Bill Text: IA SSB1142 | 2023-2024 | 90th General Assembly | Introduced
Bill Title: A bill for an act relating to the practice of physician assistants without supervision by a physician.
Spectrum: Committee Bill
Status: (Introduced - Dead) 2023-02-08 - Subcommittee: Schultz, Boulton, and Bousselot. [SSB1142 Detail]
Download: Iowa-2023-SSB1142-Introduced.html
Senate
Study
Bill
1142
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
STATE
GOVERNMENT
BILL
BY
CHAIRPERSON
SCHULTZ)
A
BILL
FOR
An
Act
relating
to
the
practice
of
physician
assistants
without
1
supervision
by
a
physician.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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S.F.
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Section
1.
Section
135.24,
subsection
7,
paragraph
d,
Code
1
2023,
is
amended
to
read
as
follows:
2
d.
“Health
care
provider”
means
a
physician
licensed
under
3
chapter
148
;
a
chiropractor
licensed
under
chapter
151
;
a
4
physical
therapist
licensed
pursuant
to
chapter
148A
;
an
5
occupational
therapist
licensed
pursuant
to
chapter
148B
;
6
a
podiatrist
licensed
pursuant
to
chapter
149
;
a
physician
7
assistant
licensed
and
practicing
under
a
supervising
physician
8
pursuant
to
chapter
148C
;
a
licensed
practical
nurse,
a
9
registered
nurse,
or
an
advanced
registered
nurse
practitioner
10
licensed
pursuant
to
chapter
152
or
152E
;
a
respiratory
11
therapist
licensed
pursuant
to
chapter
152B
;
a
dentist,
dental
12
hygienist,
or
dental
assistant
registered
or
licensed
to
13
practice
under
chapter
153
;
an
optometrist
licensed
pursuant
14
to
chapter
154
;
a
psychologist
licensed
pursuant
to
chapter
15
154B
;
a
social
worker
licensed
pursuant
to
chapter
154C
;
a
16
mental
health
counselor,
marital
and
family
therapist,
behavior
17
analyst,
or
assistant
behavior
analyst
licensed
pursuant
to
18
chapter
154D
;
a
speech
pathologist
or
audiologist
licensed
19
pursuant
to
chapter
154F
;
a
pharmacist
licensed
pursuant
to
20
chapter
155A
;
or
an
emergency
medical
care
provider
certified
21
pursuant
to
chapter
147A
.
22
Sec.
2.
Section
135G.1,
subsection
8,
Code
2023,
is
amended
23
to
read
as
follows:
24
8.
“Physician
assistant”
means
a
person
licensed
to
practice
25
under
the
supervision
of
a
physician
as
authorized
in
chapters
26
147
and
chapter
148C
.
27
Sec.
3.
Section
135P.1,
subsection
2,
Code
2023,
is
amended
28
to
read
as
follows:
29
2.
“Health
care
provider”
means
a
physician
or
osteopathic
30
physician
licensed
under
chapter
148
,
a
physician
assistant
31
licensed
and
practicing
under
a
supervising
physician
pursuant
32
to
chapter
148C
,
a
podiatrist
licensed
under
chapter
149
,
a
33
chiropractor
licensed
under
chapter
151
,
a
licensed
practical
34
nurse,
a
registered
nurse,
or
an
advanced
registered
nurse
35
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practitioner
licensed
under
chapter
152
or
152E
,
a
dentist
1
licensed
under
chapter
153
,
an
optometrist
licensed
under
2
chapter
154
,
a
pharmacist
licensed
under
chapter
155A
,
or
3
any
other
person
who
is
licensed,
certified,
or
otherwise
4
authorized
or
permitted
by
the
law
of
this
state
to
administer
5
health
care
in
the
ordinary
course
of
business
or
in
the
6
practice
of
a
profession.
7
Sec.
4.
Section
147.14,
subsection
1,
paragraph
l,
Code
8
2023,
is
amended
to
read
as
follows:
9
l.
For
the
board
of
physician
assistants,
five
members
10
licensed
to
practice
as
physician
assistants,
at
least
two
of
11
whom
practice
in
counties
with
a
population
of
less
than
fifty
12
thousand,
one
member
licensed
to
practice
medicine
and
surgery
13
who
supervises
collaborates
with
a
physician
assistant,
one
14
member
licensed
to
practice
osteopathic
medicine
and
surgery
15
who
supervises
collaborates
with
a
physician
assistant,
and
two
16
members
who
are
not
licensed
to
practice
either
medicine
and
17
surgery
or
osteopathic
medicine
and
surgery
or
licensed
as
a
18
physician
assistant
and
who
shall
represent
the
general
public.
