SF 2043

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 06/01/2020 10:26am

A bill for an act
relating to health occupations; permitting licensed physician assistant to practice
without delegation agreement with physician; amending Minnesota Statutes 2018,
sections 62A.307, subdivision 2; 147A.01, subdivisions 3, 21, 26, 27, by adding
a subdivision; 147A.02; 147A.03, by adding a subdivision; 147A.05; 147A.09;
147A.13, subdivision 1; 147A.14, subdivision 4; 147A.16; 147A.23; 152.12,
subdivision 1; Minnesota Statutes 2019 Supplement, sections 147A.06; 151.01,
subdivision 23; proposing coding for new law in Minnesota Statutes, chapter 147A;
repealing Minnesota Statutes 2018, sections 147A.01, subdivisions 4, 11, 16a,
17a, 24, 25; 147A.04; 147A.10; 147A.11; 147A.18, subdivisions 1, 2, 3; 147A.20.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2018, section 62A.307, subdivision 2, is amended to read:

Subd. 2.

Requirement.

Coverage described in subdivision 1 that covers prescription
drugs must provide the same coverage for a prescription written by a health care provider
authorized to prescribe the particular drug covered by the health coverage described in
subdivision 1, regardless of the type of health care provider that wrote the prescription. This
section is intended to prohibit denial of coverage based on the prescription having been
written by an advanced practice nurse under section 148.235, a physician assistant under
section deleted text begin 147A.18 deleted text end new text begin 147A.185 new text end , or any other nonphysician health care provider authorized to
prescribe the particular drug.

Sec. 2.

Minnesota Statutes 2018, section 147A.01, subdivision 3, is amended to read:

Subd. 3.

Administer.

"Administer" means the delivery by a physician assistant deleted text begin authorized
to prescribe legend drugs, a single dose deleted text end of a legend drug deleted text begin , including controlled substances, deleted text end
to a patient by injection, inhalation, ingestion, or by any other immediate means deleted text begin , and the
delivery by a physician assistant ordered by a physician a single dose of a legend drug by
injection, inhalation, ingestion, or by any other immediate means deleted text end .

Sec. 3.

Minnesota Statutes 2018, section 147A.01, is amended by adding a subdivision to
read:

new text begin Subd. 6a. new text end

new text begin Collaborating physician. new text end

new text begin "Collaborating physician" means a Minnesota
licensed physician who oversees the performance, practice, and activities of a physician
assistant under a collaborative agreement as described in section 147A.02, paragraph (c).
new text end

Sec. 4.

Minnesota Statutes 2018, section 147A.01, subdivision 21, is amended to read:

Subd. 21.

Prescription.

"Prescription" means a signed written order, an oral order
reduced to writing, or an electronic order meeting current and prevailing standards given
by a physician assistant deleted text begin authorized to prescribe drugs deleted text end for patients in the course of the
physician assistant's practice deleted text begin , deleted text end new text begin and new text end issued for an individual patient deleted text begin and containing the
information required in the physician-physician assistant delegation agreement deleted text end .

Sec. 5.

Minnesota Statutes 2018, section 147A.01, subdivision 26, is amended to read:

Subd. 26.

Therapeutic order.

"Therapeutic order" means deleted text begin an deleted text end new text begin a written or verbal new text end order
given to another for the purpose of treating or curing a patient in the course of a physician
assistant's practice. deleted text begin Therapeutic orders may be written or verbal, but do not include the
prescribing of legend drugs or medical devices unless prescribing authority has been
delegated within the physician-physician assistant delegation agreement.
deleted text end

Sec. 6.

Minnesota Statutes 2018, section 147A.01, subdivision 27, is amended to read:

Subd. 27.

Verbal order.

"Verbal order" means an oral order given to another for the
purpose of treating or curing a patient in the course of a physician assistant's practice. deleted text begin Verbal
orders do not include the prescribing of legend drugs unless prescribing authority has been
delegated within the physician-physician assistant delegation agreement.
deleted text end

Sec. 7.

