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A244, R247, H4015
STATUS INFORMATION
General Bill
Sponsors: Rep. White
Document Path: l:\council\bills\bbm\10744sj05.doc
Companion/Similar bill(s): 995
Introduced in the House on April 28, 2005
Introduced in the Senate on February 22, 2006
Last Amended on February 21, 2006
Passed by the General Assembly on March 8, 2006
Governor's Action: March 15, 2006, Signed
Summary: Physicians Assistants Practice Act
HISTORY OF LEGISLATIVE ACTIONS
Date Body Action Description with journal page number
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4/28/2005 House Introduced and read first time HJ-47
4/28/2005 House Referred to Committee on Medical, Military, Public and
Municipal Affairs HJ-48
2/15/2006 House Committee report: Favorable with amendment Medical,
Military, Public and Municipal Affairs HJ-34
2/16/2006 Scrivener's error corrected
2/21/2006 House Amended HJ-107
2/21/2006 House Read second time HJ-116
2/22/2006 House Read third time and sent to Senate HJ-15
2/22/2006 Senate Introduced and read first time SJ-18
2/22/2006 Senate Referred to Committee on Medical Affairs SJ-18
3/1/2006 Senate Committee report: Favorable Medical Affairs SJ-26
3/2/2006 Scrivener's error corrected
3/7/2006 Senate Read second time SJ-10
3/8/2006 Senate Read third time and enrolled SJ-27
3/14/2006 Ratified R 247
3/15/2006 Signed By Governor
3/21/2006 Copies available
3/21/2006 Effective date 03/15/06
4/5/2006 Act No. 244
View the latest legislative information at the LPITS web site
VERSIONS OF THIS BILL
4/28/2005
2/15/2006
2/16/2006
2/21/2006
3/1/2006
3/2/2006
(A244, R247, H4015)
AN ACT TO AMEND SECTIONS 40-47-910, 40-47-935, 40-47-940, 40-47-945, 40-47-950, 40-47-955, 40-47-965, 40-47-970, 40-47-980, 40-47-1000, 40-47-1010, AND 40-47-1015, CODE OF LAWS OF SOUTH CAROLINA, 1976, ALL RELATING TO THE SOUTH CAROLINA PHYSICIAN ASSISTANTS PRACTICE ACT, SO AS TO INCLUDE THE DEFINITION OF ALTERNATE SUPERVISING PHYSICIAN AND SUPERVISING PHYSICIAN; TO PROVIDE THAT ONLY PHYSICIANS ASSISTANTS HOLDING A PERMANENT LICENSE MAY PRESCRIBE DRUG THERAPY; TO UPDATE AND CLARIFY THE PROCEDURE FOR ISSUANCE OF AUTHORIZATION TO PRACTICE; TO CLARIFY THE PERMANENT LICENSURE FOR PHYSICIAN ASSISTANTS; TO CLARIFY THE LIMITED LICENSURE FOR PHYSICIAN ASSISTANTS; TO CLARIFY SUPERVISION RESPONSIBILITIES WHEN A PHYSICIAN ASSISTANT AND A PHYSICIAN PRACTICE AT THE SAME LOCATION AND PROVIDE EXCEPTIONS; TO CLARIFY THE REQUIREMENTS FOR OFF-SITE PRACTICE; TO PROVIDE THAT PATIENT CHARTS FOR PATIENTS SEEN BY A PHYSICIAN ASSISTANT IN A SUPERVISOR'S ABSENCE MUST BE REVIEWED BY THE SUPERVISING PHYSICIAN OR ALTERNATE WITHIN FIVE WORKING DAYS AND TO PROVIDE AN EXCEPTION; TO PROVIDE LIMITED CONTROLLED SUBSTANCE PRESCRIPTIVE AUTHORITY; TO CLARIFY THAT THE PHYSICIAN ASSISTANT PRACTICE IS LIMITED TO THE SUPERVISING PHYSICIAN'S SCOPE OF PRACTICE; TO PROVIDE FOR THE CONDUCT OF INVESTIGATIONS AND DISCIPLINARY PROCEEDINGS; TO PROVIDE THAT A LICENSE MAY BE RENEWED BIENNIALLY; TO PROVIDE REFERENCES; TO CHANGE CERTAIN REFERENCES FROM BOARD TO COMMITTEE; AND TO PROVIDE THAT MONETARY FEES MAY BE DECREASED OR INCREASED BIENNIALLY FOR PHYSICIAN ASSISTANTS.
