87R8740 ANG-F
By: Beckley H.B. No. 4352
A BILL TO BE ENTITLED
AN ACT
relating to the scope of practice of physician assistants.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Sections 204.202(a), (b), and (c), Occupations
Code, are amended to read as follows:
(a) The practice of a physician assistant includes
providing medical and surgical services delegated by a
collaborating [supervising] physician that are within the skills
[education, training, and experience] of the physician assistant, a
component of the physician assistant's scope of practice, and
provided through collaboration with a physician.
(b) Medical and surgical services provided by a physician
assistant may include:
(1) obtaining patient histories and performing
physical examinations;
(2) evaluating, diagnosing, managing, and providing
medical treatment;
(3) ordering, [or] performing, and interpreting
diagnostic studies and therapeutic procedures;
[(3) formulating a working diagnosis;]
(4) educating patients on health promotion and disease
prevention [developing and implementing a treatment plan];
(5) providing consultation on request [monitoring the
effectiveness of therapeutic interventions]; and
(6) writing medical orders [assisting at surgery;
[(7) offering counseling and education to meet patient
needs;
[(8) requesting, receiving, and signing for the
receipt of pharmaceutical sample prescription medications and
distributing the samples to patients in a specific practice setting
in which the physician assistant is authorized to prescribe
pharmaceutical medications and sign prescription drug orders as
provided by Section 157.0512 or 157.054;
[(9) prescribing or ordering a drug or device as
provided by Subchapter B, Chapter 157; and
[(10) making appropriate referrals].
(c) The activities listed by Subsection (b) may be performed
in a health care facility or other location [any place authorized by
a supervising physician], including a clinic, hospital, ambulatory
surgical center, patient home, nursing home, or other institutional
setting.
SECTION 2. Section 204.204, Occupations Code, is amended to
read as follows:
Sec. 204.204. COLLABORATION [SUPERVISION] REQUIREMENTS.
(a) A physician assistant shall collaborate with [be supervised
by] a collaborating [supervising] physician. A physician assistant
may have more than one collaborating [supervising] physician. The
collaborating [supervising] physician oversees the [activities of,
and accepts responsibility for,] medical services provided by the
physician assistant.
(b) Collaboration with [Supervision of] a physician
assistant by a collaborating [supervising] physician must be
continuous. The collaboration [supervision] does not require the
constant physical presence of the collaborating [supervising]
physician where physician assistant services are being performed,
but, if a collaborating [supervising] physician is not present, the
collaborating [supervising] physician and the physician assistant
must be, or must be able to easily be, in contact with one another by
radio, telephone, or another telecommunication device.
(c) The number of physician assistants a physician may
collaborate with [supervise] in a practice setting may not be less
than the number of physician assistants to whom a physician may
delegate the authority to prescribe or order a drug or device in
that practice setting under Subchapter B, Chapter 157.
SECTION 3. Sections 204.2045(a) and (c), Occupations Code,
are amended to read as follows:
(a) The collaboration [supervision] and delegation
requirements of this chapter and Subtitle B do not apply to medical
tasks performed by a physician assistant:
(1) during a disaster under the state emergency
management plan adopted under Section 418.042, Government Code;
(2) during a disaster declared by the governor or
United States government; or
(3) as a volunteer for a charitable organization or at
a public or private event, including a religious event, sporting
event, community event, or health fair.
(c) A physician assistant may perform tasks described by
this section:
(1) by collaborating with [under the supervision of]
any physician who is also performing volunteer work in the
disaster, for the charitable organization, or at the public or
private event; or
(2) without collaborating with [the supervision of] a
physician, if a physician is not available to provide supervision.
SECTION 4. Section 204.205, Occupations Code, is amended to
read as follows:
Sec. 204.205. REQUIREMENTS FOR COLLABORATING [SUPERVISING]
PHYSICIAN. A collaborating [supervising] physician must have a
practice agreement with the physician assistant with whom the
physician will collaborate regarding the scope of practice of the
physician assistant that is based on the physician assistant's
practice level and taking into consideration the physician
assistant's education, training, and experience[:
[(1) hold an unrestricted and active license as a
physician in this state;
[(2) notify the medical board of the physician's
intent to supervise a physician assistant;
[(3) submit to the medical board a statement that the
physician will:
[(A) supervise the physician assistant according
to medical board rule; and
[(B) retain professional and legal
responsibility for the care provided by the physician assistant;
and
[(4) receive approval from the medical board to
supervise the physician assistant].
SECTION 5. Section 204.206, Occupations Code, is amended to
read as follows:
Sec. 204.206. ESTABLISHMENT OF CERTAIN FUNCTIONS AND
STANDARDS. Each physician assistant and the physician assistant's
collaborating [supervising] physician shall ensure that:
(1) the physician assistant's scope of function is
identified;
(2) delegation of medical tasks is appropriate to the
physician assistant's level of education, training, and experience
[competence];
(3) the relationship between the physician assistant
and the collaborating [supervising] physician and the access of the
physician assistant to the supervising physician are defined; and
(4) a process is established for evaluating the
physician assistant's performance.
SECTION 6. Section 204.207, Occupations Code, is amended to
read as follows:
Sec. 204.207. ASSUMPTION OF PROFESSIONAL LIABILITY. A
physician assistant shall be legally responsible for the care
provided by the physician assistant [(a) Each supervising physician
retains legal responsibility for a physician assistant's patient
care activities, including the provision of care and treatment to a
patient in a health care facility].
[(b) If a physician assistant is employed by an entity,
including a health care facility, the entity shares the legal
responsibility for the physician assistant's acts or omissions with
the physician assistant's supervising physician.]
SECTION 7. This Act takes effect September 1, 2021.