19
At
least
one
of
the
physician
or
osteopathic
physician
members
20
shall
be
in
practice
in
a
county
with
a
population
of
less
than
21
fifty
thousand.
22
Sec.
5.
Section
147.107,
subsection
4,
Code
2023,
is
amended
23
to
read
as
follows:
24
4.
A
Notwithstanding
subsection
1
and
any
other
provision
25
of
this
section
to
the
contrary,
a
physician
assistant
may
26
prescribe,
dispense,
order,
administer,
or
procure
prescription
27
drugs,
controlled
substances,
or
medical
devices
necessary
to
28
complete
a
course
of
therapy
pursuant
to
section
148C.4
.
Rules
29
relating
to
the
authority
of
physician
assistants
to
prescribe
30
drugs,
controlled
substances,
and
medical
devices
pursuant
to
31
this
subsection
shall
be
adopted
by
the
board
of
physician
32
assistants
after
consultation
with
the
board
of
medicine
and
33
board
of
pharmacy.
34
Sec.
6.
Section
147.107,
subsections
5
and
6,
Code
2023,
are
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amended
by
striking
the
subsections.
1
Sec.
7.
Section
147.136A,
subsection
1,
paragraph
a,
Code
2
2023,
is
amended
to
read
as
follows:
3
a.
“Health
care
provider”
means
a
hospital
as
defined
in
4
section
135B.1
,
a
health
care
facility
as
defined
in
section
5
135C.1
,
a
health
facility
as
defined
in
section
135P.1
,
a
6
physician
or
an
osteopathic
physician
licensed
under
chapter
7
148
,
a
physician
assistant
licensed
and
practicing
under
a
8
supervising
physician
under
chapter
148C
,
a
podiatrist
licensed
9
under
chapter
149
,
a
chiropractor
licensed
under
chapter
151
,
a
10
licensed
practical
nurse,
a
registered
nurse,
or
an
advanced
11
registered
nurse
practitioner
licensed
under
chapter
152
or
12
152E
,
a
dentist
licensed
under
chapter
153
,
an
optometrist
13
licensed
under
chapter
154
,
a
pharmacist
licensed
under
chapter
14
155A
,
a
professional
corporation
under
chapter
496C
that
is
15
owned
by
persons
licensed
to
practice
a
profession
listed
in
16
this
paragraph,
or
any
other
person
or
entity
who
is
licensed,
17
certified,
or
otherwise
authorized
or
permitted
by
the
law
of
18
this
state
to
administer
health
care
in
the
ordinary
course
of
19
business
or
in
the
practice
of
a
profession.
20
Sec.
8.
Section
147A.10,
subsection
3,
Code
2023,
is
amended
21
to
read
as
follows:
22
3.
An
act
of
commission
or
omission
of
any
appropriately
23
certified
emergency
medical
care
provider,
registered
nurse,
24
or
licensed
practical
nurse,
or
physician
assistant,
while
25
rendering
emergency
medical
care
under
the
responsible
26
supervision
and
control
of
a
physician
to
a
person
who
is
27
deemed
by
them
to
be
in
immediate
danger
of
serious
injury
or
28
loss
of
life,
shall
not
impose
any
liability
upon
the
certified
29
emergency
medical
care
provider,
registered
nurse,
licensed
30
practical
nurse,
or
physician
assistant,
the
supervising
31
physician,
physician
designee,
advanced
registered
nurse
32
practitioner,
or
any
hospital,
or
upon
the
state,
or
any
33
county,
city
or
other
political
subdivision,
or
the
employees
34
of
any
of
these
entities;
provided
that
this
section
shall
not
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relieve
any
person
of
liability
for
civil
damages
for
any
act
1
of
commission
or
omission
which
constitutes
recklessness.
2
Sec.
9.
Section
148C.1,
subsections
5
and
8,
Code
2023,
are
3
amended
by
striking
the
subsections.
4
Sec.
10.
Section
148C.1,
subsection
6,
Code
2023,
is
amended
5
to
read
as
follows:
6
6.
“Physician”
means
a
person
who
is
currently
licensed
in
7
Iowa
to
practice
medicine
and
surgery
or
osteopathic
medicine
8
and
surgery.
Notwithstanding
this
subsection
,
a
physician
9
supervising
a
physician
assistant
practicing
in
a
federal
10
facility
or
under
federal
authority
shall
not
be
required
to
11
obtain
licensure
beyond
licensure
requirements
mandated
by
the
12
federal
government
for
supervising
physicians.
