2013 -- S 0281

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LC01094

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2013

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A N A C T

RELATING TO BUSINESSES AND PROFESSIONS - PHYSICIAN ASSISTANTS

     Introduced By: Senators Ottiano, Algiere, Hodgson, Nesselbush, and Sosnowski

     Date Introduced: February 12, 2013

     Referred To: Senate Health & Human Services

It is enacted by the General Assembly as follows:

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     SECTION 1. Sections 5-54-2 and 5-54-7 of the General Laws in Chapter 5-54 entitled

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"Physician Assistants" are hereby amended to read as follows:

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     5-54-2. Definitions. -- As used in this chapter, the following words have the following

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meanings:

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      (1) "Administrator" means the administrator, division of professional regulation.

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      (2) "Approved program" means a program for the education and training of physician

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assistants formally approved by the American Medical Association's (A.M.A.'s) Committee on

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Allied Health, Education and Accreditation, its successor, the Commission on Accreditation of

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Allied Health Education Programs (CAAHEP) or its successor.

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      (3) "Approved program for continuing medical education" means a program for

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continuing education approved by the American Academy of Physician Assistants (AAPA) or the

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Accreditation Council for Continuing Medical Education of the American Medical Association

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(AMA), or the American Academy of Family Physicians (AAPFP) or the American Osteopathic

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Association Committee on Continuing Medical Education (AOACCME) or any other board

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approved program.

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      (4) "Board" means the board of licensure of physician assistants.

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      (5) "Director" means the director of the department of health.

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      (6) "Division" means the division of professional regulation, department of health.

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      (7) "Formulary committee" means a committee empowered to develop a list of

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medications that physician assistants may prescribe.

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      (8) "Physician" means a person licensed under the provisions of chapter 29 or 37 of this

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title.

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      (9) "Physician assistant" means a person who is qualified by academic and practical

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training to provide those certain patient services under the supervision, control, responsibility and

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direction of a licensed physician.

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      (10) "Supervision" means overseeing the activities of, and accepting the responsibility

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for the medical services rendered by the physician assistants. Supervision is continuous, and

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under the direct control of a licensed physician expert in the field of medicine in which the

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physician assistants practice. The constant physical presence of the supervising physician or

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physician designee is not required. It is the responsibility of the supervising physician and

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physician assistant to assure an appropriate level of supervision depending on the services being

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rendered. Each physician or group of physicians, or other health care delivery organization

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excluding licensed hospital or licensed health care facilities controlled or operated by a licensed

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hospital employing physician assistants must have on file at the primary practice site a copy of a

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policy in the form of an agreement between the supervising physicians and physician assistants

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delineating:

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      (i) The level of supervision provided by the supervising physician or designee with

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particular reference to differing levels of supervision depending on the type of patient services

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provided and requirements for communication between the supervising physician or designee and

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the physician assistant.

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      (ii) A job description for the physician assistant listing patient care responsibilities and

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procedures to be performed by the physician assistant.

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      (iii) A program for quality assurance for physician assistant services including

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requirements for periodic review of the physician assistant services.

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      (iv) Requirements for supervision of physician assistants employed or extended medical

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staff privileges by licensed hospitals or other licensed health care facilities or employed by other

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health care delivery agencies shall be delineated by the medical staff by laws and/or applicable

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governing authority of the facility.

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      (v) The supervising physician or physician designee must be available for easy

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communication and referral at all times.

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      (11) "Unprofessional conduct" includes, but is not limited to, the following items or any

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combination and may be defined by regulations established by the board with prior approval of

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the director:

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      (i) Fraudulent or deceptive procuring or use of a license;

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      (ii) Representation of himself or herself as a physician;

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      (iii) Conviction of a crime involving moral turpitude; conviction of a felony; conviction

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of a crime arising out of the practice of medicine. All advertising of medical business, which is

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intended or has a tendency to deceive the public;

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      (iv) Abandonment of a patient;

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      (v) Dependence upon a controlled substance, habitual drunkenness, or rendering

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professional services to a patient while intoxicated or incapacitated by the use of drugs;

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      (vi) Promotion of the sale of drugs, devices appliances, or goods or services provided for

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a patient in a manner that exploits the patient for the financial gain of the physician assistant;

