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Physician Assistants: A Role in Regulation
August 2007
Introduction List of States All State Summaries
Introduction An increasing number of states have recognized the need for physician assistant participation in the regulation of the PA profession.
Several different approaches have been used to accomplish this goal. One is the creation of a board, whose members are primarily physicians and physician assistants, charged with regulation of PAs. Examples may be found in Arizona, Iowa, Massachusetts, Michigan, Rhode Island, Utah, and Texas.
A second approach is the designation of a physician assistant seat on the medical licensing board. This has occurred in Alaska, Connecticut, Georgia, Montana, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, Vermont, Washington, West Virginia, and Wyoming. Michigan’s PA regulatory body sends a PA member to serve on the medical and osteopathic boards. In most cases, the physician assistant is a full-fledged member of the board. In some cases, the seat may be shared with other professions regulated by the board, such as in Pennsylvania, where it alternates among PAs, nurse midwives, and nurse practitioners. Or, there may be limitations on the voting powers; for example, denying the PA a vote or restricting the seatholder to voting only on PA-related issues.
The establishment of a physician assistant committee may be undertaken in conjunction with the second approach or independently. The role of the committee may be advisory or it may have significant responsibilities: rulemaking, discipline, review and approval, or denial of applications. Most committees must forward their recommendations for action to the licensing board for implementation. Some PA committees, such as those in California, New Jersey, and Tennessee, function largely as the regulatory authority, although cooperation with the medical board may be required for rulemaking or other functions. Composition of the committees varies, but usually includes physicians (who may or may not be members of the parent licensing board), generally those with experience supervising physician assistants; PAs; and an assortment of others. Appointment of the committee members may be by the governor, other appropriate state official, or the medical board.
Physician assistant committees may be mandated by the legislature or by formal action of the medical board (in the regulations). Conversely, such committees may be established informally or on an ad hoc basis to deal with a particular project. Experience has shown us that informal committees may be less effective than committees that are formally constituted.
The American Academy of Physician Assistants believes there should be formal participation by physician assistants in the regulation of their profession.
All physician assistants who serve on PA or medical licensing boards or on PA committees are eligible for membership in the Consortium of PA Representatives to State Regulatory Agencies. The consortium meets at the AAPA’s Annual Physician Assistant Conference to discuss issues of common interest.
For additional information, contact Ann Davis, PA-C, Director of State Government Affairs, at the American Academy of Physician Assistants
List of States Click on a state's name to see the full summary
Alabama Physician Assistant Advisory Committee
(Board of Medical Examiners)
Alaska PA on State Medical Board
Arizona Regulatory Board of Physician Assistants
Arkansas Physician Assistant Advisory Committee
(Arkansas State Medical Board)
California Physician Assistant Committee
(Medical Board of California)
Colorado No representation
Connecticut PA on Medical Examining Board
Delaware Physician Assistant Regulatory Council
(Board of Medical Practice)
District of Columbia Physician Assistant Advisory Committee
(Board of Medicine)
Florida Council on Physician Assistants
(Board of Medicine)
Georgia Physician Assistant Advisory Committee
(Composite State Board of Medical Examiners);
PA advisor on CSBME
Hawaii Physician Assistant Advisory Committee
(Board of Medical Examiners)
Idaho Physician Assistant Advisory Committee
(Board of Medicine)
Illinois Physician Assistant Committee
(Board of Medicine)
Indiana Physician Assistant Advisory Committee
(Medical Licensing Board)
Iowa Board of Physician Assistants
Kansas Physician Assistant Council
(Board of Healing Arts)
Kentucky Physician Assistant Advisory Committee
(Board of Medical Licensure)
Louisiana Physician Assistant Advisory Committee
(Board of Medical Examiners)
Maine Physician Assistant Advisory Committee
(Board of Registration in Medicine)
Maryland PA on Board of Physicians
Physician Assistant Advisory Committee
Massachusetts Board of Registration of Physician Assistants
(Department of Consumer Affairs & Business Regulation)
Michigan Task Force on Physician Assistants
PA on Board of Medicine
PA on Board of Osteopathic Medicine
Minnesota Physician Assistant Advisory Council
(Board of Medical Practice)
Mississippi Physician Assistant Committee
(Board of Medical Licensure)
PA Committee may be appointed at the discretion of the board; no committee is currently appointed
Missouri Advisory Commission for Physician Assistants
(Board of Healing Arts)
Montana PA on Board of Medical Examiners
Nebraska Physician Assistant Committee
(Board of Medical Examiners)
Nevada Physician Assistant Advisory Committee
(Board of Medical Examiners)
New Hampshire PA on Board of Registration in Medicine
Physician Assistant Advisory Committee
(Board of Registration in Medicine)
New Jersey PA on Board of Medical Examiners
Physician Assistant Advisory Committee
(Board of Medical Examiners)
New Mexico One PA on Board of Medical Examiners
(Board of Medical Examiners)
New York PAs on State Board of Medicine
(State Education Department)
PAs on Board of Professional Medical Conduct
(State Department of Health)
North Carolina Physician extender on the Board of Medical Examiners
PA Advisory Committee
(Board of Medical Examiners)
North Dakota No representation
Ohio Physician Assistant Policy Committee
(State Medical Board)
Oklahoma Physician Assistant Committee
(Board of Medical Supervision and Licensure)
Oregon Physician Assistant Committee
(Board of Medical Examiners)
Pennsylvania One seat on Board of Medicine rotates among PAs, nurse midwives, and certified registered nurse practitioners
One seat on Board of Osteopathic Medicine alternates between a PA and respiratory care practitioner
Rhode Island Board of Licensure for Physician Assistants
(Department of Health)
South Carolina Physician Assistant Committee
(Board of Medical Examiners)
South Dakota Physician Assistant Advisory Committee
(Board of Medical and Osteopathic Examiners)
Tennessee Committee on Physician Assistants
(Board of Medical Examiners)
Texas Physician Assistant Board
(connected to Medical Board)
Utah Physician Assistant Licensing Board
Vermont PA on Board of Medical Practice
PA Committee (inactive)
Virginia Physician Assistant Advisory Board
(Board of Medicine)
Washington PAs on Medical Quality Assurance Commission
West Virginia PA on Board of Medicine
Wisconsin Council on Physician Assistants
(Medical Examining Board)
Wyoming PA on Board of Medicine
Advisory Committee on Physician Assistants
State Summaries ALABAMA
Regulations 540 X 7 .30
The PA Advisory Committee (PAAC) is established to enable the exchange of information between the medical board and the PAs through their representative organization. The PAAC consists of four members of the board appointed by the chair of the board and four PAs appointed by the Alabama Society of PAs. Terms are two years; reappointments may be made. The PAAC may review and recommend changes to the rules for PAs, make recommendations regarding changes to the scope of PA practice, advise the board on issues related to applications, practice agreements, disciplinary proceedings, and renewal, and discuss ideas of mutual concern regarding education, utilization, and scope of practice of PAs. Board meets quarterly upon the call of board chair, or upon the call of three members of the PAAC.