13
Sec.
11.
Section
148C.3,
subsection
2,
Code
2023,
is
amended
14
by
striking
the
subsection.
15
Sec.
12.
Section
148C.4,
subsections
2
and
3,
Code
2023,
are
16
amended
to
read
as
follows:
17
2.
a.
Notwithstanding
subsection
1
,
a
physician
assistant
18
licensed
pursuant
to
this
chapter
or
authorized
to
practice
19
in
any
other
state
or
federal
jurisdiction
who
voluntarily
20
and
gratuitously,
and
other
than
in
the
ordinary
course
of
21
the
physician
assistant’s
employment
or
practice,
responds
to
22
a
need
for
medical
care
created
by
an
emergency
or
a
state
23
or
local
disaster
may
render
such
care
that
the
physician
24
assistant
is
able
to
provide
without
supervision
as
described
25
in
this
section
or
with
such
supervision
as
is
available
.
26
b.
A
physician
who
supervises
a
physician
assistant
27
providing
medical
care
pursuant
to
this
subsection
shall
not
28
be
required
to
meet
the
requirements
of
rules
adopted
pursuant
29
to
section
148C.3,
subsection
2
,
relating
to
supervision
30
by
physicians.
A
physician
providing
physician
assistant
31
supervision
pursuant
to
this
subsection
or
a
physician
32
assistant,
who
voluntarily
and
gratuitously,
and
other
than
in
33
the
ordinary
course
of
the
physician
assistant’s
employment
or
34
practice,
responds
to
a
need
for
medical
care
created
by
an
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emergency
or
a
state
or
local
disaster
shall
not
be
subject
1
to
criminal
liability
by
reason
of
having
issued
or
executed
2
the
orders
for
provided
such
care,
and
shall
not
be
liable
for
3
civil
damages
for
acts
or
omissions
relating
to
the
issuance
or
4
execution
of
the
orders
such
care
unless
the
acts
or
omissions
5
constitute
recklessness.
6
3.
The
degree
of
collaboration
between
a
physician
7
assistant
and
the
appropriate
member
of
a
health
care
team
8
shall
be
determined
at
the
practice
level,
and
may
involve
9
decisions
made
by
the
medical
group,
hospital
service,
10
supervising
physician,
or
employer
of
the
physician
assistant,
11
or
the
credentialing
and
privileging
system
of
a
licensed
12
health
care
facility.
A
physician
shall
be
accessible
at
all
13
times
for
consultation
with
a
physician
assistant
unless
the
14
physician
assistant
is
providing
emergency
medical
services
15
pursuant
to
645
IAC
327.1(1)(n)
.
The
supervising
physician
16
shall
have
ultimate
responsibility
for
determining
the
medical
17
care
provided
by
the
supervising
physician-physician
assistant
18
team.
A
physician
assistant
shall
be
responsible
for
the
19
services
performed
by
the
physician
assistant.
20
Sec.
13.
Section
148F.7,
Code
2023,
is
amended
to
read
as
21
follows:
22
148F.7
Limitation
on
provision
of
care
and
services.
23
A
licensed
orthotist,
prosthetist,
or
pedorthist
may
provide
24
care
or
services
only
if
the
care
or
services
are
provided
25
pursuant
to
an
order
from
a
licensed
physician,
a
licensed
26
podiatric
physician,
an
advanced
registered
nurse
practitioner
27
licensed
pursuant
to
chapter
152
or
152E
,
or
a
physician
28
assistant
who
has
been
delegated
the
authority
to
order
the
29
services
of
an
orthotist,
prosthetist,
or
pedorthist
by
the
30
assistant’s
supervising
physician
licensed
under
chapter
148C
.
31
Sec.
14.
Section
154F.2,
subsection
1,
paragraph
a,
Code
32
2023,
is
amended
to
read
as
follows:
33
a.
Licensed
physicians
and
surgeons,
licensed
osteopathic
34
physicians
and
surgeons,
and
licensed
physician
assistants
,
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and
registered
nurses
acting
under
the
supervision
of
a
1
physician
or
osteopathic
physician,
persons
conducting
hearing
2
tests
under
the
direct
supervision
of
a
licensed
physician
3
and
surgeon
or
licensed
osteopathic
physician
and
surgeon,
4
or
students
of
medicine
or
surgery
or
osteopathic
medicine
5
and
surgery
pursuing
a
course
of
study
in
a
medical
school
or
6
college
of
osteopathic
medicine
and
surgery
approved
by
the
7
board
of
medicine
while
performing
functions
incidental
to
8
their
course
of
study.
