Bill Text: NY A08378 | 2023-2024 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Relates to amending physician assistant practice standards; provides for the repeal of certain provisions upon expiration thereof.

Spectrum: Partisan Bill (Democrat 6-0)

Status: (Introduced - Dead) 2024-06-06 - substituted by s9038a [A08378 Detail]

Download: New_York-2023-A08378-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          8378

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                    December 13, 2023
                                       ___________

        Introduced by M. of A. PAULIN -- read once and referred to the Committee
          on Higher Education

        AN ACT to amend the education law and the public health law, in relation
          to amending physician assistant practice standards

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Section 6542 of the education law, as amended by chapter 48
     2  of the laws of 2012, subdivisions 3 and 5 as amended  by  section  1  of
     3  part T of chapter 57 of the laws of 2013, is amended to read as follows:
     4    §  6542. Performance of medical services. 1. Notwithstanding any other
     5  provision of law, a physician assistant may  perform  medical  services,
     6  but  only  when  under the supervision of a physician and only when such
     7  acts and duties as are assigned to him or her are within  the  scope  of
     8  practice  of  such  supervising  physician unless otherwise permitted by
     9  this section.
    10    2. [Supervision shall be continuous but  shall  not  be  construed  as
    11  necessarily requiring the physical presence of the supervising physician
    12  at  the  time  and  place where such services are performed] A physician
    13  assistant may practice without the supervision of a physician under  the
    14  following circumstances:
    15    (a)  where  the physician assistant, licensed under section sixty-five
    16  hundred forty-one of this article has  practiced  for  more  than  eight
    17  thousand hours; and
    18    (i) is practicing in primary care. For the purposes of this paragraph,
    19  "primary  care"  shall  mean  non-surgical care in the fields of general
    20  pediatrics, general adult medicine, general geriatric medicine,  general
    21  internal  medicine,  obstetrics and gynecology, family medicine, or such
    22  other related areas as determined by the commissioner of health; or
    23    (ii) is employed by a health  system  or  hospital  established  under
    24  article  twenty-eight of the public health law, and the health system or
    25  hospital determines the physician assistant meets the qualifications  of

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13627-01-3
        A. 8378                             2

     1  the  medical  staff  bylaws  and the health system or hospital gives the
     2  physician assistant privileges; and
     3    (b)  where  a  physician  assistant  licensed under section sixty-five
     4  hundred forty-one of this article has completed a  program  approved  by
     5  the department of health, in consultation with the department, when such
     6  services are performed within the scope of such program.
     7    3.  [No  physician  shall employ or supervise more than four physician
     8  assistants in his or her private practice] Where supervision is required
     9  by this section, it shall be continuous but shall not  be  construed  as
    10  necessarily requiring the physical presence of the supervising physician
    11  at the time and place where such services are performed.
    12    4.  Nothing  in  this article shall prohibit a hospital from employing
    13  physician assistants provided they [work  under  the  supervision  of  a
    14  physician  designated  by the hospital and not beyond the scope of prac-
    15  tice of such physician. The numerical limitation of subdivision three of
    16  this section shall not apply to services performed in a  hospital]  meet
    17  the  qualifications of the medical staff bylaws and are given privileges
    18  and otherwise meet the requirements of this section.
    19    5. [Notwithstanding any other provision of this article, nothing shall
    20  prohibit a physician employed by or rendering services to the department
    21  of corrections and community supervision under contract from supervising
    22  no more than six physician assistants in his or  her  practice  for  the
    23  department of corrections and community supervision] A physician assist-
    24  ant  shall be authorized to prescribe, dispense, order, or procure items
    25  to commence or complete a course of therapy.
    26    6. [Notwithstanding any other  provision  of  law,  a  trainee  in  an
    27  approved  program  may  perform  medical services when such services are
    28  performed within the scope of such program] (a)  A  physician  assistant
    29  may prescribe and order a patient specific order or non-patient specific
    30  regimen  to  a  licensed  pharmacist  or  registered professional nurse,
    31  pursuant to regulations promulgated by the commissioner of  health,  and
    32  consistent with the public health law, for:
    33    (i) administering immunizations;
    34    (ii) the emergency treatment of anaphylaxis;
    35    (iii)  administering  purified  protein  derived  (PPD) tests or other
    36  tests to detect or screen for tuberculosis infections;
    37    (iv) administering tests to determine the presence of the human  immu-
    38  nodeficiency virus;
    39    (v)  administering  tests to determine the presence of the hepatitis C
    40  virus;
    41    (vi) the urgent or emergency treatment of opioid related  overdose  or
    42  suspected opioid related overdose;
    43    (vii)  screening  of persons at increased risk of syphilis, gonorrhea,
    44  and chlamydia;
    45    (viii) administering electrocardiogram tests to detect signs and symp-
    46  toms of acute coronary syndrome;
    47    (ix) administering point-of-care blood glucose tests to evaluate acute
    48  mental status changes in persons with suspected hypoglycemia;
    49    (x) administering tests and intravenous lines  to  persons  that  meet
    50  severe sepsis and septic shock criteria; and
    51    (xi) administering tests to determine pregnancy.
    52    (b)  Nothing in this subdivision shall authorize unlicensed persons to
    53  administer immunizations, vaccines, or other drugs.
    54    7. Where a  physician  assistant  licensed  under  section  sixty-five
    55  hundred  forty-one  of  this article has completed a program approved by
        A. 8378                             3