ALASKA
AS 08.64.010
The law was amended in 2001 to add a PA to the State Medical Board. The board consists of five licensed physicians residing in as many separate geographical areas of the state as possible, one physician assistant, and two public members. All members of the board are appointed by the governor.
ARIZONA
Rev. Stats. Title 32, Chapter 25
The law establishes a board on the regulation of physician assistants, consisting of the following members:
• Four physician assistants
• Two public members
• Two M.D.s
• Two D.O.s
The PAs and public members are appointed by the governor; the physician members are appointed by their respective boards. At least one M.D. and one D.O. must supervise a physician assistant at the time of appointment to the board. Terms are four years. The board elects its chair and other officers from its membership. The chair may establish subcommittees of board members and define their duties to carry out the function of the board. The board meets at least quarterly.
The board's responsibilities include licensing and regulating PAs, establishing fees, disciplining licensees, and promulgating rules.
ARKANSAS
Arkansas Code Title 17, Chapter 105, § 117(c)
The law authorizes the medical board to appoint a PA advisory committee. The committee is composed of:
• Two physician assistants
• Three M.D.s
• One D.O.
The medical board appoints the members of the advisory committee. The committee advises the board on all matters related to PAs. This includes regulations, consideration and approval of PA applications, and disciplinary matters.
CALIFORNIA
Business and Prof. Code, § 3505
The law establishes a Physician Assistant Committee of the medical board. The committee is composed of nine members appointed by the governor:
• One medical board member
• Four PAs
• Four public members
The committee's responsibilities include the establishment of standards and approval of PA programs, advice to the medical board on PA scope of practice, and consideration and approval of PA applications.
California Administrative Code § 1399.521
The committee may also deny, issue subject to terms and conditions, suspend, or revoke the license of a physician assistant for causes listed in the laws and regulations.
COLORADO
Provisions permitting physician assistant participation in professional regulation do not exist.
CONNECTICUT
Connecticut General Statutes, § 20-8a (effective 1991; amended 2000)
The law was amended in 1990 to change the composition of the Connecticut medical examining board. At the same time, the law created a new licensure system for PAs. The board's physician members increased from five to six with the addition of a registered supervising physician; its public members were increased from three to four; and one PA seat was authorized. A subsequent amendment increased the number of physician members.
The fifteen-member board consists of:
• Five physicians practicing in the state
• One physician who is a full-time member of the faculty of The University of Connecticut School of Medicine
• One physician who is a full-time chief of staff in a general-care hospital in the state
• One physician who is registered as a supervising physician for one or more physician assistants
• One physician who is a graduate of a medical education program accredited by the American Osteopathic Association
• One licensed physician assistant who practices in Connecticut
• Five public members
No professional member of the board may be an elected or appointed officer of a professional society or association relating to such member's profession at the time of appointment to the board, or has been such an officer during the year immediately preceding appointment. Members may serve no more than two consecutive terms. The governor makes all appointments.
Connecticut also uses medical hearing panels to provide the same services as members of the medical examing board. The Commissioner of Public Health establishes a list of twenty-four persons who may serve as members of medical hearing panels; members of the list may not be voting members of the board. The twenty-four appointees include eight physicians (at least one of whom must be an osteopathic physician), one licensed physician assistant, and nine members of the public.
DELAWARE
Delaware Code Chapter 17, Title 24, §1770 (enacted 1991; amended 1994)
The law creates a Regulatory Council for Physician Assistants to assist the Board of Medical Practice in its regulation of the PA profession. The president of the medical board appoints seven people to serve on the council:
• One medical board member who serves as chair
• The Board of Medical Practice appoints one physician member
• Four physician assistants
• The Board of Pharmacy appoints one pharmacist
The board, in conjunction with the PA Regulatory Council, adopts regulations regarding PA scope of practice, and licenses and disciplines PAs. The council must meet at least once a year to review the regulation of PAs and to advise the board of policy and rules relating to that regulation.
Council members are subject to the same terms and limitations of service as board members. The chair is compensated as a board member; the other members are compensated at an appropriate and reasonable level as determined by the board and are reimbursed for meeting-related travel and other expenses at the state's current approved rate.
DISTRICT OF COLUMBIA
D.C. Act 6-127 (effective March 1986), D.C. Code 2-3301 et seq, 1987 supp
Current code citation: DC Code 3-1202.03
The law establishes a Board of Medicine and several advisory committees, including one on physician assistants. The PA Advisory Committee's role is to develop and submit to the board guidelines for the licensing and regulation of physician assistants in the District of Columbia .
The guidelines set forth the actions which physician assistants may perform in collaboration with licensed physicians or osteopaths who are responsible for the overall medical direction of the care and treatment of patients and the levels of collaboration required for each action.
At the board's request, the PA Advisory Committee reviews applications for licensure to practice as a physician assistant and forwards recommendations to the board.
