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147A.20 PHYSICIAN AND PHYSICIAN ASSISTANT AGREEMENT.
(a) A physician assistant and supervising physician must sign an agreement which specifies
scope of practice and amount and manner of supervision as required by the board. The agreement
must contain:
(1) a description of the practice setting;
(2) a statement of practice type/specialty;
(3) a listing of categories of delegated duties;
(4) a description of supervision type, amount, and frequency; and
(5) 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 an internal protocol and delegation form. 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 agreement,
delegation form, and internal protocol at the address of record. Copies shall be provided to the
board upon request.
(c) Physician assistants must provide written notification to the board within 30 days of
the following:
(1) name change;
(2) address of record change;
(3) telephone number of record change; and
(4) addition or deletion of alternate supervising physician provided that the information
submitted includes, for an additional alternate physician, an affidavit of consent to act as an
alternate supervising physician signed by the alternate supervising physician.
(d) Modifications requiring submission prior to the effective date are changes to the practice
setting description which include:
(1) supervising physician change, excluding alternate supervising physicians; or
(2) delegation of prescribing, administering, or dispensing of legend drugs, controlled
substances, or medical devices.
(e) The agreement must be completed and the practice setting description submitted to the
board before providing medical care as a physician assistant.
History: 1995 c 205 art 1 s 19; 2001 c 49 s 2; 2004 c 279 art 2 s 3

Official Publication of the State of Minnesota
Revisor of Statutes