Be it enacted by the General Assembly of the State of South Carolina:
Physician Assistants Practice Act definitions
SECTION 1. Section 40-47-910(1) and (6) of the 1976 Code, as added by Act 359 of 2000, are amended to read:
"(1) 'Alternate physician supervisor' or 'alternate supervising physician' means a South Carolina licensed physician currently possessing an active, unrestricted permanent license to practice medicine in South Carolina who accepts the responsibility to supervise a physician assistant's activities in the absence of the supervising physician and this physician is approved by the physician supervisor in writing in the scope of practice guidelines.
(6) 'Physician supervisor or supervising physician' means a South Carolina licensed physician currently possessing an active, unrestricted permanent license to practice medicine in South Carolina who is approved to serve as a supervising physician for no more than two physician assistants. The physician supervisor is the individual who is responsible for supervising a physician assistant's activities."
Permanent licensee may prescribe drug therapy
SECTION 2. Section 40-47-935 of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"Section 40-47-935. Physician assistants may perform:
(1) medical acts, tasks, or functions with written scope of practice guidelines under physician supervision;
(2) those duties and responsibilities, including the prescribing and dispensing of drugs and medical devices, that are lawfully delegated by their supervising physicians. However, only physician assistants holding a permanent license may prescribe drug therapy as provided in this article.
A physician assistant is an agent of his or her supervising physician in the performance of all practice related activities including, but not limited to, the ordering of diagnostic, therapeutic, and other medical services."
Authorization to practice
SECTION 3. Section 40-47-940 of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"Section 40-47-940. (A) An application must be submitted to the board on forms supplied by the board. The application must be complete in every detail before it may be approved and must be accompanied by a nonrefundable fee. As part of the application process, the supervising physician and physician assistant must specify clearly in detail those medical acts, tasks, or functions for which approval is being sought. The specific medical acts, tasks, or functions must be included in the scope of practice guidelines, and the scope of practice guidelines must accompany the application.
(B) When a board member or board designee or the administrative staff of the board has reviewed the entire application for completeness and correctness and has determined the eligibility or appropriateness of the application a temporary authorization may be issued immediately. At the next board meeting the application may be recommended for approval for a permanent license or other authorization consistent with this article. If a temporary authorization is not considered appropriate, the application must be reviewed by the committee and may be recommended to the board for approval as presented to or modified by the committee."
Permanent license
SECTION 4. Section 40-47-945 of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"Section 40-47-945. (A) Except as otherwise provided in this article, an individual shall obtain a permanent license from the board before the individual may practice as a physician assistant. The board shall grant a permanent license as a physician assistant to an applicant who has:
(1) submitted a completed application on forms provided by the board;
(2) paid the nonrefundable application fees established in this article;
(3) successfully completed an educational program for physician assistants approved by the Accreditation Review Commission on Education for the Physician Assistant or its predecessor or successor organization;
(4) successfully completed the NCCPA certifying examination and provide documentation that the applicant possesses a current, active, NCCPA certificate;
(5) certified that the applicant is mentally and physically able to engage safely in practice as a physician assistant;
(6) no licensure, certificate, or registration as a physician assistant under current discipline, revocation, suspension, probation, or investigation for cause resulting from the applicant's practice as a physician assistant;
(7) good moral character;
(8) submitted to the board other information the board considers necessary to evaluate the applicant's qualifications;
(9) appeared before a board member or board designee with the applicant's supervising physician and all original diplomas and certificates and demonstrated knowledge of the contents of this article. A temporary authorization to practice may be issued as provided in Section 40-47-940 pending completion of this requirement and subject to satisfactory interview as provided below; and
(10) successfully completed an examination administered by the committee on the statutes and regulations regarding physician assistant practice and supervision.
(B) Not later than ninety days from the date a temporary authorization is issued, each applicant shall appear before a board member or board designee with the applicant's supervising physician and scope of practice guidelines and demonstrate knowledge of the contents of this article. Failure to appear within the prescribed time automatically results in the immediate invalidation of the authorization to practice pending compliance and further order of the board. If approved, a permanent license may be issued immediately. If not approved, the application must be reviewed by the committee and may be recommended to the board for approval as presented to or modified by the committee.
