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Minnesota Legislature

Office of the Revisor of Statutes

SF 2043

as introduced - 91st Legislature (2019 - 2020) Posted on 03/07/2019 03:45pm

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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11.17

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 147A.01, subdivisions 3, 17, 21, 26, 27; 147A.02; 147A.03, subdivision
1, by adding a subdivision; 147A.05; 147A.06; 147A.13, subdivision 1; 147A.14,
subdivision 4; 147A.16; 147A.23; 151.01, subdivision 23; 152.12, subdivision 1;
proposing coding for new law in Minnesota Statutes, chapter 147A; repealing
Minnesota Statutes 2018, sections 147A.01, subdivisions 11, 16a, 17a, 23, 24, 25;
147A.04; 147A.09; 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 147A.01, subdivision 3, is amended to read:


Subd. 3.

Administer.

"Administer" means the delivery by a physician assistant deleted text beginauthorized
to prescribe legend drugs, a single dose
deleted text end of a legend drugdeleted text begin, including controlled substances,deleted text end
to a patient by injection, inhalation, ingestion, or by any other immediate meansdeleted 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. 2.

Minnesota Statutes 2018, section 147A.01, subdivision 17, is amended to read:


Subd. 17.

Physician.

"Physician" means a person currently licensed in good standing
as a physician or osteopathic physician under chapter 147new text begin or in another state or United States
territory
new text end.

Sec. 3.

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 beginauthorized to prescribe drugsdeleted text end for patients in the course of the
physician assistant's practicedeleted text begin,deleted text endnew text begin andnew text end issued for an individual patient deleted text beginand containing the
information required in the physician-physician assistant delegation agreement
deleted text end.

Sec. 4.

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


Subd. 26.

Therapeutic order.

"Therapeutic order" means deleted text beginandeleted text endnew text begin a written or verbalnew 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 beginTherapeutic 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. 5.

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 beginVerbal
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. 6.

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 endThe 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 endAll 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.

Sec. 7.

Minnesota Statutes 2018, section 147A.03, subdivision 1, is amended to read:


Subdivision 1.

Protected titles.

No individual may use the titles "Minnesota Licensed
Physician Assistant," "Licensed Physician Assistant," new text begin"Licensed Physician Associate,"
new text end "Physician Assistant,"new text begin "Physician Associate,"new text end or "PA" in connection with the individual's
name, or any other words, letters, abbreviations, or insignia indicating or implying that the
individual is licensed by the state unless they have been licensed according to this chapter.

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 endPhysician 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 2018, section 147A.06, is amended to read:


147A.06 CANCELLATION OF LICENSE FOR NONRENEWAL.

The board shall not renew, reissue, reinstate, or restore a license that has lapsed deleted text beginon or
after July 1, 1996,
deleted text end and has not been renewed within two annual renewal cycles deleted text beginstarting 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.

Sec. 11.

new text begin [147A.095] SCOPE OF PRACTICE.
new text end

new text begin (a) The scope of practice for a physician assistant means the provision of care including:
new text end

new text begin (1) health promotion, disease prevention, health education, and counseling;
new text end

new text begin (2) interpreting and evaluating patient data;
new text end

new text begin (3) providing health assessment and screening activities;
new text end

new text begin (4) diagnosing, treating, and facilitating patients' management of their acute and chronic
illnesses and diseases;
new text end

new text begin (5) ordering, performing, supervising, and interpreting diagnostic procedures and studies;
new text end

new text begin (6) prescribing pharmacologic and nonpharmacologic therapies;
new text end

new text begin (7) prescribing, administering, and dispensing drugs, controlled substances, and medical
devices; and
new text end

new text begin (8) assisting in surgery.
new text end

new text begin (b) The scope of practice for a physician assistant requires the physician assistant to be
accountable:
new text end

new text begin (1) to patients for the quality of the care rendered;
new text end

