1.1                          A bill for an act 
  1.2             relating to health; changing the frequency with which 
  1.3             physician assistant delegated prescribing activities 
  1.4             must be reviewed; amending Minnesota Statutes 2000, 
  1.5             sections 147A.18, subdivision 1; and 147A.20. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Minnesota Statutes 2000, section 147A.18, 
  1.8   subdivision 1, is amended to read: 
  1.9      Subdivision 1.  [DELEGATION.] (a) A supervising physician 
  1.10  may delegate to a physician assistant who is registered with the 
  1.11  board, certified by the National Commission on Certification of 
  1.12  Physician Assistants or successor agency approved by the board, 
  1.13  and who is under the supervising physician's supervision, the 
  1.14  authority to prescribe, dispense, and administer legend drugs, 
  1.15  medical devices, and controlled substances subject to the 
  1.16  requirements in this section.  The authority to dispense 
  1.17  includes, but is not limited to, the authority to request, 
  1.18  receive, and dispense sample drugs.  This authority to dispense 
  1.19  extends only to those drugs described in the written agreement 
  1.20  developed under paragraph (b). 
  1.21     (b) The agreement between the physician assistant and 
  1.22  supervising physician and any alternate supervising physicians 
  1.23  must include a statement by the supervising physician regarding 
  1.24  delegation or nondelegation of the functions of prescribing, 
  1.25  dispensing, and administering of legend drugs and medical 
  2.1   devices to the physician assistant.  The statement must include 
  2.2   a protocol indicating categories of drugs for which the 
  2.3   supervising physician delegates prescriptive and dispensing 
  2.4   authority.  The delegation must be appropriate to the physician 
  2.5   assistant's practice and within the scope of the physician 
  2.6   assistant's training.  Physician assistants who have been 
  2.7   delegated the authority to prescribe, dispense, and administer 
  2.8   legend drugs and medical devices shall provide evidence of 
  2.9   current certification by the National Commission on 
  2.10  Certification of Physician Assistants or its successor agency 
  2.11  when registering or reregistering as physician assistants.  
  2.12  Physician assistants who have been delegated the authority to 
  2.13  prescribe controlled substances must present evidence of the 
  2.14  certification and hold a valid DEA certificate.  Supervising 
  2.15  physicians shall retrospectively review, on a daily basis, the 
  2.16  prescribing, dispensing, and administering of legend and 
  2.17  controlled drugs and medical devices by physician assistants, 
  2.18  when this authority has been delegated to the physician 
  2.19  assistant as part of the delegation agreement between the 
  2.20  physician and the physician assistant.  During each daily 
  2.21  review, the supervising physician shall document by signature 
  2.22  and date that the prescriptive, administering, and dispensing 
  2.23  practice of the physician assistant has been reviewed.  This 
  2.24  review must take place at least weekly.  The process and 
  2.25  schedule for the review must be outlined in the delegation 
  2.26  agreement. 
  2.27     (c) The board may establish by rule: 
  2.28     (1) a system of identifying physician assistants eligible 
  2.29  to prescribe, administer, and dispense legend drugs and medical 
  2.30  devices; 
  2.31     (2) a system of identifying physician assistants eligible 
  2.32  to prescribe, administer, and dispense controlled substances; 
  2.33     (3) a method of determining the categories of legend and 
  2.34  controlled drugs and medical devices that each physician 
  2.35  assistant is allowed to prescribe, administer, and dispense; and 
  2.36     (4) a system of transmitting to pharmacies a listing of 
  3.1   physician assistants eligible to prescribe legend and controlled 
  3.2   drugs and medical devices. 
  3.3      Sec. 2.  Minnesota Statutes 2000, section 147A.20, is 
  3.4   amended to read: 
  3.5      147A.20 [PHYSICIAN AND PHYSICIAN ASSISTANT AGREEMENT.] 
  3.6      (a) A physician assistant and supervising physician must 
  3.7   sign an agreement which specifies scope of practice and amount 
  3.8   and manner of supervision as required by the board.  The 
  3.9   agreement must contain: 
  3.10     (1) a description of the practice setting; 
  3.11     (2) a statement of practice type/specialty; 
  3.12     (3) a listing of categories of delegated duties; and 
  3.13     (4) a description of supervision type, amount, and 
  3.14  frequency; and 
  3.15     (5) a description of the process and schedule for review of 
  3.16  prescribing, dispensing, and administering legend and controlled 
  3.17  drugs and medical devices by the physician assistant authorized 
  3.18  to prescribe.  
  3.19     (b) The agreement must be maintained by the supervising 
  3.20  physician and physician assistant and made available to the 
  3.21  board upon request.  If there is a delegation of prescribing, 
  3.22  administering, and dispensing of legend drugs, controlled 
  3.23  substances, and medical devices, the agreement shall include an 
  3.24  internal protocol and delegation form.  Physician assistants 
  3.25  shall have a separate agreement for each place of employment.  
  3.26  Agreements must be reviewed and updated on an annual basis.  The 
  3.27  supervising physician and physician assistant must maintain the 
  3.28  agreement, delegation form, and internal protocol at the address 
  3.29  of record.  Copies shall be provided to the board upon request. 
  3.30     (c) Physician assistants must provide written notification 
  3.31  to the board within 30 days of the following: 
  3.32     (1) name change; 
  3.33     (2) address of record change; 
  3.34     (3) telephone number of record change; and 
  3.35     (4) addition or deletion of alternate supervising physician 
  3.36  provided that the information submitted includes, for an 
  4.1   additional alternate physician, an affidavit of consent to act 
  4.2   as an alternate supervising physician signed by the alternate 
  4.3   supervising physician. 
  4.4      (d) Modifications requiring submission prior to the 
  4.5   effective date are changes to the practice setting description 
  4.6   which include: 
  4.7      (1) supervising physician change, excluding alternate 
  4.8   supervising physicians; or 
  4.9      (2) delegation of prescribing, administering, or dispensing 
  4.10  of legend drugs, controlled substances, or medical devices.