Minnesota Statutes 2018, section 147A.02, is amended to read:

147A.02 QUALIFICATIONS FOR LICENSURE.

deleted text begin Except as otherwise provided in this chapter, an individual shall be licensed by the board
before the individual may practice as a physician assistant.
deleted text end

new text begin (a) new text end The board may grant a license as a physician assistant to an applicant who:

(1) submits an application on forms approved by the board;

(2) pays the appropriate fee as determined by the board;

(3) has current certification from the National Commission on Certification of Physician
Assistants, or its successor agency as approved by the board;

(4) certifies that the applicant is mentally and physically able to engage safely in practice
as a physician assistant;

(5) has no licensure, certification, or registration as a physician assistant under current
discipline, revocation, suspension, or probation for cause resulting from the applicant's
practice as a physician assistant, unless the board considers the condition and agrees to
licensure;

(6) submits any other information the board deems necessary to evaluate the applicant's
qualifications; and

(7) has been approved by the board.

new text begin (b) new text end All persons registered as physician assistants as of June 30, 1995, are eligible for
continuing license renewal. All persons applying for licensure after that date shall be licensed
according to this chapter.

new text begin (c) A physician assistant who qualifies for licensure must practice for at least 2,080
hours, within the context of a collaborative agreement, within a hospital or integrated clinical
setting where physician assistants and physicians work together to provide patient care. The
physician assistant shall submit written evidence to the board with the application, or upon
completion of the required collaborative practice experience. For purposes of this paragraph,
a collaborative agreement is a mutually agreed upon plan for the overall working relationship
and collaborative arrangement between a physician assistant, and one or more physicians
licensed under chapter 147, that designates the scope of services that can be provided to
manage the care of patients. The physician assistant and one of the collaborative physicians
must have experience in providing care to patients with the same or similar medical
conditions. The collaborating physician is not required to be physically present so long as
the collaborating physician and physician assistant are or can be easily in contact with each
other by radio, telephone, or other telecommunication device.
new text end

Sec. 8.

Minnesota Statutes 2018, section 147A.03, is amended by adding a subdivision to
read:

new text begin Subd. 1a. new text end

new text begin Licensure required. new text end

new text begin Except as provided under subdivision 2, it is unlawful
for any person to practice as a physician assistant without being issued a valid license
according to this chapter.
new text end

Sec. 9.

Minnesota Statutes 2018, section 147A.05, is amended to read:

147A.05 INACTIVE LICENSE.

new text begin (a) new text end Physician assistants who notify the board in writing may elect to place their license
on an inactive status. Physician assistants with an inactive license shall be excused from
payment of renewal fees and shall not practice as physician assistants. Persons who engage
in practice while their license is lapsed or on inactive status shall be considered to be
practicing without a license, which shall be grounds for discipline under section 147A.13.
Physician assistants who provide care under the provisions of section 147A.23 shall not be
considered practicing without a license or subject to disciplinary action. Physician assistants
who notify the board of their intent to resume active practice shall be required to pay the
current renewal fees and all unpaid back fees and shall be required to meet the criteria for
renewal specified in section 147A.07.

new text begin (b) Notwithstanding section 147A.03, subdivision 1, a person with an inactive license
may continue to use the protected titles specified in section 147A.03, subdivision 1, so long
as the person does not practice as a physician assistant.
new text end

Sec. 10.

Minnesota Statutes 2019 Supplement, section 147A.06, is amended to read:

147A.06 CANCELLATION OF LICENSE FOR NONRENEWAL.

Subdivision 1.

Cancellation of license.

The board shall not renew, reissue, reinstate, or
restore a license that has lapsed deleted text begin on or after July 1, 1996, deleted text end and has not been renewed within
two annual renewal cycles deleted text begin starting July 1, 1997 deleted text end . A licensee whose license is canceled for
nonrenewal must obtain a new license by applying for licensure and fulfilling all requirements
then in existence for an initial license to practice as a physician assistant.

Subd. 2.

Licensure following lapse of licensed status; transition.

(a) A licensee whose
license has lapsed under subdivision 1 before January 1, 2020, and who seeks to regain
licensed status after January 1, 2020, shall be treated as a first-time licensee only for purposes
of establishing a license renewal schedule, and shall not be subject to the license cycle
conversion provisions in section 147A.29.

(b) This subdivision expires July 1, 2022.

Sec. 11.

Minnesota Statutes 2018, section 147A.09, is amended to read:

147A.09 SCOPE OF PRACTICE deleted text begin , DELEGATION deleted text end .

Subdivision 1.

Scope of practice.