new text begin (2) for recognizing limits of knowledge and experience; and
new text end

new text begin (3) for planning for the management of situations beyond the physician assistant's
expertise.
new text end

new text begin (c) The scope of practice for a physician assistant includes accepting referrals from,
consulting with, collaborating with, or referring to other health care providers as warranted
by the needs of the patient.
new text end

new text begin (d) A physician assistant must, at the practice level, have proof of review of the physician
assistant's medical practice by a licensed physician, on at least an annual basis. Proof of the
review must be maintained at the practice level and available for submission to the board,
if requested.
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 endnew text begin (8)new text end engaging in the practice of medicine beyond that allowed deleted text beginby the
physician-physician assistant delegation agreement
deleted text endnew text begin under this chapternew 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 endadjudication 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 endnew 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 endnew 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 endnew 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 endnew text begin (13)new text end any identification of a physician assistant by the title "Physiciandeleted 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 endnew 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 endnew 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 endnew text begin (16)new text end becoming addicted or habituated to a drug or intoxicant;

deleted text begin (18)deleted text endnew 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 endnew 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 endnew 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 endnew 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;new text begin or
new text end

deleted text begin (22)deleted text endnew 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 2deleted text begin; ordeleted text endnew text begin.
new text end

deleted text begin (23) 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

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 beginphysician-patientdeleted text endnew text begin provider-patientnew text end
relationship if the patient is a physician assistant, and the treating deleted text beginphysiciandeleted text endnew text begin providernew 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 beginimposedeleted text endnew text begin imposingnew text end retraining or
rehabilitation requirements; deleted text beginrequire practice under additional supervision;deleted text end or deleted text begincondition
continued
deleted text endnew text begin limitingnew text end practice deleted text beginondeleted text endnew text begin untilnew 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 endnew 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 credentialdeleted 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 2018, 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 beginordeleted text end licensed
advanced practice registered nursenew text begin, or licensednew text enddeleted text begin. For purposes of sections 151.15, subdivision
4
; 151.252, subdivision 3; 151.37, subdivision 2, paragraphs (b), (e), and (f); and 151.461,
"practitioner" also means a
deleted text end physician assistant deleted text beginauthorized to prescribe, dispense, and
administer under chapter 147A
deleted text end. For purposes of sections 151.15, subdivision 4; 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 beginREPEALER.
new text end

new text begin Minnesota Statutes 2018, sections 147A.01, subdivisions 11, 16a, 17a, 23, 24, and 25;
147A.04; 147A.09; 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, 2019.
new text end

APPENDIX

Repealed Minnesota Statutes: 19-3104

147A.01 DEFINITIONS.

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. 23.

Supervising physician.

"Supervising physician" means a Minnesota licensed physician who accepts full medical responsibility for the performance, practice, and activities of a physician assistant under an agreement as described in section 147A.20.

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.09 SCOPE OF PRACTICE, DELEGATION.

Subdivision 1.

Scope of practice.

Physician assistants shall practice medicine only 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.

Patient service must be limited to:

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

(2) services customary to the practice of the supervising physician or alternate supervising physician;

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

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

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.

Subd. 2.

Delegation.

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

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

(2) performing physical examinations;

(3) interpreting and evaluating patient data;

(4) ordering or performing diagnostic procedures, including the use of radiographic imaging systems in compliance with Minnesota Rules 2007, chapter 4732;

(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) assisting the supervising physician in patient care in the home and in health care facilities;

(8) creating and maintaining appropriate patient records;

(9) transmitting or executing specific orders at the direction of the supervising physician;

(10) prescribing, administering, and dispensing drugs, controlled substances, and medical devices 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;

(11) 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;

(12) 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;

(13) initiating evaluation and treatment procedures essential to providing an appropriate response to emergency situations;

(14) certifying a patient's eligibility for a disability parking certificate under section 169.345, subdivision 2;

(15) assisting at surgery; and

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

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.

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.