Be it enacted by the Senate and House of Representatives
in General Court assembled, and by the authority of the same,
SECTION 1. Chapter 13 of the General Laws is hereby amended by inserting after section 10A, as appearing in the 1988 Official Edition, the following section:-
Section 10B. There shall be within the division of registration in the executive office of consumer affairs and business regulation a board of registration of physician assistants, herein called the board, to consist of nine members who are residents of the commonwealth, who shall be appointed by the governor, two of whom shall be licensed physicians who shall have been actively engaged in the practice of medicine for at least three years and at least one of whom shall be a member of the Massachusetts Medical Society; one of whom shall be an educator of physician assistants on the faculty or staff of an accredited physician assistant training program; four of whom shall be physician assistants duly certified in the commonwealth who may be selected from a list of names submitted by the Massachusetts Association of Physician Assistants or comparable organization representing physician assistants and two of whom shall be representatives of the general public.
Members shall be appointed for a term of three years. No member shall be appointed to more than two consecutive full terms; provided, however, that a member appointed for less than a full term may serve two full terms in addition to such part of a full term and a former member shall again be eligible for appointment after a lapse of one or more years. Any member of the board may be removed by the governor for neglect of duty, misconduct or malfeasance or misfeasance in office after being given a written statement of the charges against him and sufficient opportunity to be heard thereon.
Said board shall elect its chairperson annually and shall meet at the call of such chairperson or upon the request of two or more members of the board. A quorum shall consist of at least five members present. Board members shall serve without compensation but shall be reimbursed for actual and reasonable expenses incurred in the performance of their duties. The board shall meet at least four times annually.
SECTION 2. Chapter 112 of the General Laws is hereby amended by striking out sections 9C to 9H, inclusive, as so appearing, and inserting in place thereof the following nine sections:-
Section 9C. As used in sections nine C to nine K, inclusive, the following words shall have the following meanings:
"Approved program", a program for the education and training of physician assistants approved by the board.
"Board", the board of registration of physician assistants.
"Health care facility", any hospital, nursing home, extended care facility, state health or mental institution, clinic, physician's office or health maintenance organization licensed or otherwise operating legally within the commonwealth.
"Physician assistant", a person who is duly registered by the board.
"Physician assistant trainee", a person enrolled in an approved program.
Section 9D. The provisions of sections nine C to nine K, inclusive, shall not apply to services performed in any of the following areas:
(a) The practice of dentistry or dental hygiene as defined in sections fifty and fifty-one.
(b) The practice of manipulative therapy or chiropractic.
(c) The measurement of the powers or range of human vision or the determination of the accommodation and refractive states of the human eye or the scope of its functions in general or the fitting or adaptation of lenses or frames for the aid thereof.
(d) The prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training or orthoptics.
(e) The prescribing of contact lenses for, or the fitting or adaptation of contact lenses to, the human eye.
(f) The practice of podiatry as defined in section thirteen.
Nothing in clauses (c), (d), or (e) shall preclude the performance of routine visual screening by a physician assistant.
The provisions of sections nine C to nine K, inclusive, shall not apply to the practice of ophthalmology or to the use of trained assistants by ophthalmologists.
Section 9E. Notwithstanding any other provisions of law, a physician assistant may perform medical services when such services are rendered under the supervision of a registered physician. Such supervision shall be continuous but shall not require the personal presence of the supervising physician or physicians. A registered physician shall supervise no more than two physician assistants at any one time.
Physician assistants, depending upon their level of professional training and experience as determined by a supervising physician, may perform medical services of a general nature and may order tests and therapeutics in assisting physicians in private practice, in group practices or in health care facilities, consistent with any applicable bylaws and policies of such facilities.
A physician assistant may, for patients in long term care facilities or for chronic patients in home care settings where the individual would otherwise require institutionalization, order therapeutics and tests and issue written prescriptions subject to paragraph (g) of section seven of chapter ninety-four C. Any prescription of medication made by a physician assistant must include the name of the supervising physician.
If a physician assistant is employed by a physician or group of physicians, the assistant shall be supervised by and shall be the legal responsibility of the employing physician or physicians. The legal responsibility of such assistant shall remain that of the employing physician or physicians at all times including occasions when the assistant, under the direction and supervision of the employing physician or physicians, aids in the care and treatment of patients in health care facilities.
If a physician assistant is employed by a health care facility, the legal responsibility for his actions and omissions shall be that of the employing facility. Such physician assistants shall be supervised by registered physicians. Such physician assistants employed by health care facilities shall not be utilized as the sole medical personnel in charge of emergency or outpatient services or any other clinical service where a physician is not regularly available.
Notwithstanding any other provisions of law, a physician assistant trainee may perform medical services when such services are rendered within the scope of a program approved under section nine K.
Section 9F. The board shall register and issue certificates of registration to physician assistants in the commonwealth, take appropriate disciplinary action against physician assistants, approve and issue certificates of approval of programs for the training of physician assistants and maintain a current roster of persons serving as physician assistants in the commonwealth as well as a list of approved training programs.
The board shall adopt, amend and rescind such rules and regulations, not inconsistent with other provisions of the General Laws, as it deems necessary to carry out the provisions of this chapter. The board may, in consultation with the board of registration in medicine, and consistent with the authority of the board of registration in medicine over the supervising physician and the practice of medicine, adopt rules and regulations governing the practice and employment of physician assistants in order to promote the public health, safety and welfare.