The mayor appoints three members to serve on the committee:
• One M.D. or D.O. with experience working with PAs
• One physician assistant
• The Director of the Department of Health or the director's designee
Committee members receive compensation and are reimbursed for reasonable travel and other expenses. The mayor chooses the chair.
FLORIDA
§ 458.347, Florida Statutes (enacted 1995, revised 1996, 2001)
The law creates a Council on Physician Assistants that consists of five members:
• Three physician members of the medical board, one of whom must supervise a physician assistant
• One physician member of the osteopathic board
• One physician assistant
The chairs of the respective boards appoint the physician members. The secretary of the Department of Health or the secretary's designee appoints the physician assistant. All members are appointed for four-year terms. The council chairperson is elected from among its members.
The council develops all rules regulating the practice of physician assistants except for rules relating to the formulary. The medical and osteopathic boards then consider and adopt the rules, following their own rulemaking process. Either board may not adopt a proposed rule submitted by the council unless both boards are adopting identical language. The council is also charged to make recommendations on licensure of physician assistants and to make recommendations to the boards regarding all matters relating to physician assistants.
The 1995 statute also created a five-member Formulary Committee appointed by the Secretary of the Department of Health. This committee established a formulary of drugs that could be prescribed by physician assistants. At the same time, the formulary for prescribing PAs was changed to a negative formulary, delinating those medications a PA is prohibited from prescribing. In a 2001 statutory change, the Formulary Committee was disbanded and the Council on Physician Assistants assumed its role.
GEORGIA
Official Code of Georgia Annotated, Title 43, Chapter 34, § 21(e)
The law establishes a Physician Assistant Advisory Committee composed of four physicians, two of whom are members of the board, and four physician assistants. Members serve two-year terms until their successors are appointed and qualified.
The committee reviews matters that come before the board which relate to PAs, including but not limited to applicants for physician assistant licensure and renewal, education requirements, and proposed board regulations concerning PAs. The committee periodically makes recommendations to the board regarding matters reviewed. The members of the advisory committee are compensated at the same rate as medical board members.
The committee appoints a PA in an advisory capacity to the board. The advisory person serves at the pleasure of the committee as an ex officio advisor to the board in all matters relating to PAs and shares in the privileges and benefits of the board without a vote.
HAWAII
Hawaii Revised Statutes Chapter 453-5.4 (amended 1993)
Legislation was enacted in 1993 to create a Physician Assistant Advisory Committee under the board. The committee is composed solely of PAs. Its role is to review all complaints and requests relating to PAs and to review and recommend revisions of the PA regulations. The chair of the committee is the representative of the committee to the board for the purpose of providing input from the PAs' perspective on issues and concerns, including complaints and requests, regarding PAs. The chair is not a member of the board.
IDAHO
Idaho Board of Medicine Regulations, 22.01.03.011
The Idaho State Board of Medicine created, by board resolution, a Physician Assistant Advisory Committee. The resolution was formalized in 2004 as Chapter 3, §011 of the Board of Medicine regulations. The medical board appoints three physician assistants to serve on the advisory committee. Each member serves a term of three years, and may serve two consecutive terms. The committee elects a chair from its membership. PAs appointed to the board must be licensed and actively practicing as physician assistants in Idaho for three years immediately preceding their appointment to the Advisory Committee.
The advisory committee makes recommendations to the board on evaluations and qualifications of PA applicants for licensure, investigations of misconduct, and recommendations regarding discipline. The Committee meets as often as necessary to fulfill its responsibilities. All final decisions are made by the Board of Medicine. Committee members are compensated in accordance with state guidelines.
ILLINOIS
Illinois Compiled Statutes, 225 ILCS 95/11
A 1987 revision of the Physician Assistant Practice Act included language establishing a physician assistant advisory committee to the Medical Licensing Board. The committee is to "review and make recommendations to the board regarding all matters relating to physician assistants." It is composed of seven members:
• Two physicians who are medical board members, appointed by the chair
• One supervising physician, not a member of the medical board, appointed by the governor
• Three PAs appointed by the governor from a list of 10 names submitted by the Illinois Academy of PAs
• One public member appointed by the governor
The committee is required to meet and report to the board quarterly and as PA issues arise. Members serve four-year terms, with a 2-term limit.
Further revisions to the law were made in 1995. These included adding provisions for reimbursement of committee members, language defining what constitutes a quorum, and adding a clause that provides immunity to committee members who are performing duties within the provisions of the law.
[Licensure of PAs is handled by the Department of Registration and Education without involvement of the Medical Licensing Board.]
INDIANA
Indiana Code 25-27.5-3 et seq (amended 1993)
The law establishes a five-member Physician Assistant Committee. The governor appoints members to three-year terms. The committee is composed of three PAs who have at least three years experience; a licensed physician who is familiar with PA practice; and one consumer. PAs appointed to the committee must continue to practice as PAs while serving. Committee members receive a per diem and traveling expenses.
The committee considers the qualifications of individuals applying for certificates, provides for examinations, certifies qualified individuals, proposes rules for PA practice to the board, and recommends fees. The committee may refuse to issue a certificate to practice or may issue temporary and probationary certificates.
IOWA
Iowa Code 1987 §147.14(12) (amended 2007), Iowa Administrative Code, Chapter 325.1 et seq
Amendments to the law in 2007 renamed the Board of Physician Assistants, composed of:
- Five licensed physician assistants (at least two of whom practice in counties with populations of less than 50,000)
- One allopathic supervising physician
- One osteopathic supervising physician
- Two public members
(At least one of the supervising physicians must practice in a county with less than 50,000 population.)
The Board of Physician Assistants registers and licenses PAs, investigates, disciplines, and otherwise regulates the profession.
KANSAS
Kansas Statutes Annotated, 65-28a11 (created in 1988 and amended in 1989)
The portion of the law creating the Physician Assistant Council was moved from the Healing Arts Act to the Physician Assistant Act in 2001. The Physician Assistant Council was created "to advise the board" in carrying out the provisions of the PA practice act. The council consists of five members: one board-appointed supervising physician, the board president or the president's designee, and three governor-appointed PAs. The Kansas Academy of PAs recommends to the governor two PAs for each seat to be filled. Terms are for three years. Reimbursement is provided for attendance at meetings of the council or any of its subcommittees.