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      (vii) Immoral conduct of a physician assistant in the practice of medicine;

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      (viii) Willfully making and filing false reports or records;

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      (ix) Willful omission to file or record or willfully impeding or obstructing a filing or

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recording, or inducing another person to omit to file or record medical or other reports as required

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by law;

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      (x) Agreeing with clinical or bioanalytical laboratories to accept payments from these

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laboratories for individual tests or test series for patients;

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      (xi) Practicing with an unlicensed physician or physician assistant or aiding or abetting

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these unlicensed persons in the practice of medicine;

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      (xii) Offering, undertaking or agreeing to cure or treat a disease by a secret method,

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procedure, treatment or medicine;

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      (xiii) Professional or mental incompetence;

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      (xiv) Surrender, revocation, suspension, limitation of privilege based on quality of care

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provided, or any other disciplinary action against a license or authorization to practice in another

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state or jurisdiction; or surrender, revocation, suspension, or any other disciplinary action relating

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to membership on any medical staff or in any medical professional association, or society while

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under disciplinary investigation by any of those authorities or bodies for acts or conduct similar to

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acts or conduct which would constitute grounds for action as stated in this chapter;

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      (xv) Any adverse judgment, settlement, or award arising from a medical liability claim

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related to acts or conduct, which would constitute grounds for action as stated in this chapter;

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      (xvi) Failure to furnish the board, the administrator, investigator or representatives,

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information legally requested by the board;

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      (xvii) Violation of any provisions of this chapter or the rules and regulations

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promulgated by the director or an action, stipulation, or agreement of the board;

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      (xviii) Cheating or attempting to subvert the certifying examination;

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      (xix) Violating any state or federal law or regulation relating to controlled substances;

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      (xx) Medical malpractice;

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      (xxi) Sexual contact between a physician assistant and patient during the existence of the

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physician assistant/patient relationship;

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      (xxii) Providing services to a person who is making a claim as a result of a personal

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injury, who charges or collects from the person any amount in excess of the reimbursement to the

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physician assistant by the insurer as a condition of providing or continuing to provide services or

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treatment.

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     5-54-7. Board of licensure -- Powers and duties. -- (a) The board shall administer,

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coordinate, and enforce the provisions of this chapter, approve programs for the training of

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physician assistants, evaluate the qualifications of applicants, supervise any examination of

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applicants deemed necessary, recommend to the director the commencement of disciplinary

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hearings in accordance with chapter 35 of title 42 and the provisions of this chapter, and

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investigate persons engaging in practices which violate the provisions of this chapter. This

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authority shall specifically encompass practicing physician assistants, supervisory physicians, and

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those health care agencies employing physician assistants. The board shall investigate all persons

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and agencies engaging in practices which violate the provisions in this chapter.

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      (b) The board shall conduct hearings of a non-disciplinary nature and shall keep the

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records and minutes that are necessary to an orderly dispatch of business.

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      (c) The board, with the approval of the director of the department of health, shall adopt

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rules and regulations necessary to carry into effect the provisions of this chapter and may amend

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or repeal them.

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      (d) Regular meetings of the board shall be held at any time and places that the board

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prescribes and special meetings shall be held upon the call of the chairperson; provided, that at

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least one regular meeting is held each year.

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      (e) The conferral or enumeration of specific powers in this chapter shall not be construed

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as a limitation of the general powers conferred by this section.

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      (f) The board shall recommend to the director for registration those persons meeting the

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criteria stated by this chapter.

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      (g) The board shall recommend to the director the revocation or suspension of the

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registration of any physician assistant who does not conform to the requirements of this chapter

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or regulations adopted under this chapter.

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      (h) In accordance with its authority under subsection (a) of this section the board shall

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make recommendations to the director for discipline of supervising physicians and employing

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health care agencies found wanting in their use of physician assistants.

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      (i) The board shall approve programs for continuing medical education.

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     SECTION 2. This act shall take effect upon passage.

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LC01094

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO BUSINESSES AND PROFESSIONS - PHYSICIAN ASSISTANTS

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     This act would remove the powers of the department of health board of licensure to

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approve programs for the training of physician assistants.

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     This act would take effect upon passage.

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LC01094

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