(C) The supervising physician of a limited licensee physically must be present on the premises at all times when the limited licensee is performing a task. No on-the-job training, or task not listed on the application, may be approved for a limited license holder."
Limited license
SECTION 5. Section 40-47-950 of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"Section 40-47-950. (A) The board may issue a limited physician assistant license to an applicant who has:
(1) submitted a completed application on forms provided by the board;
(2) paid the nonrefundable application fees established by this regulation;
(3) successfully completed an educational program for physician assistants approved by the Accreditation Review Commission on Education for the Physician Assistant or its predecessor or successor organization;
(4) never previously failed two consecutive NCCPA certifying examinations and has registered for, or intends to register to take the next offering of, the NCCPA examination;
(5) certified that the applicant mentally and physically is able to engage safely in practice as a physician assistant;
(6) no licensure, certificate, or registration as a physician assistant under current discipline, revocation, suspension, probation, or investigation for cause resulting from the applicant's practice as a physician assistant;
(7) good moral character;
(8) submitted to the board any other information the board considers necessary to evaluate the applicant's qualifications;
(9) appeared before a board member or board designee with the applicant's supervising physician and all original diplomas and certificates and demonstrated knowledge of the contents of this article; and
(10) successfully completed an examination administered by the committee on the statutes and regulations regarding physician assistant practice and supervision.
(B) A limited license is not renewable and is valid only until the results of a limited licensee's two consecutive NCCPA certifying examinations are reported to the board. When a limited licensee has failed two consecutive NCCPA certifying examinations, or fails one exam and does not take the NCCPA certifying examination at the next opportunity or, after applying for a limited license, fails to register for the next offering of the examination, the limited license immediately is void and the applicant is no longer eligible to apply for further limited licensure.
(C) The supervising physician of a limited licensee physically must be present on the premises at all times when the limited licensee is performing a task. No on-the-job training or task not listed on the application may be approved for a limited license holder."
Supervision responsibilities, onsite and offsite
SECTION 6. Section 40-47-955 of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"Section 40-47-955. (A) The supervising physician is responsible for all aspects of the physician assistant's practice. Supervision must be continuous but must not be construed as necessarily requiring the physical presence of the supervising physician at the time and place where the services are rendered, except as otherwise required for limited licensees. The supervising physician shall identify the physician assistant's scope of practice and determine the delegation of medical acts, tasks, or functions. Medical acts, tasks, or functions must be defined in approved written guidelines which must be appropriate to the physician assistant's ability and knowledge.
(B) In an on-site practice setting, the supervising physician or alternate supervising physician physically must be present at the same location as the physician assistant at least seventy-five percent of the time each month the physician assistant is providing services at the same location as the supervising physician or alternate supervising physician. The physician assistant may not provide services in the absence of the supervising physician or alternate supervising physician for more than seven consecutive days each month without the prior written approval of the board. The board may grant in writing exceptions to the seventy-five percent direct supervision requirement provided for in this subsection.
(C) For off-site practice, a physician assistant must have six months of clinical experience with the current supervising physician before being permitted to practice at a location off site from the supervising physician, except that a physician assistant who has at least two years continuous practice in South Carolina in the same specialty will be permitted to practice at a location off site from the supervising physician after three months clinical experience with the supervising physician and upon request of the supervising physician. This three-month requirement may be waived for experienced physician assistants and supervisors upon recommendation of the committee and approval by the board. The off-site location may not be more than forty-five miles or sixty minutes travel time from the supervising physician or alternate supervising physician without written approval of the board. The supervising physician or alternate supervising physician must be physically present at the off-site location not less than twenty percent of the time each month the physician assistant is providing services there. Notice of off-site practice must be filed with the administrative staff of the board before off-site practice may be authorized. The supervising physician or alternate must review, initial, and date the off-site physician assistant's charts not later than five working days from the date of service if not sooner as proportionate to the acuity of care and practice setting.
(D) A supervising physician may not supervise more than two physician assistants.
(E) Upon written request, and recommendation of the committee, the board may authorize exceptions to the requirements of this section."