KENTUCKY
KRS 311.842 (revised July 1998 and July 2002)
The board shall establish a nine-member PA advisory committee to review and make recommendations to the board regarding all PA-related matters. These include but are not limited to applications, renewals, approval of supervising physicians, disciplinary actions, and establishment of regulations. The advisory committee consists of five practicing PAs, two supervising physicians, one board member, and one public member. The committee elects its chair. Members are reimbursed for expenses.
LOUISIANA
R.S. 37:1270.1 (enacted 1993, amended 1997)
The law creates a Physician Assistant Advisory Committee of the Board of Medical Examiners, consisting of three governor-appointed licensed PAs, chosen from a list of names the Louisiana Academy of PAs submits, and two governor-appointed supervising physicians, chosen from a list of names the Board of Medical Examiners submits. At least one of the PAs must practice in a parish or municipality with a population of less than 20,000 people. The PAs must also have at least three years of practice experience.
The original law was amended in 1997 to expand the role of the Advisory Commimttee. Changes to the law empowered the committee to advise the board on all matters specifically dealing with the licensing or disciplining of PAs or the drafting and promulgating of PA regulations. The committee also reviews and makes recommendations on PA applications for licensure.
Each member serves a six-year term and may succeed himself unless the governor removes or replaces the member. The committee shall meet at least twice a year or more frequently as necessary. Four members constitute a quorum. Each member receives $50 per day while engaged in committee business, plus hotel and traveling expenses, paid out of the medical board's treasury.
Board of Medical Examiners rules, chapter 15, §1511.
The advisory committee is authorized to advise the board on all matters specifically dealing with licensing or disciplining of physician assistants or the drafting and promulgating of regulations relating to physician assistants. The advisory committee also reviews and makes recommendations to the board on applications for licensure as physician assistants. The board shall not act on any matter relating to physician assistants without first consulting with the advisory committee.
The advisory committee meets not less than twice each calendar year, or more frequently as the chairman or a majority of the members of the advisory committee deems necessary or appropriate. Meetings are held at the call of the chair.
MAINE
Statutes, Title 32, § 3270-B(6)
The law authorizes appointment of an advisory committee for continuing review of PA programs and rules and regulations.
Maine Board of Registration in Medicine, Regulations Chapter 2, §15
The board appoints an advisory committee for PAs comprised of such persons it deems appropriate but it must include at least two physicians and two licensed PAs. Medical board members and its executive director may serve on the committee. The duties of the committee are to review all matters pertaining to physician assistants and their supervision. The committee may make recommendations for action to the board. Committee members serve four-year terms with a 2-term limit. Members elect a chair, but the chair shall not be a regular member of the medical board.
MARYLAND
Code of Maryland, Title 14-201, Board of Physicians
(a) (1) The Board shall consist of 21 members appointed by the Governor with the advice of the Secretary and the advice and consent of the Senate.
(2) Of the 21 members:
(iv) 1 shall be a certified physician assistant appointed at the Governor's discretion as provided in subsections (f) and (g) of this section;
(f) (1) For the vacancy of a certified physician assistant appointed in accordance with subsection (a)(2)(iv) of this section, the Board shall:
(i) Notify all practicing certified physician assistants and professional organizations representing at least 25 certified physician assistants in the State of the vacancy;
(ii) Provide information regarding the selection process as provided under subsection (a)(2)(iv) of this section;
(iii) Solicit nominations for the vacancy; and
(iv) Forward to the Governor:
1. Valid nominations submitted by professional organizations representing at least 25 certified physician assistants in the State; and
2. Valid petitions submitted by practicing certified physician assistants supporting the appointment of the certified physician assistant to the Board that are signed by at least 25 practicing certified physician assistants in the State.
(2) The Board shall meet the requirements of paragraph (1) of this subsection within:
(i) 4 months prior to an upcoming vacancy on the Board; or
(ii) 2 months after a vacancy exists on the Board.
(g) For each vacancy of a certified physician assistant appointed in accordance with subsection (a)(2)(iv) of this section, the Governor may:
(1) Reappoint a member who has not served for more than two consecutive full terms; or
(2) Appoint a certified physician assistant in accordance with subsection (a)(2)(iv) of this section from lists submitted by the Board as provided in subsection (f)(1)(iv) of this section.
(h) Before taking office, each appointee to the Board shall take the oath required by Article I, § 9 of the State Constitution.
(i) (1) The term of a member is 4 years.
(2) The terms of members are staggered as required by the terms provided for members of the Board on August 1, 2003.
(3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.
(4) A member may not serve more than 2 consecutive full terms.
(j) (1) If a vacancy occurs as to a member, the Governor shall appoint a new member to serve only for the rest of the term and until a successor is appointed and qualifies.
(2) To the extent practicable, the Governor shall fill any vacancy on the Board within 60 days of the date of the vacancy.
(k) (1) On the recommendation of the Board, the Secretary may remove any member of the Board for neglect of duty, misconduct, malfeasance, or misfeasance in office.
(2) Upon the recommendation of the Secretary, the Governor may remove a member whom the Secretary finds to have been absent from 2 successive Board meetings without adequate reason.
(3) The Governor may remove a member for incompetence or misconduct.
Code of Maryland , Title 15-202, 302 (effective July 1, 1986; amended 2000); COMAR 10.32.03.03
The law and regulations outline a Physician Assistant Advisory Committee which functions as a subunit of the Maryland Board of Physicians. The committee consists of seven board-appointed members:
• Three licensed physicians, at least one of whom must specialize in general surgery or a surgical subspecialty and at least one of whom must specialize in internal medicine, family practice, or a similar primary care specialty
• Three certified physician assistants, from lists of names the Maryland Academy of PAs and the state institutions of higher learning with approved PA programs submit
• One consumer, which the Secretary of the Department of Health and Mental Hygiene selects
Two of the three physicians on the committee must have supervised PAs. The board elects a chair from among its members. The chair has a non-voting seat on the Board of Physicians.
