Physician Assistants and Collaboration

Earlier this year, New Mexico amended its Medical Practice Act to allow collaborative practice relationships between physician assistants (PAs) and licensed physicians (HB 215).

The changes to the law allow PAs who practice primary care to collaborate with a licensed physician but require PAs who practice specialty care to be supervised by a licensed physician. Collaboration is defined as the “process by which a licensed physician and a physician assistant jointly contribute to the health care and medical treatment of patients” and requires each of the parties to deliver only the services they are licensed and authorized to provide. A collaborating physician does not need to be physically present when a PA is providing services.

New Mexico also changed the certification requirements for PAs. In the past, a PA had to be certified by the National Commission on Certification of Physician Assistants. Now the state medical board can designate additional certifying agencies.

The West Virginia Legislature also addressed the issue of PA collaboration and passed a bill amending the state’s Physician Assistants Practice Act (SB 347). Unlike the change to New Mexico’s law, which makes a distinction between collaboration and supervision, the West Virginia bill essentially substitutes the term “supervision” with “collaboration” (i.e., the definition of collaboration is the same as supervision).

While it did not create a difference between collaboration and supervision, the bill did make other key changes to PA practice. First, it provided that PAs are entitled to 100 percent of the allowable reimbursement rate given to physicians or advanced practice registered nurses by private and public insurance plans. Second, the bill gave PAs signatory authority for documents within their scope of practice including death certificates, do-not-resuscitate forms, handicap hunting certificates, and utility service maintenance forms. Finally, the bill removed a requirement for PAs to maintain certification from the National Commission on Certification of Physician Assistants. The removal of the PA certification requirement caused West Virginia’s governor to veto the bill. In his veto message, the governor stated that “[b]y removing the state’s requirement that physician assistants maintain national certification as a condition of renewing their license, the interests of West Virginia patients are not being protected as strongly as they should be.”

To find out more about how states are dealing with PA scope of practice issues please visit the Legislative Database page.