HCS HB 497 -- PHYSICIAN ASSISTANTS

SPONSOR:  Wasson (Sater)

COMMITTEE ACTION:  Voted "do pass" by the Special Committee on
Professional Registration and Licensing by a vote of 8 to 0.

This substitute expands the definition of "supervision" of
physician assistants to allow supervising physicians to be
available via telecommunications for consultation, assistance, or
intervention.  Supervising physicians must be present a minimum
of 66% of the clinic's hours for practice supervision and
collaboration when utilizing physician assistants, and physician
assistants must practice within 30 miles of the supervising
physician.

The Advisory Commission on Physician Assistants is authorized to
create a waiver mechanism by which an individual physician and a
physician assistant together may apply with the State Board of
Registration for the Healing Arts for alternate amounts of
on-site supervision.  After receiving a waiver, the physician
assistant will be allowed to conduct unsupervised practice up to
50 miles from the supervising physician in a designated health
professional shortage area.

Prior to allowing a physician assistant to practice without the
physician being physically present, the physician assistant will
practice for one month with continuous physician supervision.
After January 1, 2008, a physician assistant applicant must have
a master's degree in a health or medical science related field.

The substitute also voids and makes it against public policy to
require any physician to enter into any contract or other
agreement to act as a supervising physician for any physician
assistant.  A physician has the right to refuse to act as a
supervising physician, and no contract will limit the supervising
physician's ultimate authority over any protocols or standing
orders.

Except in a hospital setting, a physician cannot supervise more
than three full-time physician assistants.

FISCAL NOTE:  No impact on state funds in FY 2008, FY 2009, and
FY 2010.

PROPONENTS:  Supporters say that the bill increases access to
care and is not an attempt to set up independent practices.
Missouri is the only state that has no onsite percentage
supervision requirements.  If the bill is not passed this year,
many services in rural health clinics will be reduced or
completely eliminated.

Testifying for the bill were Representative Sater; Missouri
Association of Physician Assistants; Paul Winter, Missouri
Academy of Physician Assistants; Andrew Johnson; Floyd
Northington, D.O.; Toby Bisges; Missouri Hospital Association;
and Missouri Farm Bureau.

OPPONENTS:  Those who oppose the bill say that it will not
increase access to care, but is an attempt for physician
assistants to increase their scope of practice and establish
independent practices.  The proposed 55% of supervision is
difficult to quantify, and a more rounded percentage of 80% would
work better.

Testifying against the bill were Missouri State Medical
Association; Missouri Academy of Family Physicians; and Missouri
Association of Osteopathic Physicians and Surgeons.

Missouri House of Representatives
94th General Assembly, 1st Regular Session
Last Updated July 25, 2007 at 11:19 am