Funds for compensation, expenses, and staff for the committee are allocated to the board in the state budget.
The committee, on its initiative or at the board's request, may recommend to the board regulations for implementing the law. The committee reviews delegation agreements and recommends to the board the approval, rejection, or modification of the delegation agreement and application. The committee is charged with conducting personal interviews of the PAs and their supervising physicians. It may also report to the board any conduct of a supervising physician or physician assistant that may be cause for disciplinary action, or any alleged unauthorized practice of a PA.
MASSACHUSETTS
General Laws, 1988, Chapter 13, Board of Registration of Physician Assistants (1989 amendment)
Legislation enacted in 1989, effective January 1, 1990, replaced the Board of Approval and Certification of PA Programs with a new Board of Registration of PAs under the Department of Consumer Affairs and Business Regulation.
The governor appoints board members, which include two physicians (at least one of whom is a member of the Massachusetts Medical Society), one PA educator, four PAs (selected from a list of names submitted by the Massachusetts Association of PAs), and two public members.
The board registers and issues certificates to PAs, takes appropriate disciplinary action, approves and issues certificates to PA programs, and maintains rosters. In consultation with the Board of Registration in Medicine, the PA board may adopt rules governing the practice and employment of PAs. It shall encourage the development of continuing education for PAs and has authority to adopt rules as to the type and amount of CME required for renewal of registration certificates.
MICHIGAN
Statutes, Chapter 325, § 333.17025
A joint task force was created for physician assistants. The task force consists of the following nine members:
• One member each from the board of medicine and the board of osteopathic medicine and surgery holding a license other than a health profession subfield license
• Five PAs
• Two public members
The task force promulgates rules regarding PA license approval, renewal, minimum qualifications, supervision, etc., and establishes criteria for evaluation of PA educational programs. One of its members sits on the medical board and another on the osteopathic board.
§333.17021
The Michigan board of medicine consists of nineteen voting members: ten physicians, one PA, and eight public members.
§333.17521
The Michigan board of osteopathic medicine and surgery consists of eight voting members: five physicians, one PA, and two public members.
MINNESOTA
Statute 147A
The statute creates a Physician Assistant Advisory Council. The Board of Medical Examiners appoints the council, which must include:
• Two public members
• Three registered PAs
• Two licensed physicians with experience supervising PAs
Members are limited to serving two terms. The council shall advise the board regarding PA registration standards and enforcement of grounds for discipline; provide for distribution of information regarding PA registration standards; review applications and recommend applicants for registration or reregistration; receive and process complaints about applicants and registrants; perform disciplinary investigations; and other duties the board requires.
MISSISSIPPI
Mississippi Code 73-43-11
The state board of medical licensure may appoint a task force or committee to address physician assistant regulation. At the present time, no such committee has been appointed.
If there is such a committee, at least one member shall be a PA the board selects from a list of three recommendations the Mississippi Academy of Physician Assistants submits, and at least one member shall be a nurse practitioner who is either a member of the Board of Nursing or a nurse practitioner the board selects from a list of three recommendations the Mississippi Nurses Association submits.
MISSOURI
§334.749 Advisory Commission for Physician Assistants
Law was established in 1996 to create an Advisory Commission for Physician Assistants. The commission makes recommendations to the Board of Healing Arts on issues concerning physician assistants and assists the board in carrying out the provisions of the PA practice act. The commission is to consist of five members: one member of the board, two physician assistants, one physician who supervises a PA, and one lay member. The governor appoints all members, with the exception of the board member appointee. All commission members serve three-year terms, with a two-term limit. The commission elects a chair and a secretary from its members. Commission members are reimbursed for expenses.
MONTANA
Montana Code Annotated § 37-20-406
The Montana Academy of Physician Assistants appoints one person to serve as a nonvoting liaison to the board to represent the interests of PAs.
Montana Code Annotated § 2-15-1731 (amended 1993 and 1995)
In 1993, the Board of Medical Examiners proposed legislation to add a physician assistant to the board. As enacted, the law now reads that the board consists of 11 members which the governor appoints with the consent of the Senate: five M.D.s, one D.O., one podiatrist, one nutritionist, one PA, and two public members.
NEBRASKA
Statutes, Chapter 71, § 1,107.25
The law establishes a Physician Assistant Committee which shall review and make recommendations to the board of medical examiners regarding all matters relating to PAs that come before the board, including but not limited to: applications for licensure, PA education, scope of practice, discipline, licensure requirements, and continuing medical education. The committee is directly responsible to the board. It is composed of:
• Two physician assistants
• One supervising physician
• One member of the board
• One layperson
The chair is elected by majority vote of the committee members. The Board of Health makes all appointments and reappointments. Terms are for four-years, at staggered intervals. Members may serve no more than two consecutive terms. The committee is required to meet on a regular basis and members receive reimbursement for time and travel expenditures as provided for state employees.
NEVADA
Board of Medical Examiners Regulations, § 630.415
The board appoints three licensed PAs to an advisory committee. These physician assistants must have lived in and actively and continuously practiced in Nevada as licensed PAs for a period of at least three years before their appointment. At the request of the board, the advisory committee reviews and makes recommendations to the board concerning any matters relating to licensed PAs.
NEW HAMPSHIRE
Revised Statutes § 329:2 (1981 Supp.)
The law establishes a board of registration in medicine consisting of seven members, including:
• Five members selected from among physicians and surgeons
• One member selected to represent paramedical personnel regulated by the board [only PAs currently so regulated]
• One public member
The governor appoints each member, with the approval of the council, to a term of five years. No member may serve more than two consecutive terms.
Revised Statutes § 328-0:9
The law also establishes a committee to serve in an advisory capacity to the board, consisting of:
• Two physicians who have supervised PAs
• Two physician assistants
Committee members are appointed by the board biennially. Members of the committee receive expense reimbursement plus $50 per day while on committee. Members serve a three-year term, and may not serve more than two consecutive terms. The committee is to review all PA issues, including applications for licensure, and to make recommendations to the board. The committee is to cooperate with the board in adopting rules.
