800) 778-4123.
TEXAS
Qualifications: Graduation from accredited PA program and current NCCPA certification; must also pass board-approved jurisprudence exam on state PA law and regulations.
Application: By PA for license.
Scope of practice: Medical services delegated by the supervising physician within education, training, and experience of PA.
Prescribing/dispensing: PA may carry out or sign a prescription drug order if delegated this task under standing orders. Limited to medically underserved areas, practices with preponderance of medically indigent patients, a physician's primary practice site, hospital, location when physician is present, or an alternate site when specified conditions are met. Authority includes Schedules III-V and non-controlled medications. PAs who prescribe controlled medications must register with DEA.
Supervision: Supervision shall be continuous but constant physical presence of physician not required. Establishment of office practice setting separate from that of supervising physician limited to site serving medically underserved and physician must be on-site to provide medical direction and consultation at least once every 10 business days and randomly review and cosign at least 10% of the charts.
Participation in regulation: Three PAs serve on nine-member PA board.
Texas Physician Assistant Board, c/o Texas Medical Board, P.O. Box 2018, Austin, TX 78768-2018; (512) 305-7022.
UTAH
Qualifications: Graduation from accredited PA program and NCCPA examination, as well as exam on state laws and rules.
Application: By PA for license; to practice in Utah PA must have a delegation of services agreement with a Utah licensed physician.
Scope of practice: Delegated medical services within supervising physician's scope of practice, within PA's skills, and included on the delegation of services agreement.
Prescribing/dispensing: PA may prescribe Schedules II-V and non-scheduled drugs. Any limitations on prescribing may be made in the delegation agreement. Prescriptions for Schedules II and III medications require chart co-signature. PAs who prescribe controlled medications must register with the DEA and hold a state controlled substance license.
Supervision: Physician must be available for consultation by electronic means if not on-site; shall cosign sufficient number of charts to ensure patient health, safety, and welfare.
Participation in regulation: One PA and one PA educator serve on seven-member PA board.
Utah Physician Assistant Licensing Board, P.O. Box 146741, Salt Lake City, UT 84114-6741; (801) 530-6628 or (866) 275-3675.
VERMONT
Qualifications: Graduation from an accredited PA program and passage of NCCPA examination, or completion of board-approved apprenticeship program.
Application: By PA for state certification and by physician (includes employment contract and job description).
Scope of practice: Delegated medical acts within supervising physician's normal scope of practice, consistent with PA education and experience, and approved by board. Separate approval required for each practice site.
Prescribing/dispensing: PA may prescribe those drugs authorized by physician in job description and approved by board. (May include legend drugs and Schedules II-V medications.) PAs who prescribe controlled medications must register with the DEA.
Supervision: Physician must be available for consultation and review. Separate board approval required for each site where physician supervises PA.
Participation in regulation: One PA serves on medical board.
Vermont Board of Medical Practice, P.O. Box 70, Burlington, VT 05402-0070; (802) 657-4220 or (800) 745-7371.
VIRGINIA
Qualifications: Graduation from accredited PA program and NCCPA examination; current NCCPA certificate required for renewal.
Application: By PA for license; prior to practice, PA and physician submit description of practice.
Scope of practice: Medical care services delegated by supervising physician, included in a delegation agreement, and approved by the board. Physician must see patient on follow-up visit if condition has not improved and must see patient with continuing illness at least every fourth visit.
Prescribing/dispensing: PAs may prescribe non-controlled drugs and devices and Schedules II-V controlled drugs. PAs who prescribe controlled substances must register with the DEA.
Supervision: Continuous supervision, but supervising physician not required to be present; physician must review PA record of services proportionate to acuity of care and practice setting.
Participation in regulation: Three PAs serve on five-member Advisory Board.
Virginia State Board of Medicine: Perimeter Center, 9960 Mayland Drive, Suite 300 Richmond, VA 23233-1463; (804) 367-4600.
WASHINGTON
Qualifications: Graduation from accredited PA program and NCCPA examination.
Application: By PA for license. Practice arrangement plan must be filed with the board.
