1997 Regular Session
To: Public Health and Welfare
By: Representative Barnett (92nd)
House Bill 1576
AN ACT TO PROVIDE FOR THE LICENSURE AND REGULATION OF PHYSICIAN ASSISTANTS BY THE BOARD OF MEDICAL LICENSURE; TO DEFINE CERTAIN TERMS; TO AUTHORIZE THE BOARD OF LICENSURE TO PROMULGATE RULES AND REGULATIONS TO CARRY OUT THE PURPOSES OF THIS ACT; TO DEFINE THE SCOPE OF PRACTICE OF A PHYSICIAN ASSISTANT; TO PRESCRIBE QUALIFICATIONS FOR APPLICANTS; TO PROVIDE FOR RENEWAL OF LICENSES; TO PROVIDE FOR SUPERVISING PHYSICIANS; TO PROVIDE IDENTIFICATION REQUIREMENTS; TO PROVIDE FOR VIOLATIONS OF THIS ACT AND DISCIPLINARY ACTIONS AND PENALTIES THEREFOR; TO PROVIDE FOR ADMINISTRATIVE AND FISCAL SUPPORT; TO AMEND SECTION 73-43-11, MISSISSIPPI CODE OF 1972, IN CONFORMITY TO THE PROVISIONS OF THIS ACT; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. As used in this act:
(a) "Board" means the State Board of Medical Licensure.
(b) "Physician assistant" means a person who has graduated from a physician assistant or surgeon assistant program accredited by the American Medical Association's Committee on Allied Health Education and Accreditation or its successor, and who has passed the certifying examination administered by the National Commission on Certification of Physician Assistants, or a person who is a 1974 graduate of the University of Mississippi Physician Assistant Program and who is credentialed as a physician assistant by a federal employer in Mississippi on July 1, 1997.
(c) "Supervising physician" means a doctor of medicine or a doctor of osteopathic medicine who holds an unrestricted license from the board, and who is in the full-time practice of medicine and who has been approved by the board to supervise physician assistants.
(i) The "primary supervising physician" is the physician who, by signing the application to the board, accepts full responsibility for the physician assistant's medical services at all times when the physician personally is providing supervision or when supervision is being provided by a back-up supervising physician.
(ii) The "back-up supervising physician" is the physician who, by signing the application to the board, accepts the responsibility to supervise the physician assistant's medical services in the absence of the primary supervising physician.
(d) "Supervision" means overseeing and accepting responsibility for the medical services rendered by a physician assistant in a manner approved by the board.
SECTION 2. The board may promulgate and publish reasonable rules and regulations necessary to enable it to discharge its functions and to enforce the provisions of law regulating the practice of physician assistants.
SECTION 3. (1) Notwithstanding any other provisions of law, a physician assistant shall only perform medical services within his educational preparation and experience when such services are delegated and supervised by a licensed physician approved by the board. A licensed physician assistant practicing with a new supervising physician must work with on-site supervision for a minimum of one hundred sixty (160) hours. New graduate licensed physician assistants (which is defined as a licensed physician assistant who has been in practice for less than one (1) year from the date of his graduation) must practice with on-site supervision for a minimum of three (3) months. All supervisory requirements must be in compliance with regulations adopted by the board. A physician assistant shall only perform medical services within the scope of practice of the primary supervising physician or back-up supervising physician.
(2) Medical services rendered by physician assistants are limited to:
(a) Obtaining patient histories and performing physical examinations;
(b) Ordering and/or performing diagnostic and therapeutic procedures;
(c) Formulating a diagnosis;
(d) Developing and implementing a treatment plan;
(e) Monitoring the effectiveness of therapeutic interventions;
(f) Assisting at surgery;
(g) Offering counseling and education to meet patient needs; and
(h) Recommending referrals to the supervising physician and facilitating the referrals of the supervising physician as directed.
(3) The services listed in subsection (2) of this section may be performed in any setting authorized by the supervising physician, including but not limited to, clinics, hospitals, ambulatory surgical centers, patient homes, nursing homes and other institutional settings.
(4) Medical services rendered by physician assistants do not include prescriptive authority. This act does not confer prescriptive authority on physician assistants.
SECTION 4. (1) A person must be licensed by the board before he may practice as a physician assistant.
(2) The board may license as a physician assistant an applicant who:
(a) Submits an application on forms approved by the board;
(b) Pays the appropriate fee as determined by the board;
(c) Has successfully completed an educational program for physician assistants or surgeon assistants accredited by the Committee on Allied Health Education and Accreditation or its successor;
(d) Has passed the Physician Assistant National Certifying Examination administered by the National Commission on Certification of Physician Assistants, or is a 1974 graduate of the University of Mississippi Physician Assistant Program and is credentialed as a physician assistant by a federal employer in Mississippi on July 1, 1997;
(e) Certifies that he is mentally and physically able to engage safely in practice as a physician assistant;
(f) Has no licensure, certification, or registration as a physician assistant under current discipline, revocation, suspension, restriction or probation for cause resulting from the applicant's practice as a physician assistant, unless the board considers such condition and agrees to licensure;
(g) Submits to the board any other information the board deems necessary to evaluate the applicant's qualifications; and
(h) Has been approved by the board.
