SENATE DOCKET, NO. 450        FILED ON: 1/15/2023

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1354

The Commonwealth of Massachusetts

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PRESENTED BY:

Julian Cyr

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act relative to removing barriers to care for physician assistants.

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PETITION OF:

SENATE DOCKET, NO. 450        FILED ON: 1/15/2023

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1354

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 740 OF 2021-2022.]

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Third General Court
(2023-2024)

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An Act relative to removing barriers to care for physician assistants.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Chapter 94C of the General Laws, as appearing in the 2020 Official Edition, is hereby amended in section 7 by striking in section (g) the following, “pursuant to guidelines mutually developed and agreed upon by the supervising physician and the physician assistant,” and by further striking in the second sentence the following, “the board of registration in medicine”.

SECTION 2. Chapter 112 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended in section 9E by striking in line 2 the following: “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.” and inserting instead thereof, “…when such services are within the education, training and experience of the physician assistant and which the physician assistant is competent to perform.”

SECTION 3. Said Chapter 112 of the General Laws, as appearing in the 2018 Official Edition, is hereby further amended in section 9E by striking in the second paragraph the following: “as determined by a supervising physician” and further striking from the same paragraph the following: “...in assisting physicians in private practice, in group practices or in health care facilities, consistent with any applicable bylaws and policies of such facilities.”

SECTION 4. Said Chapter 112 of the General Laws, as appearing in the 2020 Official Edition, is hereby further amended in section 9E by striking in the fourth and fifth paragraph the following: “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.” and inserting instead thereof the following, “"The legal responsibility of the physician assistant shall remain that of the individual physician assistant, employing physician, group of physicians, or healthcare facility as part of the healthcare team responsible for the care and treatment of the patient"

SECTION 5. Said Chapter 112 of the General Laws, as appearing in the 2020 Official Edition, is hereby further amended in section 9E by adding the following paragraphs: “A Physician Assistant must practice for at least 2,000 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. A collaborative agreement is a mutually agreed upon plan for the overall working relationship between the physician assistant and one or more physicians that designates the scope of collaboration necessary to manage the care of patients. The physician assistant and collaborating physician(s) must have experience in providing care to patients with the same or similar medical problems. Nothing in this section shall allow a physician assistant to open their own practice and practice independently. Notwithstanding any other provisions of law, a physician assistant may bill separately for services rendered.”

SECTION 6. Said Chapter 112 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended in section 9F by striking in the third paragraph the following: “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”

SECTION 7. Said Chapter 112 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended in section 9I by striking in the third paragraph the following: “and the name and address of any supervising physician.”

SECTION 8. Said Chapter 112 of the General Laws, as appearing in the 2020 Official Edition, is hereby further amended in section 9I by striking in the fourth paragraph the following: “change of supervising physician.”

SECTION 9.  Said Chapter 112 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended in section 12B by striking in line 3 the following: “or supervising”.