PA history made in Maine: LD 1660

[PolakPA]

Per new law:

Collaborative agreement requirements. A physician assistant with less than 4000 hours of clinical practice documented to the board shall work in accordance with a written
collaborative agreement with an active physician that describes the physician assistant’s scope of practice, except that a physician assistant working in a physician group practice setting or a health care facility setting under a credentialing and privilege plan and scope of practice agreement may use that credentialing and privilege plan and scope of practice agreement in lieu of a collaborative agreement. A physician assistant is legally responsible and assumes legal liability for any medical service provided by the physician assistant in accordance with the physician assistant’s scope of practice under subsection 2 and a collaborative agreement under this subsection. Under a collaboration agreement, collaboration may occur through electronic means and does not require the physical presence of the physician at the time or place that the medical services are provided. A physician assistant shall submit the collaborative agreement, or, if appropriate, the scope of practice agreement, to the board for approval and the agreement must be kept on file at the main location of the place of practice and be made available to the board or the board's representative upon request. Upon submission of documentation for 4000 hours of clinical practice to the board, a physician assistant is no longer subject to this requirement.

Practice agreement requirements. A physician assistant who has more than
4000 hours of clinical practice may be the principal clinical provider in a practice that does not include a physician partner as long as the physician assistant has a practice agreement with an active physician or physicians, and other health professionals as necessary, that describes the physician assistant’s scope of practice. A physician assistant is legally responsible and assumes legal liability for any medical service provided by the physician assistant in accordance with the physician assistant’s scope of practice under subsection 2 and a practice agreement under this subsection. A physician assistant shall submit the practice agreement to the board for approval and the agreement must be kept on file at the main location of the physician assistant's practice and be made available to the board or the board's representative upon request. Upon any change in the parties to the practice agreement or other substantive change in the practice agreement, the physician assistant shall submit the revised practice agreement to the board for approval. Under a practice agreement, consultation may occur through electronic means and does not require the physical presence of the physician, physicians or other health care providers who are parties to the agreement at the time or place that the medical services are provided.

[LT_Oneal_PAC]

2 hours ago, PolakPA said:

Per new law:

Collaborative agreement requirements. A physician assistant with less than 4000 hours of clinical practice documented to the board shall work in accordance with a written
collaborative agreement with an active physician that describes the physician assistant’s scope of practice, except that a physician assistant working in a physician group practice setting or a health care facility setting under a credentialing and privilege plan and scope of practice agreement may use that credentialing and privilege plan and scope of practice agreement in lieu of a collaborative agreement. A physician assistant is legally responsible and assumes legal liability for any medical service provided by the physician assistant in accordance with the physician assistant’s scope of practice under subsection 2 and a collaborative agreement under this subsection. Under a collaboration agreement, collaboration may occur through electronic means and does not require the physical presence of the physician at the time or place that the medical services are provided. A physician assistant shall submit the collaborative agreement, or, if appropriate, the scope of practice agreement, to the board for approval and the agreement must be kept on file at the main location of the place of practice and be made available to the board or the board's representative upon request. Upon submission of documentation for 4000 hours of clinical practice to the board, a physician assistant is no longer subject to this requirement.

Practice agreement requirements. A physician assistant who has more than
4000 hours of clinical practice may be the principal clinical provider in a practice that does not include a physician partner as long as the physician assistant has a practice agreement with an active physician or physicians, and other health professionals as necessary, that describes the physician assistant’s scope of practice. A physician assistant is legally responsible and assumes legal liability for any medical service provided by the physician assistant in accordance with the physician assistant’s scope of practice under subsection 2 and a practice agreement under this subsection. A physician assistant shall submit the practice agreement to the board for approval and the agreement must be kept on file at the main location of the physician assistant's practice and be made available to the board or the board's representative upon request. Upon any change in the parties to the practice agreement or other substantive change in the practice agreement, the physician assistant shall submit the revised practice agreement to the board for approval. Under a practice agreement, consultation may occur through electronic means and does not require the physical presence of the physician, physicians or other health care providers who are parties to the agreement at the time or place that the medical services are provided.

 

[PAinPenna]

Looks like Iowa loosened restrictions as well ! 

[LT_Oneal_PAC]

4 hours ago, PAinPenna said:

Looks like Iowa loosened restrictions as well ! 

Iowa finally has full prescriptive authority, but supervision remains relatively unchanged. Also received ability to direct bill medicaid. It has a long way to as far as supervision rules.

[PAinPenna]

Well at least they got somewhere ...

[dfw6er]

13 hours ago, PolakPA said:

Per new law:

Collaborative agreement requirements. A physician assistant with less than 4000 hours of clinical practice documented to the board shall work in accordance with a written
collaborative agreement with an active physician that describes the physician assistant’s scope of practice, except that a physician assistant working in a physician group practice setting or a health care facility setting under a credentialing and privilege plan and scope of practice agreement may use that credentialing and privilege plan and scope of practice agreement in lieu of a collaborative agreement. A physician assistant is legally responsible and assumes legal liability for any medical service provided by the physician assistant in accordance with the physician assistant’s scope of practice under subsection 2 and a collaborative agreement under this subsection. Under a collaboration agreement, collaboration may occur through electronic means and does not require the physical presence of the physician at the time or place that the medical services are provided. A physician assistant shall submit the collaborative agreement, or, if appropriate, the scope of practice agreement, to the board for approval and the agreement must be kept on file at the main location of the place of practice and be made available to the board or the board's representative upon request. Upon submission of documentation for 4000 hours of clinical practice to the board, a physician assistant is no longer subject to this requirement.