SECTION 5. Each person who holds a license as a physician assistant in this state shall, upon notification from the board, renew the license by:
(a) Submitting the appropriate fee as determined by the board;
(b) Completing the appropriate forms; and
(c) Meeting any other requirements set forth by the board.
SECTION 6. (1) Any doctor of medicine or osteopathic medicine with an unrestricted license and in the full-time practice of medicine in this state may apply to the board for permission to supervise a physician assistant. The application shall include a signed statement from the physician indicating that he will exercise supervision over the physician assistant in accordance with any rules adopted by the board and that he will retain professional and legal responsibility for the care rendered by the physician assistant.
(2) The board may approve or reject such applications.
SECTION 7. (1) Any person other than one who has been licensed by the board who holds himself out as a physician assistant or who uses any other term indicating or implying that he is a physician assistant is guilty of a misdemeanor and shall be subject to penalties applicable to the unlicensed practice of medicine as stipulated in Section 97-23-43.
(2) An unlicensed physician shall not be permitted to use the title of "physician assistant" or to practice as a physician assistant unless he fulfills the requirements of this act.
SECTION 8. (1) Licensed physician assistants shall keep proof of current licensure for inspection at their primary place of practice and shall, when engaged in their professional activities, wear a name tag identifying themselves as a "physician assistant."
(2) Any physician's office, clinic or hospital which utilizes physician assistants shall post a notice to that effect in a prominent place.
SECTION 9. The grounds for disciplinary action as described in Section 10 of this act are:
(a) Habitual or inappropriate personal use of legend drugs, or any other drug having addiction-forming or addiction-sustaining liability.
(b) Habitual or inappropriate use of intoxicating liquors, or any beverage, to an extent that affects professional competency.
(c) Administering or dispensing any legend drug, any narcotic drug, or any other drug having addiction-forming or addiction-sustaining liability without proper order of the supervising physician documented in the patient chart.
(d) Prescribing any legend drug, any narcotic drug, or any other drug having addiction-forming or addiction-sustaining liability.
(e) Conviction of violation of any federal or state law regulating the possession, distribution or use of any narcotic drug or any drug considered a controlled substance under state or federal law, a certified copy of the conviction order or judgment rendered by the trial court being prima facie evidence thereof, notwithstanding the pendency of any appeal.
(f) Conviction of a felony or misdemeanor involving moral turpitude, a certified copy of the conviction order or judgment rendered by the trial court being prima facie evidence thereof, notwithstanding the pendency of any appeal.
(g) Obtaining or attempting to obtain a license by fraud or deception.
(h) Professional incompetence.
(i) In addition to any other investigators the board employs, the board may appoint one or more licensed physician assistants to act for the board in investigating the conduct relating to the competency of a physician assistant whenever disciplinary action is being considered for professional incompetence.
(ii) Any investigator employed by the board or any licensed physician assistant appointed to act for the board may inspect patient records in accordance with the provisions of Section 73-25-28.
(i) Unprofessional conduct, which includes but is not limited to:
(i) Practicing as a physician assistant under a false or assumed name or impersonating another practitioner, living or dead.
(ii) Knowingly performing any act which in any way assists an unlicensed person to practice medicine or to practice as a physician assistant.
(iii) Making or willfully causing to be made any flamboyant claims concerning the licensee's professional excellence.
(iv) Being guilty of any dishonorable or unethical conduct likely to deceive, defraud or harm the public.
(v) Obtaining a fee as personal compensation or gain from a person on fraudulent representation that a disease or injury condition generally considered incurable by competent medical authority in the light of current scientific knowledge and practice can be cured, or offering, undertaking, attempting or agreeing to cure or treat the same by a secret method, which he refuses to divulge to the board upon request.
(vi) Use of any false, fraudulent, or forged statement or document, or the use of any fraudulent, deceitful, dishonest or immoral practice in connection with any of the licensing requirements, including the signing in his professional capacity any certificate that is known to be false at the time he makes or signs such certificate.
(vii) Practicing under the supervision of a physician other than a board-approved supervising physician.
(j) The refusal of a licensing authority of another state or jurisdiction to issue or renew a license, permit, or certificate to practice in that jurisdiction or the revocation, suspension or other restriction imposed on a license, permit or certificate issued by such licensing authority that prevents or restricts practice in the jurisdiction, a certified copy of the disciplinary order or action taken by the other state or jurisdiction being prima facie evidence thereof, notwithstanding the pendency of any appeal.
(k) Surrender of a license or authorization to practice as a physician assistant in another state or jurisdiction or surrender of membership on any medical staff or in any professional association or society while under disciplinary investigation by any of those authorities or bodies for acts or conduct similar to acts or conduct that would constitute grounds for action as defined in this section.