NEW JERSEY
N. J. R. S. § 45: 9 (amended 1992)
The governor appoints one physician assistant to the board of medical examiners. The board is composed of 21 members, including 12 licensed physicians, 3 public members, one podiatrist, one physician assistant, one nurse midwife, and one licensed bio-analytical laboratory director. The governor appoints all members to serve 3-year terms.
A physician assistant advisory committee was created under the board of medical examiners, consisting of five members (three PAs, one physician, one public member) appointed by the governor to three-year terms. Initial appointments were made for staggered terms. Members are limited to two consecutive terms; expenses incurred in the performance of official duties are compensated. The committee must meet at least twice a year and may hold additional meetings as necessary to discharge its duties, which include the evaluation and approval of applicants' qualifications; disciplinary action against PAs who violate the law; adoption and administration of an examination; adoption of standards and approval of continuing medical education; and recommendations to the board regarding any pertinent subjects. The committee has an executive director appointed and paid by the division of consumer affairs.
The medical board must give due consideration to advice from the committee in adopting regulations regarding protocols and additional procedures that may be performed by PAs routinely or when directed by their supervising physicians.
NEW MEXICO
New Mexico Statutes Annotated 61-6-2 (amended 2005)
The Medical Practice Act was amended in 2005 to provide for one PA member on the medical board. The PA must be a licensed physician assistant and a resident of New Mexico for at least five years immediately preceding the date of appointment. The physician assistant member is appointed from a list of names the New Mexico Academy of Physician Assistants or its authorized governing body or council submits to the governor.
Members are appointed to four-year terms, staggered so that no more than three terms expire in a year. All board members shall hold office until their successors are appointed and qualified.
Duties of the board include enforcing the provisions of the Physician Assistant Act, reviewing and approving applicants for licensure, and adopting reasonable rules related to the practice of physician assistants.
An advisory committee was previously established via New Mexico Statutes Annotated 61-6-8.1 to review and make recommendations to the medical board on all matters relating to PAs. The committee was composed of four members appointed by the medical board. One member was a physician with experience supervising PAs. The other three, one of whom served as chair, were PAs the New Mexico Academy of PAs nominated to the board. The chair of the committee was a nonvoting advisor to the board. This advisory committee was abolished in the 2005 sunset of the Medical Practice Act, subsequent to a PA being added to the Medical Board.
NEW YORK
Title 8, Sec 6523 (Education Law)
A 1991 amendment changes the composition of the state board for medicine to include at least two physician assistants. The medical board, which the Board of Regents appoints on the recommendation of the commissioner of education, exists to assist the Regents and the Department of Education on matters of professional licensing. The medical board also addresses matters concerning undergraduate and graduate education, medical manpower supply and demand, practice issues, and continuing competency. The board also has 20 physicians and two public members.
Public Health Law section 230
The New York law contains a provision for creation of the Board of Professional Medical Conduct. This board is mandated to include physicians (M.D.s or D.O.s) as a two-thirds majority of board members, with the remaining one-third being public members. The board does all investigations and recommendations for disciplinary actions. Members serve three-year terms. The board is made up of 229 members. Physician assistants hold five of the public member seats.
NORTH CAROLINA
General Statutes of North Carolina §90-2 (amended 1993)
Legislation enacted in 1993 changed the composition of the medical board through the addition of more public members and one physician extender (PA or NP). The 12-member board is composed of seven physicians, at least three public members, and one physician extender. The governor appoints all members.
In 1995 a Physician Assistant Advisory Committee was created by a vote of the medical board. Members are medical board appointees. The committee consists of 15 members, four of whom are medical board members. The role of the committee is to advise the board on regulatory issues relating to physician assistants.
NORTH DAKOTA
Provisions permitting physician assistant participation in professional regulation do not exist.
OHIO
Ohio Revised Code 4730 (amended February 2006)
In a 1995 revision of the statute, the Physician Assistant Advisory Committee to the medical board was replaced by the Physician Assistant Policy Committee of the state medical board. The committee consists of seven members. Three of the members are physicians, one a medical board member, one to be appointed from a list of five physicians recommended by the Ohio State Medical Association, and one appointed from a list of five physicians recommended by the Ohio Osteopathic Association. At all times the physician membership of the committee shall include at least one physician who is a supervising physician of a physician assistant, preferably with at least two years experience as a supervising physician. Three committee members are to be physician assistants appointed from a list of five candidates recommended by the Ohio Association of Physician Assistants. The seventh member is to be a person who is not affiliated with any health care profession.
Two additional members are pharmacists appointed to serve only when the committee is developing or revising policy and procedures for physician-delegated prescriptive authority for physician assistants. Of these members, one is appointed from a list of five clinical pharmacists the Ohio pharmacists association recommends and one is appointed from the pharmacist members of the state board of pharmacy, preferably a clinical pharmacist member.
Committee members serve two-year terms with a three consecutive term limit, and receive reimbursement for actual expenses and a state-approved committee member stipend. The committee elects its own chair and meets at least quarterly.
The role of the committee is to submit recommendations to the board concerning:
• Education and registration requirements for PAs
• Rules, administration and enforcement relating to the PA statute
• Utilization plans
• Any issue referred to them by the medical board
The medical board must consider committee recommendations within 90 days and must approve or disapprove the recommendation. Disapproval requires a statement of reasons from the board. The committee may resubmit the recommendation after addressing the board's concerns. The board may also take action without committee recommendation.
OKLAHOMA
Oklahoma Statutes Title 59 § 519.2 (amended 1993)
Although the medical board by rule (Oklahoma Administrative Code, Title 435, 435:15-5-5) had established a physician assistant advisory committee, the PA practice act was revised in 1993, to create a committee with specific responsibilities.