Physician assistants shall practice medicine only deleted text begin with
physician supervision. Physician assistants may perform those duties and responsibilities
as delegated in the physician-physician assistant delegation agreement and delegation forms
maintained at the address of record by the supervising physician and physician assistant,
including the prescribing, administering, and dispensing of drugs, controlled substances,
and medical devices, excluding anesthetics, other than local anesthetics, injected in
connection with an operating room procedure, inhaled anesthesia and spinal anesthesia deleted text end new text begin
under an established practice agreement new text end .

deleted text begin Patient service must be limited to deleted text end new text begin A physician assistant's scope of practice includes new text end :

(1) services within the training and experience of the physician assistant;

(2) new text begin patient new text end services customary to the practice of the deleted text begin supervising physician or alternate
supervising physician deleted text end new text begin physician assistant and the practice agreement new text end ; new text begin and
new text end

(3) deleted text begin services delegated by the supervising physician or alternate supervising physician
under the physician-physician assistant delegation agreement; and
deleted text end

deleted text begin (4) deleted text end services within the parameters of the laws, rules, and standards of the facilities in
which the physician assistant practices.

deleted text begin Nothing in this chapter authorizes physician assistants to perform duties regulated by
the boards listed in section 214.01, subdivision 2, other than the Board of Medical Practice,
and except as provided in this section.
deleted text end

Subd. 2.

deleted text begin Delegation deleted text end new text begin Patient services new text end .

Patient services may include, but are not limited
to, the following deleted text begin , as delegated by the supervising physician and authorized in the delegation
agreement deleted text end :

(1) taking patient histories and developing medical status reports;

(2) performing physical examinations;

(3) interpreting and evaluating patient data;

(4) ordering deleted text begin or deleted text end new text begin , new text end performing new text begin , or reviewing new text end diagnostic procedures, including the use of
radiographic imaging systems in compliance with Minnesota Rules 2007, chapter 4732 new text begin , but
excluding interpreting computed tomography scans, magnetic resonance imaging scans,
positron emission tomography scans, nuclear scans, and mammography new text end ;

(5) ordering or performing therapeutic procedures including the use of ionizing radiation
in compliance with Minnesota Rules 2007, chapter 4732;

(6) providing instructions regarding patient care, disease prevention, and health
promotion;

(7) deleted text begin assisting the supervising physician in deleted text end new text begin providing new text end patient care in the home and in health
care facilities;

(8) creating and maintaining appropriate patient records;

(9) transmitting or executing specific orders deleted text begin at the direction of the supervising physician deleted text end ;

(10) prescribing, administering, and dispensing drugs, controlled substances, and medical
devices deleted text begin if this function has been delegated by the supervising physician pursuant to and
subject to the limitations of section 147A.18 and chapter 151. For physician assistants who
have been delegated the authority to prescribe controlled substances, such delegation shall
be included in the physician-physician assistant delegation agreement, and all schedules of
controlled substances the physician assistant has the authority to prescribe shall be specified deleted text end new text begin ,
and includes administering local anesthetics, but excluding anesthetics injected in connection
with an operating room procedure, inhaled anesthesia, and spinal anesthesia new text end ;

(11) deleted text begin for physician assistants not delegated prescribing authority, administering legend
drugs and medical devices following prospective review for each patient by and upon
direction of the supervising physician;
deleted text end

deleted text begin (12) deleted text end functioning as an emergency medical technician with permission of the ambulance
service and in compliance with section 144E.127, and ambulance service rules adopted by
the commissioner of health;

deleted text begin (13) deleted text end new text begin (12) new text end initiating evaluation and treatment procedures essential to providing an
appropriate response to emergency situations;

deleted text begin (14) deleted text end new text begin (13) new text end certifying a patient's eligibility for a disability parking certificate under section
169.345, subdivision 2;

deleted text begin (15) deleted text end new text begin (14) new text end assisting at surgery; and

deleted text begin (16) deleted text end new text begin (15) new text end providing medical authorization for admission for emergency care and treatment
of a patient under section 253B.05, subdivision 2.