9
Sec.
15.
Section
225C.6,
subsection
4,
paragraph
c,
10
subparagraph
(1),
Code
2023,
is
amended
to
read
as
follows:
11
(1)
A
comprehensive
set
of
wraparound
services
for
persons
12
who
have
had
or
are
at
imminent
risk
of
having
acute
or
13
crisis
mental
health
symptoms
that
do
not
permit
the
persons
14
to
remain
in
or
threatens
removal
of
the
persons
from
their
15
home
and
community,
but
who
have
been
determined
by
a
mental
16
health
professional
and
a
licensed
health
care
professional,
17
subject
to
the
professional’s
scope
of
practice,
not
to
need
18
inpatient
acute
hospital
services.
For
the
purposes
of
this
19
subparagraph,
“mental
health
professional”
means
the
same
as
20
defined
in
section
228.1
and
“licensed
health
care
professional”
21
means
a
person
licensed
under
chapter
148
to
practice
medicine
22
and
surgery
or
osteopathic
medicine
and
surgery,
an
advanced
23
registered
nurse
practitioner
licensed
under
chapter
152
or
24
152E
,
or
a
physician
assistant
licensed
to
practice
under
the
25
supervision
of
a
physician
as
authorized
in
chapters
147
and
26
chapter
148C
.
27
Sec.
16.
Section
280.16,
subsection
1,
paragraph
d,
Code
28
2023,
is
amended
to
read
as
follows:
29
d.
“
Licensed
health
care
professional”
means
a
person
30
licensed
under
chapter
148
to
practice
medicine
and
surgery
or
31
osteopathic
medicine
and
surgery,
an
advanced
registered
nurse
32
practitioner
licensed
under
chapter
152
or
152E
and
registered
33
with
the
board
of
nursing,
or
a
physician
assistant
licensed
to
34
practice
under
the
supervision
of
a
physician
as
authorized
in
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chapters
147
and
chapter
148C
.
1
Sec.
17.
Section
489.1102,
subsection
2,
paragraph
b,
Code
2
2023,
is
amended
to
read
as
follows:
3
b.
Nothing
in
this
section
shall
be
construed
to
expand
4
the
scope
of
practice
of
a
physician
assistant
or
modify
the
5
requirement
in
section
148C.4
that
a
physician
assistant
6
perform
medical
services
under
the
supervision
of
a
licensed
7
physician
.
8
Sec.
18.
Section
489.1105,
subsection
2,
paragraph
b,
Code
9
2023,
is
amended
to
read
as
follows:
10
b.
Nothing
in
this
section
shall
be
construed
to
expand
11
the
scope
of
practice
of
a
physician
assistant
or
modify
the
12
requirement
in
section
148C.4
that
a
physician
assistant
13
perform
medical
services
under
the
supervision
of
a
licensed
14
physician
.
15
Sec.
19.
Section
496C.4,
subsection
2,
paragraph
b,
Code
16
2023,
is
amended
to
read
as
follows:
17
b.
Nothing
in
this
section
shall
be
construed
to
expand
18
the
scope
of
practice
of
a
physician
assistant
or
modify
the
19
requirement
in
section
148C.4
that
a
physician
assistant
20
perform
medical
services
under
the
supervision
of
a
licensed
21
physician
.
22
Sec.
20.
Section
496C.7,
subsection
3,
paragraph
b,
Code
23
2023,
is
amended
to
read
as
follows:
24
b.
Nothing
in
this
section
shall
be
construed
to
expand
25
the
scope
of
practice
of
a
physician
assistant
or
modify
the
26
requirement
in
section
148C.4
that
a
physician
assistant
27
perform
medical
services
under
the
supervision
of
a
licensed
28
physician
.
29
Sec.
21.
REPEAL.
Sections
148.13,
148C.5,
and
148.12,
Code
30
2023,
are
repealed.
31
EXPLANATION
32
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
33
the
explanation’s
substance
by
the
members
of
the
general
assembly.
34
This
bill
relates
to
the
practice
of
physician
assistants.
35
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8
S.F.
_____
The
bill
repeals
requirements
that
physician
assistants
1
practice
under
the
supervision
of
a
licensed
physician
and
2
surgeon
or
osteopathic
physician
and
surgeon.
The
bill
3
repeals
provisions
requiring
rulemaking
for
the
supervision
4
of
physician
assistants
and
requiring
the
board
of
physician
5
assistants
and
board
of
medicine
to
submit
an
annual
report
6
regarding
collaborative
efforts,
and
makes
other
conforming
7
changes.
8
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