(l) Having disciplinary action taken by his peers within any physician assistant professional association or society, whether any such association or society is local, regional, state or national in scope, or being disciplined by a licensed hospital or medical staff of the hospital. Any body taking action as set forth in this paragraph shall report such action to the board within thirty (30) days of its occurrence.
(m) Failure to furnish the board, its investigators or representatives information legally requested by the board.
(n) Representing himself as a physician.
(o) Violation of any provision of this act or the rules and regulations of the board or of any order, stipulation or agreement with the board.
SECTION 10. (1) Whenever the board finds any person unqualified because of any of the grounds set forth in Section 9 of this act, it may impose one or more of the following measures:
(a) Deny his application for initial licensure or renewal of a license to practice as a physician assistant.
(b) Administer a public or private reprimand.
(c) Limit or restrict his license to practice as a physician assistant.
(d) Suspend or revoke his license to practice as a physician assistant. All actions taken by the board to suspend or revoke the license of a physician assistant are subject to the requirements described in Section 73-25-27. The board has the right to obtain medical records to pursue disciplinary proceedings against a physician assistant identical to its right to examine records as described in Section 73-25-28 when investigating a physician licensee.
(e) Impose a period of probation, the terms of which may be set by the board.
(f) Require him to submit to care, counseling or treatment by physicians designated by the board.
(g) Require him to participate in a program of education prescribed by the board; or
(h) Take any other action in relation to his license as the board may deem proper under the circumstances.
(2) If the board determines that evidence in its possession indicates that a physician assistant's continuation in practice or unrestricted practice would constitute an immediate danger to the public, the board may take any of the same actions on a temporary basis, without a hearing. In the event of such temporary action without a hearing, a hearing must be held within thirty (30) days of such action.
(3) Any entity, organization or person, including the board, any member of the board, its agents or employees, and including any entity or organization or its members, acting without malice in making any report or other information available to the board pursuant to law, or who assists in the organization, investigation or preparation of such report or information, or assists the board in carrying out any of its duties or functions provided by law shall be immune from civil or criminal liability, except that unlawful disclosure of confidential information possessed by the board may be a misdemeanor if otherwise so provided by law.
(4) Any person against whom disciplinary action is taken shall have the right to judicial appeal. However, no such person shall be allowed to deliver health care services in violation of any disciplinary order or action of the board while any such appeal is pending.
SECTION 11. (1) A person whose license to practice as a physician assistant has been revoked or suspended may petition the board to reinstate his license after a period of not less than one (1) year has elapsed from the date of the revocation or suspension.
(2) The petition shall be accompanied by two (2) or more verified recommendations from physicians or osteopaths licensed by the board to which the petition is addressed and by two (2) or more recommendations from citizens each having personal knowledge of the activities of the petitioner since the disciplinary penalty was imposed and such facts as may be required by the board. The petition may be heard at the next regular meeting of the board but not earlier than thirty (30) days after the petition was filed. No petition shall be considered while the petitioner is under sentence for any criminal offense, including any period during which he is under probation or parole. The hearing may be continued from time to time as the board finds necessary.
(3) In determining whether the disciplinary penalty should be set aside and the terms and conditions, if any, which should be imposed if the disciplinary penalty is set aside, the board may investigate and consider all activities of the petitioner since the disciplinary action was taken against him, the offense for which he was disciplined, his activity during the time his certification was in good standing, his general reputation for truth, professional ability and good character; and it may require the petitioner to pass an oral examination.
(4) The secretary-treasurer of the board shall enter into his records of the case all actions of the board in setting aside a disciplinary penalty under this section and he shall certify notices to the proper court clerk. The clerk shall make such changes on his records as may be necessary.
SECTION 12. The Legislature shall appropriate a sufficient amount to allow physician assistants to be licensed and regulated by the board. This amount shall be sufficient to cover all administrative costs and the costs of any necessary investigation and disciplinary actions undertaken by the board. It is the intent of the Legislature that this section shall be repealed when licensure fees are sufficient to cover the costs incurred by the board for all aspects of licensure of physician assistants.
SECTION 13. Section 73-43-11, Mississippi Code of 1972, is amended as follows:
73-43-11. The State Board of Medical Licensure shall have the following powers and responsibilities:
(a) Setting policies and professional standards regarding the medical practice of physicians, osteopaths and podiatrists;
(b) Considering applications for licensure;
(c) Conducting examinations for licensure;
(d) Investigating alleged violations of the medical practice act;
(e) Conducting hearings on disciplinary matters involving violations of state and federal law, probation, suspension and revocation of licenses;
(f) Considering petitions for termination of probationary and suspension periods, and restoration of revoked licenses;
(g) To promulgate and publish reasonable rules and regulations necessary to enable it to discharge its functions and to enforce the provisions of law regulating the practice of medicine;
(h) To enter into contracts with any other state or federal agency, or with any private person, organization or group capable of contracting, if it finds such action to be in the public interest and in the furtherance of its responsibilities; and
(i) Perform the duties prescribed by Sections 1 through 12 of this act.
SECTION 14. This act shall take effect and be in force from and after July 1, 1997.