deleted text begin Orders of physician assistants shall be considered the orders of their supervising
physicians in all practice-related activities, including, but not limited to, the ordering of
diagnostic, therapeutic, and other medical services.
deleted text end

new text begin Subd. 3. new text end

new text begin Practice agreement review. new text end

new text begin A physician assistant shall have a practice
agreement at the practice level that describes the practice of the physician assistant. The
practice agreement must be reviewed on an annual basis by a licensed physician within the
same clinic, hospital, health system, or other facility as the physician assistant and has
knowledge of the physician assistant's practice to ensure that the physician assistant's medical
practice is consistent with the practice agreement. A document stating that the review
occurred must be maintained at the practice level and made available to the board, upon
request.
new text end

new text begin Subd. 4. new text end

new text begin Scope of practice limitations; spinal injections for acute and chronic
pain. new text end

new text begin Notwithstanding subdivision 1, a physician assistant may only perform spinal injections
to address acute and chronic pain symptoms upon referral and in collaboration with a
physician licensed under chapter 147. For purposes of performing spinal injections for acute
or chronic pain symptoms, the physician assistant and one or more physicians licensed under
chapter 147 must have a mutually agreed upon plan that designates the scope of collaboration
necessary for treating patients with acute and chronic pain.
new text end

Sec. 12.

Minnesota Statutes 2018, section 147A.13, subdivision 1, is amended to read:

Subdivision 1.

Grounds listed.

The board may refuse to grant licensure or may impose
disciplinary action as described in this subdivision against any physician assistant. The
following conduct is prohibited and is grounds for disciplinary action:

(1) failure to demonstrate the qualifications or satisfy the requirements for licensure
contained in this chapter or rules of the board. The burden of proof shall be upon the applicant
to demonstrate such qualifications or satisfaction of such requirements;

(2) obtaining a license by fraud or cheating, or attempting to subvert the examination
process. Conduct which subverts or attempts to subvert the examination process includes,
but is not limited to:

(i) conduct which violates the security of the examination materials, such as removing
examination materials from the examination room or having unauthorized possession of
any portion of a future, current, or previously administered licensing examination;

(ii) conduct which violates the standard of test administration, such as communicating
with another examinee during administration of the examination, copying another examinee's
answers, permitting another examinee to copy one's answers, or possessing unauthorized
materials; and

(iii) impersonating an examinee or permitting an impersonator to take the examination
on one's own behalf;

(3) conviction, during the previous five years, of a felony reasonably related to the
practice of physician assistant. Conviction as used in this subdivision includes a conviction
of an offense which if committed in this state would be deemed a felony without regard to
its designation elsewhere, or a criminal proceeding where a finding or verdict of guilt is
made or returned but the adjudication of guilt is either withheld or not entered;

(4) revocation, suspension, restriction, limitation, or other disciplinary action against
the person's physician assistant credentials in another state or jurisdiction, failure to report
to the board that charges regarding the person's credentials have been brought in another
state or jurisdiction, or having been refused licensure by any other state or jurisdiction;

(5) advertising which is false or misleading, violates any rule of the board, or claims
without substantiation the positive cure of any disease or professional superiority to or
greater skill than that possessed by another physician assistant;

(6) violating a rule adopted by the board or an order of the board, a state, or federal law
which relates to the practice of a physician assistant, or in part regulates the practice of a
physician assistant, including without limitation sections 604.201, 609.344, and 609.345,
or a state or federal narcotics or controlled substance law;

(7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the
public, or demonstrating a willful or careless disregard for the health, welfare, or safety of
a patient; or practice which is professionally incompetent, in that it may create unnecessary
danger to any patient's life, health, or safety, in any of which cases, proof of actual injury
need not be established;

deleted text begin (8) failure to adhere to the provisions of the physician-physician assistant delegation
agreement;
deleted text end

deleted text begin (9) deleted text end new text begin (8) new text end engaging in the practice of medicine beyond deleted text begin that deleted text end new text begin what is new text end allowed deleted text begin by the
physician-physician assistant delegation agreement deleted text end new text begin under this chapter new text end , or aiding or abetting
an unlicensed person in the practice of medicine;

deleted text begin (10) deleted text end new text begin (9) new text end adjudication as mentally incompetent, mentally ill or developmentally disabled,
or as a chemically dependent person, a person dangerous to the public, a sexually dangerous
person, or a person who has a sexual psychopathic personality by a court of competent
jurisdiction, within or without this state. Such adjudication shall automatically suspend a
license for its duration unless the board orders otherwise;

deleted text begin (11) deleted text end new text begin (10) new text end engaging in unprofessional conduct. Unprofessional conduct includes any
departure from or the failure to conform to the minimal standards of acceptable and prevailing
practice in which proceeding actual injury to a patient need not be established;