The Physician Assistant Committee is composed of seven members: two PAs appointed by the medical board from a list of names submitted by the Oklahoma Academy of PAs; one physician member of the board; one physician who is not a member of the board, appointed from a list submitted by the Oklahoma State Medical Association; one physician member of the osteopathic board; one osteopathic physician who is not a board member, appointed from a list submitted by the Oklahoma Osteopathic Association; and one licensed pharmacist appointed by the pharmacy board. Terms are for five years, with staggered appointments.
The committee meets at least quarterly. Members elect a chairperson who represents the committee at all board meetings. Four members constitute a quorum. The committee advises the board on matters pertaining to PAs, including but not limited to: education and licensure requirements; methods to assure continued competency after licensure; drugs PAs may order and prescribe; grounds for suspension or revocation of a PA's license; education and experience requirements for practice in remote settings; etc. The committee also reviews and makes recommendations to the board on PA applications for licensure and for practice and assists in all PA disciplinary hearings.
When the committee considers applications for licensure, to establish standards of training or approve institutions for training, the committee includes the director (or the director's designee) of all PA educational programs in the state.
OREGON
Statutes Chapter 677, Regulations of the Board of Medical Examiners, 847-50-0063,-0065
The law establishes a Physician Assistant Committee which consists of five members. Members of the committee shall be appointed as follows:
• The board shall appoint one of its members and one physician (one of the two must supervise a PA).
• The Oregon Society of PAs shall appoint two PAs.
• The State Board of Pharmacy shall appoint one pharmacist.
Members serve three-year terms with a two consecutive term limit.
Duties of the committee include:
• Reviewing all applications for PA licensure and renewal.
• Reviewing applications of PAs for dispensing privileges.
• Recommending approval or disapproval of applications to the board.
• Recommending criteria to be used in granting dispensing privileges.
• Recommending the formulary for prescriptive privileges.
• Recommending the approval, disapproval or modification of applications for prescriptive privileges.
PENNSYLVANIA
Medical Practice Act (amended December 1985)
The State Board of Medicine consists of:
• The Commissioner
• The Secretary of Health
• Two members appointed by the governor who represent the public
• Seven members appointed by the governor, six of whom are medical doctors with unrestricted licenses to practice medicine and surgery [in Pennsylvania ] for five years immediately preceding their appointment; and
• One who shall be a nurse midwife, physician assistant, or certified registered nurse practitioner licensed or certified under the laws of Pennsylvania
The governor assures that nurse midwives, physician assistants, and certified registered NPs are appointed to four-year terms on a rotating basis so that of every three appointments, one is a nurse midwife, one is a PA, and one is a certified registered nurse practitioner. Members serve four-year terms with a two consecutive term limit.
Pennsylvania Osteopathic Medical Practice Act (amended to include PA or respiratory therapist in July 1993)
The State Board of Osteopathic Medicine consists of:
• Commissioner of Professional and Occupational affairs or Commissioner's designee
• Secretary of Health or Secretary's designee
• Two public members
• One member who is either a PA or a respiratory therapist
• Six osteopathic physicians
The public members, physicians, and PA and respiratory therapist members are governor appointees. The governor shall assure that the respiratory therapist and PA are appointed to rotating terms. Members serve four-year terms with a two consecutive term limit.
RHODE ISLAND
Statutes, § 5-54-5 (enacted 1982, amended 1991 and 1995)
With the governor's approval, the director of health appoints a Board of Registration of Physician Assistants, consisting of seven state residents. The board executes the duties, powers, and authority as set forth in the PA Practice Act, and is composed of the following:
• Two licensed physicians actively practicing medicine
• One CEO of health care facilities located/licensed in state (or their designees)
• Two representatives of the general public
• Two physician assistants
The duties of board are to administer, coordinate, and enforce provisions of the act, approve PA training programs, evaluate applicant qualifications, supervise any necessary examination, recommend disciplinary hearings, and investigate persons violating the act. This authority encompasses practicing PAs, supervising physicians, and those health care agencies employing PAs.
Members serve one-year terms.
SOUTH CAROLINA
South Carolina Code of Laws § 40-47-925
In 2000, the law was amended to create an eight member Physician Assistant Committee. The committee serves in an advisory role to the Board of Medical Examiners. The committee is composed of:
• Three licensed physician assistants who have worked in the state for at least three years
• Three licensed physicians, one of whom regularly employs a physician assistant
• One consumer
• One board member, who serves ex officio
All organizations, groups, or interested individuals may submit two names for each position to be filled. The board appoints the members. Terms are for four years and a member may not serve more than two consecutive terms. The committee meets at least twice a year, quorum is five members, and committee members receive mileage, subsistence, and per diem as provided by law. Chair, vice-chair, and secretary are elected by committee members.
In addition to recommending regulations to the board, the committee determines qualifications and makes recommendations regarding issuing and renewing licenses. The committee hears disciplinary cares and recommends findings to the board, which makes the final decision.
SOUTH DAKOTA
In 1987, the South Dakota Board of Medical and Osteopathic Examiners appointed three physician assistants to a newly created PA Advisory Committee. At the request of the board, the committee reviews and makes recommendations on applications for licensure, PA education, scope of practice, disciplinary action, licensure requirements, CME, and other matters.
Members serve staggered, three-year terms, and are limited to serving three consecutive terms.
TENNESSEE
Tennessee Code Annotated, Title 63 chapter 19
The law establishes a Committee on Physician Assistants within the Board of Medical Examiners to help in the performance of responsibilities enumerated in the law. The committee consists of five licensed PAs appointed by the governor; terms are four years. Members receive a per diem of $100.00 and travel reimbursement.
The committee elects a chair and secretary from among its members. All actions are effective after adoption by a majority of the committee and after adoption by a majority vote of the board at its next meeting.