Scope of practice: Medical services delegated by supervising physician and approved by board.
Prescribing/dispensing: PAs may write and sign prescriptions, including controlled substances in Schedules II-V. PAs who prescribe controlled medications must register with the DEA. PAs supervised by osteopathic physicians may prescribe controlled substances in Schedules II-V(NCCPA certification required for Schedule II Rx privileges).
Supervision: Physician not required to be physically present where PA services are rendered. Board approval required for PA utilization in remote site. PA supervised by osteopathic physicians: chart review within one week.
Participation in regulation: Two PAs serve on medical quality assurance commission. Commission has established PA Advisory Committee.
Washington State Department of Health, Medical Quality Assurance Commission, PO Box 47865 , Olympia , WA 98504-7865(360)236-4700.
Board of Osteopathic Medicine and Surgery, Health Professions Quality Assurance, PO Box 47865, Olympia, WA 98504, (360) 236-4700.
WEST VIRGINIA
Qualifications: Graduation from accredited PA program and NCCPA examination. Bachelor's or master's degree required.
Application: By PA for license; by supervising physician for approval to supervise (includes job description).
Scope of practice: Medical procedures delegated by supervising physician, within physician's normal scope of practice, included on PA's job description, and approved by the board.
Prescribing/dispensing: PAs with two years of experience who have completed board-approved pharmacology course and maintain NCCPA certification may prescribe controlled (Schedules III-V) and non-controlled drugs from formulary. Schedule IIIs limited to 72-hour supply. Schedules IV-V limited to 90 dosage units or 30 days. Other drugs not to exceed six-month supply. Registration with the DEA required. Under certain conditions PAs may dispense legend drugs.
Supervision: Physician's constant physical presence not required provided consultation available by radio, telephone, or telecommunication.
Participation in regulation: One PA serves on medical board.
West Virginia Board of Medicine, 101 Dee Dr., Ste. 103, Charleston, WV 25311; (304) 558-2921.
West Virginia State Board of Osteopathy, 334 Penco Road, Weirton, WV 26062; (304) 723-4638 or (800) 206-6625.
WISCONSIN
Qualifications: Graduation from accredited PA program and current NCCPA certification.
Application: By PA for license
Scope of practice: Patient services include taking histories; physical examinations, routine diagnostic studies, and therapeutic procedures; counseling; monitoring treatment and therapy plans; referrals; and assisting the physician in a hospital or other facility.
Prescribing/dispensing: PA may prescribe Schedules II-V and non-controlled drugs in situations specified in written guidelines developed by supervising physician. Guidelines must be reviewed annually. Supervising physician must sign patient record within 72 hours, review patient record within 72 hours, or review by telephone within 48 hours and sign patient record within one week. PA prescribers of controlled medications must register with the DEA (note: chart co-signature and record review requirement repealed effective 9/1/09).
Supervision: Physician must be available at all times for consultation either in person or within 15 minutes of contact by telephone, two-way radio, or television. Physician must visit and review on-site any facilities attended by PA at least once a month.
Participation in regulation: Three PAs serve on five-member advisory council.
Wisconsin Medical Examining Board, P.O. Box 8935, Madison, WI 53708-8935; (608) 266-2112.
WYOMING
Qualifications: Graduation from accredited PA program and current NCCPA certification.
Application: By PA for license; by physician for approval to supervise.
Scope of practice: Medical services delegated by supervising physician and approved by the board in the specialty area(s) for which physician and PA are trained or experienced.
Prescribing/dispensing: Physicians may delegate prescribing of non-controlled and Schedules II-V medications to PAs; also dispensing of prepackaged medications in rural areas when pharmacy services unavailable. PAs must register with the DEA if they prescribe controlled medications.
Supervision: Physician must be readily available for consultation, in person or by telecommunication.
Participation in regulation: One PA serves on medical board; two PAs serve on four-member advisory committee.
Wyoming Board of Medical Examiners, 211 W. 19th St., 2nd Floor, Colony Bldg., Cheyenne, WY 82002; (307) 778-7053 or (800) 438-5784.
Updated July 2009