deleted text begin (12) deleted text end new text begin (11) new text end inability to practice with reasonable skill and safety to patients by reason of
illness, drunkenness, use of drugs, narcotics, chemicals, or any other type of material, or as
a result of any mental or physical condition, including deterioration through the aging
process or loss of motor skills;

deleted text begin (13) deleted text end new text begin (12) new text end revealing a privileged communication from or relating to a patient except when
otherwise required or permitted by law;

deleted text begin (14) deleted text end new text begin (13) new text end any identification of a physician assistant by the title "Physician deleted text begin , deleted text end " deleted text begin "Doctor,"
or "Dr." deleted text end in a patient care setting or in a communication directed to the general public;

deleted text begin (15) deleted text end new text begin (14) new text end improper management of medical records, including failure to maintain adequate
medical records, to comply with a patient's request made pursuant to sections 144.291 to
144.298, or to furnish a medical record or report required by law;

deleted text begin (16) deleted text end new text begin (15) new text end engaging in abusive or fraudulent billing practices, including violations of the
federal Medicare and Medicaid laws or state medical assistance laws;

deleted text begin (17) deleted text end new text begin (16) new text end becoming addicted or habituated to a drug or intoxicant;

deleted text begin (18) deleted text end new text begin (17) new text end prescribing a drug or device for other than medically accepted therapeutic,
experimental, or investigative purposes authorized by a state or federal agency or referring
a patient to any health care provider as defined in sections 144.291 to 144.298 for services
or tests not medically indicated at the time of referral;

deleted text begin (19) deleted text end new text begin (18) new text end engaging in conduct with a patient which is sexual or may reasonably be
interpreted by the patient as sexual, or in any verbal behavior which is seductive or sexually
demeaning to a patient;

deleted text begin (20) deleted text end new text begin (19) new text end failure to make reports as required by section 147A.14 or to cooperate with an
investigation of the board as required by section 147A.15, subdivision 3;

deleted text begin (21) deleted text end new text begin (20) new text end knowingly providing false or misleading information that is directly related
to the care of that patient unless done for an accepted therapeutic purpose such as the
administration of a placebo;

deleted text begin (22) deleted text end new text begin (21) new text end aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation
of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an injunction
issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5; or

(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.
The board shall investigate any complaint of a violation of section 609.215, subdivision 1
or 2; or

deleted text begin (23) deleted text end new text begin (22) new text end deleted text begin failure to maintain annually reviewed and updated physician-physician assistant
delegation agreements for each physician-physician assistant practice relationship, or failure
to provide copies of such documents upon request by the board deleted text end new text begin failure to maintain the proof
of review document as required under section 147A.09, subdivision 3, or to provide a copy
of the document upon request of the board new text end .

Sec. 13.

Minnesota Statutes 2018, section 147A.14, subdivision 4, is amended to read:

Subd. 4.

Licensed professionals.

Licensed health professionals and persons holding
residency permits under section 147.0391, shall report to the board personal knowledge of
any conduct which the person reasonably believes constitutes grounds for disciplinary action
under this chapter by a physician assistant, including any conduct indicating that the person
may be incompetent, or may have engaged in unprofessional conduct or may be medically
or physically unable to engage safely in practice as a physician assistant. No report shall be
required if the information was obtained in the course of a deleted text begin physician-patient deleted text end new text begin provider-patient new text end
relationship if the patient is a physician assistant, and the treating deleted text begin physician deleted text end new text begin provider new text end
successfully counsels the person to limit or withdraw from practice to the extent required
by the impairment.

Sec. 14.

Minnesota Statutes 2018, section 147A.16, is amended to read:

147A.16 FORMS OF DISCIPLINARY ACTION.

When the board finds that a licensed physician assistant has violated a provision of this
chapter, it may do one or more of the following:

(1) revoke the license;

(2) suspend the license;

(3) impose limitations or conditions on the physician assistant's practice, including
limiting the scope of practice to designated field specialties; deleted text begin impose deleted text end new text begin imposing new text end retraining or
rehabilitation requirements; deleted text begin require practice under additional supervision; deleted text end or deleted text begin condition
continued deleted text end new text begin limiting new text end practice deleted text begin on deleted text end new text begin until new text end demonstration of knowledge or skills by appropriate
examination or other review of skill and competence;

(4) impose a civil penalty not exceeding $10,000 for each separate violation, the amount
of the civil penalty to be fixed so as to deprive the physician assistant of any economic
advantage gained by reason of the violation charged or to reimburse the board for the cost
of the investigation and proceeding; new text begin or
new text end

deleted text begin (5) order the physician assistant to provide unremunerated professional service under
supervision at a designated public hospital, clinic, or other health care institution; or
deleted text end

deleted text begin (6) deleted text end new text begin (5) new text end censure or reprimand the licensed physician assistant.