Prescriptive authority
SECTION 7. Section 40-47-965 of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"Section 40-47-965. (A) If the written scope of practice guidelines authorizes the physician's assistant to prescribe drug therapy:
(1) prescriptions for authorized drugs and devices shall comply with all applicable state and federal laws;
(2) prescriptions must be limited to drugs and devices authorized by the supervising physician and set forth in the written scope of practice guidelines;
(3) prescriptions must be signed by the physician assistant and must bear the physician assistant's identification number as assigned by the board and all prescribing numbers required by law. The preprinted prescription form shall include both the physician assistant's and physician's name, address, and phone number and shall comply with the provisions of Section 39-24-40;
(4) drugs or devices prescribed must be specifically documented in the patient record;
(5) the physician assistant may request, receive, and sign for professional samples of drugs authorized in the written scope of practice guidelines, except for controlled substances in Schedule II, and may distribute professional samples to patients in compliance with appropriate federal and state regulations and the written scope of practice guidelines.
(B) When applying for controlled substance prescriptive authority, the applicant shall comply with the following requirements:
(1) the physician assistant shall provide evidence of completion of sixty contact hours of education in pharmacotherapeutics acceptable to the board before application;
(2) the physician assistant shall provide at least fifteen contact hours of education in controlled substances acceptable to the board;
(3) every two years, the physician assistant shall provide documentation of four continuing education contact hours in prescribing controlled substances acceptable to the board; and
(4) the physician assistant and supervising physician must read and sign a document approved by the board describing the management of expanded controlled substances prescriptive authority for physician assistants in South Carolina which must be kept on file for review. Within the two-year period, the physician assistant and the supervising physician periodically shall review this document and the physician assistant's prescribing practices to ensure proper prescribing procedures are followed. This review must be documented in writing with a copy kept at each practice site.
(C) A physician assistant's prescriptive authorization may be terminated by the board if the physician assistant:
(1) practices outside the written scope of practice guidelines;
(2) violates any state or federal law or regulation applicable to prescriptions; or
(3) violates a state or federal law applicable to physician assistants."
Limitations on practice
SECTION 8. Section 40-47-970 of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"Section 40-47-970. A physician assistant may not:
(1) perform a medical act, task, or function which has not been listed and approved on the scope of practice guidelines;
(2) prescribe drugs, medications, or devices not specifically authorized by the supervising physician and documented in the written scope of practice guidelines;
(3) prescribe, under any circumstances, controlled substances in Schedule II;
(4) perform a medical act, task, or function that is outside the usual practice of the supervising physician."
Treatment of patients
SECTION 9. Section 40-47-980 of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"Section 40-47-980. In the treatment of patients in chronic care and long-term care facilities including, but not limited to, nursing homes or chronic dialysis units, the supervising physician must conduct the initial patient visit. Thereafter, the physician supervisor or alternate physician supervisor must see the patient every six months for routine evaluation."
Investigations and disciplinary proceedings
SECTION 10. Section 40-47-1000(D) of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"(D) Investigations and disciplinary proceedings under this article must be conducted in accordance with the provisions of Article 1."
License renewal
SECTION 11. Section 40-47-1010 of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"Section 40-47-1010. A license issued pursuant to this chapter may be renewed biennially or as otherwise provided by the board and department. A person who has not demonstrated continuing education, as required by this article, is not eligible for issuance or renewal of an authorization to practice."
Fees
SECTION 12. Section 40-47-1015 of the 1976 Code, as added by Act 359 of 2000, is amended to read:
"Section 40-47-1015. (A) Fees for physician assistant licensure are established as follows:
(1) initial licensing fee, not to exceed five hundred dollars;
(2) renewal of license fee, not to exceed one hundred and fifty dollars;
(3) late renewal fee, not to exceed the renewal fee doubled;
(4) reactivation application fee, not to exceed two hundred dollars;
(5) change in supervisor fee, not to exceed one hundred and fifty dollars;
(6) additional primary supervisor for dual employment fee, not to exceed one hundred and fifty dollars.
(B) Fees may be adjusted biennially pursuant to Section 40-1-50 to ensure that they are sufficient but not excessive to cover expenses including the total of the direct and indirect costs to the State for the operations of the committee."
Time effective
SECTION 13. This act takes effect upon approval by the Governor.
Ratified the 14th day of March, 2006.
Approved the 15th day of March, 2006.
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