American Academy of Physician Assistants

Major PA Victory in Michigan

Dec. 21, 2016 (updated Dec. 23, 2016)

PAs in Michigan are applauding the enactment of House Bill 5533, which increases patient access to healthcare by modernizing and updating how PAs practice. Under the new law, physicians within PA-physician healthcare teams will be recognized as participating physicians instead of supervising physicians to better reflect the PA’s and physician's role within the team. The new law also removes physician responsibility for PA practice, making each member of the healthcare team responsible for their own decisions. And it removes the rigid ratio restriction that arbitrarily limited the number of PAs with whom a physician may practice. Last, the new law grants PAs more autonomy to serve patients by recognizing PAs as full “prescribers” rather than limiting their care to “delegated prescriptive authority.” Signed by the governor on December 21, the new law is effective immediately.

This important legislation, which has been the priority for the Michigan Academy of PAs (MAPA) for the past two years, enacts key provisions of AAPA’s Model State Legislation for PAs, and is consistent with the revised Guidelines for State Regulation of PAs passed by the AAPA House of Delegates in May 2016. (This short video explains the Model and Guidelines.) AAPA worked with MAPA to support this breakthrough legislation and commends the Michigan Academy on this huge accomplishment.

“PAs are already providing excellent care to patients across Michigan,” said Josanne K. Pagel, MPAS, PA-C, Karuna ® RMT, DFAAPA, AAPA president and board chair. “As the healthcare delivery system changes, so must the regulations and laws governing it. We applaud Michigan lawmakers for approving this important legislation which breaks down barriers that prevent PAs from practicing medicine to the top of their education and experience.”

R. David Doan III, MS, PA-C, president of the Michigan Academy of PAs (MAPA), was enthusiastic about the work of the chapter.

“Much like how PAs practice medicine, passage of this important legislation was a team effort. We worked with important allies like Michigan State Medical Society and Michigan Osteopathic Association,” Doan said. “We also came together as a profession to make the case for why this legislation will help patients. We are excited about these changes and how they will improve how we can deliver care.”

Critically, HB 5533 makes PAs responsible for their professional actions. Studies have documented that PAs provide high quality cost-effective medical care. Physician liability for PA care is no longer necessary and its elimination removes an undue burden on physicians.

The bill also removes language defining PAs as an “agent” of the physician, a term employed decades ago to enable PAs to perform specific medical and surgical tasks on behalf of a physician. Some of these tasks included signing forms for sports physicals, accepting pharmaceutical samples or ordering specific tests or therapies. This term and concept are now outdated. Years ago, a common PA practice model was a single physician hiring a single PA. Today 32 percent of the PAs in Michigan are employed by hospitals and another 42 percent by group practices.

HB 5533 also fully recognizes PAs as “prescribers.” This is a change from PAs prescribing “as a delegated act of a supervising physician.” It reflects the level of autonomy PAs have in evaluating patients and writing prescriptions. It is also consistent with federal Drug Enforcement Administration (DEA) policy. In the eyes of the DEA, PAs are separate prescribers who must register and have their own individual DEA number before prescribing controlled medications for patients.

PAs have a proven record of providing high-quality care and these improvements to PA practice are big wins for patients in Michigan.