Upon judicial review of any board disciplinary action taken under this chapter, the
reviewing court shall seal the administrative record, except for the board's final decision,
and shall not make the administrative record available to the public.

Sec. 15.

new text begin [147A.185] PRESCRIBING DRUGS AND THERAPEUTIC DEVICES.
new text end

new text begin Subd. 1. new text end

new text begin Diagnosis, prescribing, and ordering. new text end

new text begin A physician assistant is authorized to:
new text end

new text begin (1) diagnose, prescribe, and institute therapy or referrals of patients to health care agencies
and providers;
new text end

new text begin (2) prescribe, procure, sign for, record, administer, and dispense over-the-counter drugs,
legend drugs, and controlled substances, including sample drugs; and
new text end

new text begin (3) plan and initiate a therapeutic regimen that includes ordering and prescribing durable
medical devices and equipment, nutrition, diagnostic services, and supportive services
including but not limited to home health care, hospice, physical therapy, and occupational
therapy.
new text end

new text begin Subd. 2. new text end

new text begin Drug Enforcement Administration requirements. new text end

new text begin (a) A physician assistant
must:
new text end

new text begin (1) comply with federal Drug Enforcement Administration (DEA) requirements related
to controlled substances; and
new text end

new text begin (2) file any and all of the physician assistant's DEA registrations and numbers with the
board.
new text end

new text begin (b) The board shall maintain current records of all physician assistants with DEA
registration and numbers.
new text end

new text begin Subd. 3. new text end

new text begin Other requirements and restrictions. new text end

new text begin (a) Each prescription initiated by a
physician assistant shall indicate the following:
new text end

new text begin (1) the date of issue;
new text end

new text begin (2) the name and address of the patient;
new text end

new text begin (3) the name and quantity of the drug prescribed;
new text end

new text begin (4) directions for use; and
new text end

new text begin (5) the name and address of the prescribing physician assistant.
new text end

new text begin (b) In prescribing, dispensing, and administering legend drugs, controlled substances,
and medical devices, a physician assistant must comply with this chapter and chapters 151
and 152.
new text end

Sec. 16.

Minnesota Statutes 2018, section 147A.23, is amended to read:

147A.23 RESPONDING TO DISASTER SITUATIONS.

deleted text begin (a) deleted text end A physician assistant duly licensed or credentialed in a United States jurisdiction or
by a federal employer who is responding to a need for medical care created by an emergency
according to section 604A.01, or a state or local disaster may render such care as the
physician assistant is trained to provide, under the physician assistant's license or credential deleted text begin ,
without the need of a physician-physician assistant delegation agreement or a notice of
intent to practice as required under section 147A.20. A physician assistant may provide
emergency care without physician supervision or under the supervision that is available deleted text end .

deleted text begin (b) The physician who provides supervision to a physician assistant while the physician
assistant is rendering care in accordance with this section may do so without meeting the
requirements of section 147A.20.
deleted text end

deleted text begin (c) The supervising physician who otherwise provides supervision to a physician assistant
under a physician-physician assistant delegation agreement described in section 147A.20
shall not be held medically responsible for the care rendered by a physician assistant pursuant
to paragraph (a). Services provided by a physician assistant under paragraph (a) shall be
considered outside the scope of the relationship between the supervising physician and the
physician assistant.
deleted text end

Sec. 17.

Minnesota Statutes 2019 Supplement, section 151.01, subdivision 23, is amended
to read:

Subd. 23.

Practitioner.

"Practitioner" means a licensed doctor of medicine, licensed
doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of
dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, deleted text begin or deleted text end licensed
advanced practice registered nurse deleted text begin . For purposes of sections 151.15, subdivision 4; 151.211,
subdivision 3; 151.252, subdivision 3; 151.37, subdivision 2, paragraphs (b), (e), and (f);
and 151.461, "practitioner" also means a deleted text end new text begin , or licensed new text end physician assistant deleted text begin authorized to
prescribe, dispense, and administer under chapter 147A deleted text end . For purposes of sections 151.15,
subdivision 4; 151.211, subdivision 3; 151.252, subdivision 3; 151.37, subdivision 2,
paragraph (b); and 151.461, "practitioner" also means a dental therapist authorized to dispense
and administer under chapter 150A.