     1  the department of health, in consultation with the department, when such
     2  services are performed within the scope of such program.
     3    8.  Nothing  in this article, or in article thirty-seven of the public
     4  health law, shall be construed  to  authorize  physician  assistants  to
     5  perform  those  specific  functions and duties specifically delegated by
     6  law to those persons licensed as allied health professionals  under  the
     7  public health law or this chapter.
     8    §  2.  Subdivision  1  of  section  3701  of the public health law, as
     9  amended by chapter 48 of the  laws  of  2012,  is  amended  to  read  as
    10  follows:
    11    1.  to  promulgate  regulations  defining  and  restricting the duties
    12  [which may be assigned to] of physician assistants [by their supervising
    13  physician, the degree of supervision required and the  manner  in  which
    14  such duties may be performed] consistent with section sixty-five hundred
    15  forty-two of the education law;
    16    § 3. Subdivisions 1 and 3 of section 3702 of the public health law, as
    17  amended  by  chapter  48  of  the  laws  of 2012, are amended to read as
    18  follows:
    19    1. Inpatient medical orders. A licensed physician  assistant  employed
    20  or  extended  privileges  by  a  hospital  may, if permissible under the
    21  bylaws, rules and regulations of the  hospital,  write  medical  orders,
    22  including those for controlled substances and durable medical equipment,
    23  for  inpatients  [under the care of the physician responsible for his or
    24  her supervision. Countersignature of such  orders  may  be  required  if
    25  deemed  necessary  and  appropriate  by the supervising physician or the
    26  hospital, but in no event shall countersignature be  required  prior  to
    27  execution].
    28    3.  Prescriptions  for  controlled  substances.  A  licensed physician
    29  assistant, in good faith and acting within his or her  lawful  scope  of
    30  practice,  and  to  the  extent  assigned  by  his  or  her  supervising
    31  physician, as applicable pursuant to section sixty-five  hundred  forty-
    32  two of the education law, may prescribe controlled substances as a prac-
    33  titioner  under  article thirty-three of this chapter, to patients under
    34  the care of such physician responsible for his or her  supervision.  The
    35  commissioner,  in  consultation  with the commissioner of education, may
    36  promulgate such regulations as are necessary to carry out  the  purposes
    37  of this section.
    38    §  4.  Section 3703 of the public health law, as amended by chapter 48
    39  of the laws of 2012, is amended to read as follows:
    40    § 3703. Statutory construction. A physician assistant may perform  any
    41  function in conjunction with a medical service lawfully performed by the
    42  physician  assistant, in any health care setting, that a statute author-
    43  izes or directs a physician to perform and that is  appropriate  to  the
    44  education,  training  and experience of the licensed physician assistant
    45  and within the ordinary practice of the supervising physician, as appli-
    46  cable pursuant to section sixty-five hundred forty-two of the  education
    47  law.  This  section  shall  not be construed to increase or decrease the
    48  lawful scope of practice of a physician assistant  under  the  education
    49  law.
    50    § 5. Paragraph a of subdivision 2 of section 902 of the education law,
    51  as  amended  by  chapter  376 of the laws of 2015, is amended to read as
    52  follows:
    53    a. The board of education, and the trustee or  board  of  trustees  of
    54  each  school district, shall employ, at a compensation to be agreed upon
    55  by the parties, a qualified physician, a physician assistant, or a nurse
    56  practitioner to the extent authorized by  the  nurse  practice  act  and
        A. 8378                             4

     1  consistent  with  subdivision three of section six thousand nine hundred
     2  two of this chapter, to perform the duties of  the  director  of  school
     3  health  services, including any duties conferred on the school physician
     4  or  school  medical inspector under any provision of law, to perform and
     5  coordinate the provision of health services in the public schools and to
     6  provide health appraisals of students attending the  public  schools  in
     7  the  city  or  district. The physicians, physicians assistants, or nurse
     8  practitioners so employed shall be duly licensed pursuant to  applicable
     9  law.
    10    §  6.  Subdivision 5 of section 6810 of the education law, as added by
    11  chapter 881 of the laws of 1972, is amended to read as follows:
    12    5. Records of all prescriptions filled or refilled shall be maintained
    13  for a period of at least five years and upon request made available  for
    14  inspection  and  copying  by  a  representative  of the department. Such
    15  records  shall  indicate  date  of  filling  or  refilling,   [doctor's]
    16  prescriber's  name,  patient's name and address and the name or initials
    17  of  the  pharmacist  who  prepared,   compounded,   or   dispensed   the
    18  prescription.  Records  of prescriptions for controlled substances shall
    19  be maintained pursuant to requirements of article  thirty-three  of  the
    20  public health law.
    21    §  7.  Subdivision  27  of  section  3302 of the public health law, as
    22  amended by chapter 92 of the  laws  of  2021,  is  amended  to  read  as
    23  follows:
    24    27. "Practitioner" means:
    25    A  physician,  physician assistant, dentist, podiatrist, veterinarian,
    26  scientific investigator, or other person licensed, or otherwise  permit-
    27  ted  to  dispense,  administer  or  conduct  research  with respect to a
    28  controlled substance in the course of a licensed  professional  practice
    29  or  research  licensed  pursuant  to  this article. Such person shall be
    30  deemed a "practitioner" only as to such substances, or conduct  relating
    31  to  such  substances,  as is permitted by [his] their license, permit or
    32  otherwise permitted by law.
    33    § 8. This act shall take effect on the one hundred twentieth day after
    34  it shall have become a law. Effective  immediately,  the  department  of
    35  education  and  the  department  of health are authorized to promulgate,
    36  amend and/or repeal any rule or regulation necessary for the implementa-
    37  tion of section one of this act on or before such effective date.