Section 9G. The board shall keep a record of the names and addresses of all persons registered by it and all programs approved by it and a duplicate thereof shall be open to inspection in the office of the state secretary. The board shall make an annual report on the status of physician assistants in the commonwealth to the governor and the general court.
Section 9H. The board shall investigate all complaints relating to the proper practice of any physician assistant holding a certificate of registration under sections nine C to nine K, inclusive, and all complaints relating to any violation of said sections.
The board may, after a hearing pursuant to chapter thirty A, revoke, suspend or cancel the certificate of registration or reprimand, censure or otherwise discipline a physician assistant registered under said sections nine C to nine K, inclusive upon proof satisfactory to a majority of the board that said physician assistant:
(a) fraudulently procured said certificate of registration;
(b) is guilty of an offense against any provision of the laws of the commonwealth relating to the authorized practice of physician assistants or any rule or regulation adopted thereunder;
(c) is guilty of gross misconduct in practicing as a physician assistant or of practicing fraudulently or beyond the scope of authorized physician assistant practice or with gross incompetence or with gross negligence on a particular occasion or negligence on repeated occasions;
(d) is guilty of practicing as a physician assistant while the ability to practice is impaired by alcohol, drugs, physical disability or mental instability;
(e) is guilty of being habitually intoxicated or being or having been within the past two years addicted to, dependent on or a habitual user of narcotics, barbituates, amphetamines, hallucinogens or other drugs having similar effects;
(f) is guilty of knowingly permitting, aiding or abetting an unlicensed person to perform activities requiring a license for purposes of fraud, deception or personal gain, excluding activities permissible under any provision of the laws of the commonwealth relative to the training of medical providers in authorized health care institutions and facilities;
(g) has been convicted of a criminal offense which reasonably calls into question his ability to practice as a physician assistant;
(h) is guilty of violating any rule or regulation of the board governing the practice of physician assistants.
No person filing a complaint or reporting or providing information pursuant to this section or assisting the board at its request in any manner in discharging its duties and functions shall be liable in any cause of action arising out of the receiving of such information or assistance; provided, however, that the person making the complaint or reporting or providing such information or assistance does so in good faith and without malice. The board shall keep confidential any complaint, report, record or other information received or kept by the board in connection with an investigation conducted by the board pursuant to this section; and provided, further, that, except to the extent that disclosures of records or other information may be restricted as otherwise provided by law or by the board's regulations, investigative records or information of the board shall not be kept confidential after the board has disposed of the matter under investigation by issuing an order to show cause, by dismissing a complaint or by taking other final action nor shall the requirement that investigative records or information be kept confidential, at any time, apply to requests from the person under investigation, the complainant or other state or federal agencies, boards or institutions as the board shall determine by regulation.
Section 9I. All persons serving as physician assistants in the commonwealth shall register with the board by July first, nineteen hundred and ninety and every two years thereafter. Applications for registration shall be submitted in accordance with procedures established by the board.
Each applicant shall furnish the board with satisfactory proof of graduation from a training program approved by the board, having received a bachelor's degree from an accredited college or university or an equivalent approved by the board, and having passed the certifying examination of the National Commission on Certification of Physician Assistants or other such certifying examination as specified or administered by the board. Persons practicing as physician assistants on January first, nineteen hundred and ninety shall be exempt from the requirement of a bachelor's degree. Subject to such rules and regulations as the board may prescribe, an applicant who otherwise meets the qualifications for registration may, while awaiting the results of the certification examination, practice as a physician assistant. An applicant failing such examination shall be entitled to a re-examination within two years of graduation and to practice as a physician assistant until notified of the results of said examination. Thereafter, an applicant may not practice as a physician assistant without having passed the certification examination.
Each application shall be accompanied by payment of a license fee to be determined by the commissioner of administration under the provisions of section three B of chapter seven. An applicant shall submit such proof as required by the board as to the applicant's good moral character. Each applicant shall provide the board with a current office address and the name and address of any supervising physician.
Every physician assistant shall register biennially with the board. A physician assistant seeking to re-register shall satisfy those requirements of continuing education established by the board by rule and regulation. A registered physician assistant shall promptly notify the board of any change in employment, change of supervising physician or departure from the commonwealth.
Section 9J. Whoever, not being lawfully registered as a physician assistant in the commonwealth in accordance with sections nine C to nine K, inclusive, holds himself out as a physician assistant or uses the title of physician assistant or whoever impersonates another physician assistant or whoever practices or attempts to practice any fraud in connection with the filing of an application or whoever files an application under a false or assumed name or under a name other than his own or whoever impersonates or attempts to impersonate another applicant for registration during an examination, shall be punished by a fine of not less than two hundred dollars. The board may also bring a petition in superior court to enjoin such actions or any other violation of this chapter or regulations of the board.
Section 9K. The board shall issue certificates of approval of programs for the education and training of physician assistants which meet the standards established by the board. The board, in developing criteria for approved programs and in approving such programs may accept as approved programs those that have been certified by a nationally recognized accrediting agency or organization.
The board shall adopt regulations concerning the quality of education and clinical training to be received by a physician assistant trainee and the supervision of a physician assistant trainee.
The board shall encourage the development of continuing education for physician assistants and shall have the authority to adopt rules and regulations as to the type and amount of continuing education required for recertification. The board may periodically review the quality of the curriculum, faculty and the facilities of approved programs.