On Feb. 24, the new
Physician Assistant Affiliated Credentialing Board approved new rules that will go into effect on April 1 implementing
2021 Act 23, which removed burdensome direct supervision and physician ratio requirements for physician assistants and added additional clarity to physician assistant scope of practice. The new rules will be formally published and enacted in the coming days.
Both Act 23 and the newly approved rules change the nature of the required affiliation with a physician. Specifically, rather than requiring a supervising physician, both the act and the rule specify that a physician assistant may work either under a collaborative agreement with a physician or may demonstrate that pursuant to the physician assistant’s employment there is a physician who is primarily responsible for the overall direction and management of the physician assistant’s professional activities and for assuring that the services provided by the physician assistant are medically appropriate. In either case, the statute specifies that there is no requirement for the physical presence of a physician at the time and place a physician assistant renders a service.
“During the development of the Act 23 legislation, WHA worked with the Wisconsin Academy of Physician Assistants to have an alternative to a collaborative agreement that enable employers to utilize an administratively simpler oversight process akin to general supervision,” said WHA General Counsel Matthew Stanford. “We believe many organizations will find that the employment oversight option will require little or no changes to their current physician assistant practice policies in order to be compliant with the new law on April 1.”
In January 2020, WHA testified in support of Act 23, describing it as a “good balance of reducing the regulatory burden on physician assistants, physicians, hospitals and health systems, while also preserving the important role of physicians in a team-based care delivery model and other safeguards to preserve high-quality care in Wisconsin.”
However, an earlier version of the draft rules released in late January 2022 by the Physician Assistant Affiliated Credentialling Board would have added requirements that physician assistants track hours of practice and eliminated the distinction between the collaborative agreement option and employment oversight option. In response, WHA worked with both the Wisconsin Academy of Physician Assistants (WAPA) and the new board to remove these new, last minute policy changes.
“Since the enactment of 2021 Wisconsin Act 23 in March 2021, physician assistants and the hospitals and clinics in which they work, have been preparing to practice based on the clear standards set out in Act 23 statutory language,” wrote WHA and WAPA in a
February 22 joint memo to the Physician Assistant Affiliated Credentialing Board. “We are concerned that some of the emergency rules as drafted…create new standards not specified in the statutory language and will disrupt care delivery transitions for April 1 already established based on the clear standards in statute. At a minimum…we ask you to simply restate the standards as provided in the statute.”
The Physician Assistant Affiliated Credentialing Board agreed with the recommendations of WHA and WAPA and made the recommended changes to the draft emergency rule before approving the rules for publication. Prior to being formally published and enacted, the rule requires a formal approval by the governor and the creation of a plain language analysis, both of which are expected to occur in the coming days.
WHA has created a PowerPoint summary of Act 23 that can be found
here. Contact WHA General Counsel
Matthew Stanford with questions.