California Improves Chart Co-Signature Requirements for PAs

Oct. 6, 2015

On Oct. 6, California Gov. Jerry Brown signed a bill into law that improves documentation requirements for PAs in California. Senate Bill (SB) 337, sponsored by the California Academy of PAs (CAPA), adds flexibility to the state’s current chart co-signature requirements that will allow for a reduction in the number of charts that are required to be co-signed by a physician.

The bill creates two new alternatives to the current 5 percent monthly chart co-signature requirement when practicing with protocols. The first option allows PAs to have a minimum of 10 cases reviewed through medical records review meetings that occur during at least 10 months of the year. The second new option requires a review of at least 10 records per month for 10 months during the year using a combination of countersignature and the medical records review meeting documentation methods. The medical records review meetings may occur in person or by electronic communication.

The bill also reduces the state’s Schedule II chart co-signature requirement from 100 percent to 20 percent for PAs that have completed a controlled substance course as outlined in California regulations.

CAPA sponsored SB 337 in an effort to reduce the administrative burden chart co-signing places on PA teams. Jeremy Adler, MS, PA-C, DFAAPA, CAPA’s immediate past president and a PA working in pain management, made enacting this change a priority when he took office as CAPA’s president last year.

“In my practice, I saw the impact an excessive chart co-signature requirement had on PA teams and how it disadvantages PAs in the workforce,” Adler said. “With SB 337, I hope that PA teams will now have more time to provide care to patients and the ability to better decide on chart review policies that best fit their practice setting.”

AAPA supported CAPA’s efforts on this bill from the beginning by discussing strategies and providing draft bill language, resource materials and data. We applaud CAPA’s great advocacy work to achieve this legislative improvement for PA practice in California.

SB 337 takes effect Jan. 1, 2016. For more information, please contact Keisha Pitts, JD, director of constituent organization outreach and advocacy.