The committee has the following duties:
• To promulgate all necessary rules to implement the act, including specifying offenses subject to disciplinary action
• To set and collect fees
• To review and approve or reject qualifications of applicants for initial license and biennial license renewal
• To issue, in the board's name, all approved PA licenses and renewals
• To deny, suspend, or revoke license or otherwise discipline by a fine or reprimand a licensee who is guilty of violating the law
• To adopt or administer examinations
• To conduct hearings
TEXAS
Texas Revised Civil Statutes Art. § 4495b-1 (amended 1993, 1995, and 2005)
When enacted in 1993, the physician assistant licensing law created a Physician Assistant Advisory Council "as an advisory board to the Texas State Board of Medical Examiners." A 1995 statutory revision changed the council's name to the Texas Board of Physician Assistant Examiners. A 2005 statutory revision changed the board's name to the Texas Physician Assistant Board. The board consists of nine members appointed by the governor: three physician assistants who have at least five years of clinical experience as practicing PAs; three physicians who currently supervise PAs; and three public members. Each board member is entitled to a per diem and transportation expenses. Board members may be removed for failing to maintain the required qualifications or failure to attend at least one-half of the regularly scheduled board meetings held in a calendar year. Anyone registered as a lobbyist may not serve on the board. Terms are for six years, with staggered appointments, and a limitation on serving more than two consecutive full terms or more than a total of three full terms. The board selects its own chair. Five members constitute a quorum.
The board adopts rules; reviews and approves or rejects PA applications for licensure and licensure renewals; issues all licenses; denies, suspends or revokes licenses; disciplines licenseholders; and collects fees. The board annually designates a portion of the revenue generated from PA licensing fees for student loan reimbursement for PAs practicing in rural health professional shortage areas.
UTAH
Utah Code Annotated § 58-70a-301 et seq (amended 1990)
At the initiative of the Department of Business Regulation, a law was passed in 1990 (effective July 1, 1990) establishing a Physician Assistant Licensing Board. The board consists of four physicians (at least two of whom are or have been PA supervisors, and one of whom may be a member of the Physicians Licensing Board), one PA, one PA program administrator, and one public member. The board has the authority to adopt rules and advise on disciplinary matters.
VERMONT
26 VSA § 1351(e)
The law states that every five years in January, the governor appoints a PA to the state board of medical practice to participate in PA-related matters only. The appointment is made from a list of PAs certified pursuant to the law. The PA appointed has a three-year term and is entitled to the same compensation and reimbursement for expenses as other members of the board.
Rules of the Board of Medical Practice, Section II, Rules for Physician Assistants, 5.2
According to this regulation, "PA committee" means a committee of the board that reviews matters relating to PAs, reports its findings to the board, and makes recommendations for action. (No committee is currently appointed.)
VIRGINIA
Code of Virginia 54.1-2950.1
The law creates the Advisory Committee on Physician Assistants appointed by the governor. The committee is composed of five members, to include:
• One physician who supervises PAs
• Three licensed PAs who have at least three years of practice experience
• One public member
Members serve for four-year terms with a two consecutive term limit.
WASHINGTON
RCW § 18.71.015
A 1994 revision of the statute combined the previously separate licensing and disciplinary boards into the Medical Quality Assurance Commission. This 19-member commission consists of 13 individuals licensed to practice medicine, two licensed physician assistants, and four public members. All commission members are appointed by the governor and are compensated for participation under state guidelines. The commission adopts all rules to carry out the medical practice act and physician assistant practice act, issues and denies licenses, and disciplines licensees. Terms are four years in length.
WEST VIRGINIA
West Virginia Code, § 30-3-5
The West Virginia Board of Medicine consists of 15 members. One member is the state director of health ex officio, with the right to vote as a member of the board. The other 14 members are appointed by the governor, with the advice and consent of the Senate. Eight of the members are physicians and two are podiatrists. One member is a licensed physician assistant. Members must be duly licensed or certified to practice their profession in West Virginia on the date of appointment and must have been licensed or certified and actively practicing that profession for at least five years immediately preceding the date of appointment. Three lay members are appointed to represent health care consumers.
Not more than four physicians, one podiatrist, and two lay members appointed by the governor as members of the board shall belong to the same political party. The physician assistant member may not belong to the same political party to which a majority of the lay members belong.
Members of the board receive one hundred dollars for each day actually spent attending sessions of the board or its committees. Board members are also reimbursed for all reasonable and necessary expenses for travel and board.
WISCONSIN
Statutes, Chapter 15, § 407(2), Council on PAs
The law creates a council on physician assistants in the Department of Regulation and Licensing to serve the medical examining board in an advisory capacity. The council's membership consists of:
• The vice chancellor for health sciences of University of Wisconsin-Madison or vice chancellor's designee
• One public member appointed by the governor for a two-year term
• Three physician assistants selected by the medical examining board for staggered two-year terms
Statutes, Chapter 448, § 20, Council on PAs; duties
The duties of the council on PAs are to recommend and advise the board on PA licensure and practice standards and to advise the board of regents regarding PA educational programs.
WYOMING
Statutes, 33-26-503 and Chapter V Rules and Procedures for the Licensure of and for the Conduct of Disciplinary Proceedings Against Physician Assistants, section 5
Revisions of the Medical Practice Act in 1987 codifed the existence of an advisory committee on physician assistants. The language in the law reads: "The board is empowered and directed to...appoint members to serve on an advisory committee to the board of medical examiners. At least two of the members shall be physician assistants and two members shall be physicians. The committee members are responsible to and shall serve at the board's pleasure. The advisory committee shall review and make recommendations to the board regarding all matters relating to PAs that come before the board, including but not limited to: applications for licensure, PA education, scope of practice, licensure requirements, and continuing medical education."
The advisory council meets in conjunction with the board for the purpose of interviewing candidates for recommendation to the board for licensure and other matters as directed by the board. The advisory council may recommend conditions, denial, suspension or revocation of licensure when it finds that the medical practice act and/or these rules are not being followed.
In 2001 the statute (Statutes, 33-26-501) was amended to add a PA to the Wyoming State Board of Medicine. The board consists of five physicians licensed to practice in Wyoming , one of whom must be a D.O., one PA, and two public members. The governor appoints all board members.
Last Revised: 8/10/07