Sec. 18.

Minnesota Statutes 2018, section 152.12, subdivision 1, is amended to read:

Subdivision 1.

Prescribing, dispensing, administering controlled substances in
Schedules II through V.

A licensed doctor of medicine, a doctor of osteopathic medicine,
duly licensed to practice medicine, a doctor of dental surgery, a doctor of dental medicine,
a licensed doctor of podiatry, a licensed advanced practice registered nurse, new text begin a licensed
physician assistant, new text end or a licensed doctor of optometry limited to Schedules IV and V, and
in the course of professional practice only, may prescribe, administer, and dispense a
controlled substance included in Schedules II through V of section 152.02, may cause the
same to be administered by a nurse, an intern or an assistant under the direction and
supervision of the doctor, and may cause a person who is an appropriately certified and
licensed health care professional to prescribe and administer the same within the expressed
legal scope of the person's practice as defined in Minnesota Statutes.

Sec. 19. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 147A.01, subdivisions 4, 11, 16a, 17a, 24, and 25;
147A.04; 147A.10; 147A.11; 147A.18, subdivisions 1, 2, and 3; and 147A.20, new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2020.
new text end

APPENDIX

Repealed Minnesota Statutes: S2043-1

147A.01 DEFINITIONS.

Subd. 4.

Agreement.

"Agreement" means the document described in section 147A.20.

Subd. 11.

Drug category.

"Drug category" means one of the categories listed on the physician-physician assistant delegation agreement.

Subd. 16a.

Notice of intent to practice.

"Notice of intent to practice" means a document sent to the board by a licensed physician assistant that documents the adoption of a physician-physician assistant delegation agreement and provides the names, addresses, and information required by section 147A.20.

Subd. 17a.

Physician-physician assistant delegation agreement.

"Physician-physician assistant delegation agreement" means the document prepared and signed by the physician and physician assistant affirming the supervisory relationship and defining the physician assistant scope of practice. The physician-physician assistant delegation agreement outlines the role of the physician assistant in the practice, describes the means of supervision, and specifies the categories of drugs, controlled substances, and medical devices that the supervising physician delegates to the physician assistant to prescribe. The physician-physician assistant delegation agreement must comply with the requirements of section 147A.20, be kept on file at the address of record, and be made available to the board or its representative upon request.

Subd. 24.

Supervision.

"Supervision" means overseeing the activities of, and accepting responsibility for, the medical services rendered by a physician assistant. The constant physical presence of the supervising physician is not required so long as the supervising physician and physician assistant are or can be easily in contact with one another by radio, telephone, or other telecommunication device. The scope and nature of the supervision shall be defined by the individual physician-physician assistant delegation agreement.

Subd. 25.

Temporary license.

"Temporary license" means a license granted to a physician assistant who meets all of the qualifications for licensure but has not yet been approved for licensure at a meeting of the board.

147A.04 TEMPORARY LICENSE.

The board may issue a temporary license to practice to a physician assistant eligible for licensure under this chapter only if the application for licensure is complete, all requirements have been met, and a nonrefundable fee set by the board has been paid. The temporary license remains valid only until the next meeting of the board at which a decision is made on the application for licensure.

147A.10 SATELLITE SETTINGS.

Physician assistants may render services in a setting geographically remote from the supervising physician.

147A.11 EXCLUSIONS OF LIMITATIONS ON EMPLOYMENT.

Nothing in this chapter shall be construed to limit the employment arrangement of a physician assistant licensed under this chapter.

147A.18 DELEGATED AUTHORITY TO PRESCRIBE, DISPENSE, AND ADMINISTER DRUGS AND MEDICAL DEVICES.

Subdivision 1.

Delegation.

(a) A supervising physician may delegate to a physician assistant who is licensed by the board, certified by the National Commission on Certification of Physician Assistants or successor agency approved by the board, and who is under the supervising physician's supervision, the authority to prescribe, dispense, and administer legend drugs, controlled substances, and medical devices subject to the requirements in this section. The authority to dispense includes, but is not limited to, the authority to request, receive, and dispense sample drugs. This authority to dispense extends only to those drugs described in the written agreement developed under paragraph (b).