Practice agreement requirements. A physician assistant who has more than
4000 hours of clinical practice may be the principal clinical provider in a practice that does not include a physician partner as long as the physician assistant has a practice agreement with an active physician or physicians, and other health professionals as necessary, that describes the physician assistant’s scope of practice. A physician assistant is legally responsible and assumes legal liability for any medical service provided by the physician assistant in accordance with the physician assistant’s scope of practice under subsection 2 and a practice agreement under this subsection. A physician assistant shall submit the practice agreement to the board for approval and the agreement must be kept on file at the main location of the physician assistant's practice and be made available to the board or the board's representative upon request. Upon any change in the parties to the practice agreement or other substantive change in the practice agreement, the physician assistant shall submit the revised practice agreement to the board for approval. Under a practice agreement, consultation may occur through electronic means and does not require the physical presence of the physician, physicians or other health care providers who are parties to the agreement at the time or place that the medical services are provided.

So what does the bolded section mean, exactly?  Does the wording leave an opening to allow the NPs to push through legislation making them the "other health professionals" that Maine PAs must have a practice agreement with?

[LT_Oneal_PAC]

48 minutes ago, dfw6er said:

So what does the bolded section mean, exactly?  Does the wording leave an opening to allow the NPs to push through legislation making them the "other health professionals" that Maine PAs must have a practice agreement with?

I read it as it could even be a specialty PA. If you read through the whole document though, it specifically notes in certain areas that a physician must always be available to consult with.

https://www.mainepa.com/resources/Documents/2020AnnualMtg/Presentation 2020/LD 1660 final draft amendment 2.20.20.pdf

 

Of note, this legislation does a lot more too. It also increases the number on f PAs on the osteopathic and medicine boards to 2 from 1, and that scope of practice is determined by training and practice setting. Pretty awesome piece of legislation. The dominoes are falling.

[EMEDPA]

This is awesome, but not that different than the NC regulations, right?

[LT_Oneal_PAC]

https://ncapa.org/resources/documentation/
@EMEDPA

I think it’s way better than NC.

[KpsPac]

6 hours ago, dfw6er said:

So what does the bolded section mean, exactly?  Does the wording leave an opening to allow the NPs to push through legislation making them the "other health professionals" that Maine PAs must have a practice agreement with?

Exactly what I thought the minute I read it....... 3 years ago, no one (PAs) would believe we would be losing our jobs to NPs. This is definitely a loophole. 

We need to start adding our education to all these tweets, posts, and insta posts!!! 

[Jerobe]

Can someone briefly explain the change and how this is beneficial compared to what was? From my reading, I understand it to say PAs with more than 4000 hrs of experience still need a practice or collaboration agreement with a physician I order to practice. How does this differ than before?

[deltawave]

20 hours ago, KpsPac said:

 We need to start adding our education to all these tweets, posts, and insta posts!!! 

How would you do that succinctly?

[Guillaw]

5 hours ago, Jerobe said:

Can someone briefly explain the change and how this is beneficial compared to what was? From my reading, I understand it to say PAs with more than 4000 hrs of experience still need a practice or collaboration agreement with a physician I order to practice. How does this differ than before?

I think the following explanation is much more clear (From the AAPA website):

On March 18, Maine Gov. Janet Mills signed LD 1660, an Act to Improve Access to Physician Assistant Care. The bill has been the Maine Association of PAs top legislative priority for the last two years. It was passed by the legislature on Tuesday, March 17, when only legislation that could help address the public health crisis of COVID-19 in Maine was under consideration before the legislature adjourned indefinitely.

The legislation makes numerous improvements to PA practice in Maine. Among the changes, LD 1660:

• Removes the term “supervision” from Maine law.
• Requires PAs with less than 4,000 hours of practice to practice in a collaborative agreement with a physician.
• Allows a majority of PAs with more than 4,000 hours to practice without a written agreement. A physician must simply be available for consultation. (PAs who are the principal provider in a practice that does not include a physician partner must have a practice agreement with a physician).
• Adds a second PA to the Maine Board of Licensure in Medicine (allopathic) and the Maine Board of Osteopathic Licensure. The boards now consist of six physicians, three public members, and two PAs.
• Makes PAs responsible for the care they provide.
• Authorizes PAs to be eligible for direct payment.
• Eliminates the requirement that a PA receive a certificate of registration (in addition to a license) prior to practicing.

“This is a groundbreaking moment in Maine PA history, and it occurs just as we enter into an unprecedented public health emergency,” said MEAPA President Gretchen Preneta, PA-C. “We hope that our success will pave the way for other states to achieve similar victories, particularly at this time when we all need to be able to practice medicine to the full extent of our education and training.”