(b) The delegation agreement between the physician assistant and supervising physician must include a statement by the supervising physician regarding delegation or nondelegation of the functions of prescribing, dispensing, and administering legend drugs, controlled substances, and medical devices to the physician assistant. The statement must include categories of drugs for which the supervising physician delegates prescriptive and dispensing authority, including controlled substances when applicable. The delegation must be appropriate to the physician assistant's practice and within the scope of the physician assistant's training. Physician assistants who have been delegated the authority to prescribe, dispense, and administer legend drugs, controlled substances, and medical devices shall provide evidence of current certification by the National Commission on Certification of Physician Assistants or its successor agency when applying for licensure or license renewal as physician assistants. Physician assistants who have been delegated the authority to prescribe controlled substances must also hold a valid DEA registration. Supervising physicians shall retrospectively review the prescribing, dispensing, and administering of legend drugs, controlled substances, and medical devices by physician assistants, when this authority has been delegated to the physician assistant as part of the physician-physician assistant delegation agreement. The process and schedule for the review must be outlined in the physician-physician assistant delegation agreement.

(c) The board may establish by rule:

(1) a system of identifying physician assistants eligible to prescribe, administer, and dispense legend drugs and medical devices;

(2) a system of identifying physician assistants eligible to prescribe, administer, and dispense controlled substances;

(3) a method of determining the categories of legend drugs, controlled substances, and medical devices that each physician assistant is allowed to prescribe, administer, and dispense; and

(4) a system of transmitting to pharmacies a listing of physician assistants eligible to prescribe legend drugs, controlled substances, and medical devices.

Subd. 2.

Termination and reinstatement of prescribing authority.

The authority of a physician assistant to prescribe, dispense, and administer legend drugs, controlled substances, and medical devices shall end immediately when:

(1) the physician-physician assistant delegation agreement is terminated;

(2) the authority to prescribe, dispense, and administer is terminated or withdrawn by the supervising physician;

(3) the physician assistant's license is placed on inactive status;

(4) the physician assistant loses National Commission on Certification of Physician Assistants or successor agency certification; or

(5) the physician assistant loses or terminates licensure status.

Subd. 3.

Other requirements and restrictions.

(a) Each prescription initiated by a physician assistant shall indicate the following:

(1) the date of issue;

(2) the name and address of the patient;

(3) the name and quantity of the drug prescribed;

(4) directions for use; and

(5) the name and address of the prescribing physician assistant.

(b) In prescribing, dispensing, and administering legend drugs, controlled substances, and medical devices, a physician assistant must conform with the agreement, chapter 151, and this chapter.

147A.20 PHYSICIAN-PHYSICIAN ASSISTANT AGREEMENT DOCUMENTS.

Subdivision 1.

Physician-physician assistant delegation agreement.

(a) A physician assistant and supervising physician must sign a physician-physician assistant delegation agreement which specifies scope of practice and manner of supervision as required by the board. The agreement must contain:

(1) a description of the practice setting;

(2) a listing of categories of delegated duties;

(3) a description of supervision type; and

(4) a description of the process and schedule for review of prescribing, dispensing, and administering legend and controlled drugs and medical devices by the physician assistant authorized to prescribe.

(b) The agreement must be maintained by the supervising physician and physician assistant and made available to the board upon request. If there is a delegation of prescribing, administering, and dispensing of legend drugs, controlled substances, and medical devices, the agreement shall include a description of the prescriptive authority delegated to the physician assistant. Physician assistants shall have a separate agreement for each place of employment. Agreements must be reviewed and updated on an annual basis. The supervising physician and physician assistant must maintain the physician-physician assistant delegation agreement at the address of record.

(c) Physician assistants must provide written notification to the board within 30 days of the following:

(1) name change;

(2) address of record change; and

(3) telephone number of record change.

Subd. 2.

Practice location notification.

A licensed physician assistant shall submit a practice location notification to the board within 30 business days of starting practice, changing practice location, or changing supervising physician. The notification shall include the name, business address, and telephone number of the supervising physician and the physician assistant. Individuals who practice without submitting a practice location notification shall be subject to disciplinary action under section 147A.13 for practicing without a license, unless the care is provided in response to a disaster or emergency situation pursuant to section 147A.23.