Arkansas Administrative Code › Agency 007 - ARKANSAS DEPARTMENT OF HEALTH › Division 33 - Division of Health Related Boards and Commissions › Rule 007.33.22-010 - Rule 24 - Physician Assistants

Current through Register Vol. 49, No. 6, June, 2024
RULE
			 24 RULES GOVERNING PHYSICIAN ASSISTANTS
1. A physician assistant must possess a
			 license issued by the Arkansas State Medical Board prior to engaging in such
			 occupation.
2. To obtain a license
			 from the Arkansas State Medical Board the physician assistant must do the
			 following:
a. Answer all questions to include
			 the providing of all documentation requested on an application form as provided
			 by the Arkansas State Medical Board;
b. Pay the required fee for licensure as
			 delineated elsewhere in this rule;
c. Provide proof of successful completion of
			 Physician Assistant National Certifying Examination, as administered by the
			 National Commission on Certification of Physician Assistants;
d. Certify and provide such documentation, as
			 the Arkansas State Medical Board should require that the applicant is mentally
			 and physically able to engage safely in the role as a physician
			 assistant;
e. Certify that the
			 applicant is not under any current discipline, revocation, suspension or
			 probation or investigation from any other licensing board;
f. Provide letters of recommendation as to
			 quality of practice history;
g. The
			 applicant should be at least 21 years of age;
h. Show proof of graduation with a Bachelor's
			 Degree from an accredited college or university or prior service as a military
			 corpsman;
i. Provide proof of
			 graduation from a physician assistant education program recognized by the
			 Accreditation Review Commission on Education for the Physician Assistant or by
			 its successor agency, and has passed the Physician Assistant National
			 Certifying Examination administered by the National Commission on Certification
			 of Physician Assistants;
j. The
			 submission to the Board of a delegation agreement delineating the scope of
			 practice that the physician assistant will engage in, the program of evaluation
			 and supervision by the supervising physician;
3. If an applicant for a license submits all
			 of the required information, complies with all the requirements in paragraph 2,
			 except paragraph 2 (j) and the same is reviewed and approved by the Board, then
			 the applicant may request a Letter of Intent from the Board and the Board may
			 issue the same. Said Letter of Intent from the Board will state that the
			 applicant has complied with all licensure requirements of the Board except the
			 submission of a Delegation Agreement and supervising physician and that upon
			 those being submitted to the Board, it is the intent of the board to license
			 the applicant as a physician assistant. Said Letter of Intent will expire six
			 (6) months from date of issue.
4.
			 The Delegation Agreement
a. This delegation
			 agreement is to be completed and signed by the physician assistant and his/her
			 designated supervising physician. Said delegation agreement will be written in
			 the form issued by the Arkansas State Medical Board. Said protocol must be
			 accepted by the Arkansas State Medical Board prior to licensure of the
			 physician assistant.
b. The
			 delegation agreement as completed by the physician assistant and the
			 supervising physician will include the following:
(1) area or type of practice;
(2) location of practice;
(3) geographic range of supervising
			 physician;
(4) the type and
			 frequency of supervision by the supervising physician;
(5) the process of evaluation by the
			 supervising physician;
(6) the name
			 of the supervising physician;
(7)
			 the qualifications of the supervising physician in the area or type of practice
			 that the physician assistant will be functioning in;
(8) the type of drug prescribing
			 authorization delegated to the physician assistant by the supervising
			 physician;
(9) the name of the
			 back-up supervising physician(s) and a description of when the backup
			 supervising physician(s) will be utilized.
c. A copy of the approved must be kept at the
			 practice location of the physician assistant.
5.
a. A
			 physician assistant must be authorized by his supervising physician to
			 prescribe legend drugs and scheduled medication for patients. Said
			 authorization must be stated in the delegation agreement and the request
			 approved by the Board. A supervising physician may only authorize a physician
			 assistant to prescribe schedule medication that the physician is authorized to
			 prescribe. A physician assistant may only be authorized to receive, prescribe,
			 order and administer schedule 2 through 5 medications, except that a physician
			 assistant may prescribe hydrocodone combination products reclassified from
			 Schedule 3 to Schedule 2 as of October 6, 2014, if authorized by the physician
			 assistant's supervising physician, and in accord with other requirements of the
			 section. Prescriptions written by a physician assistant must contain the name
			 of the supervising physician on the prescription. A physician assistant's
			 prescriptive authority extends to drugs in Schedule 2, except regarding
			 hydrocodone as stated above, only if the prescription is for:
(1) an opioid, if the prescription is only
			 for a five-day period or less; or
(2) a stimulant, if the prescription was
			 originally initiated by a physician; the physician has evaluated the patient
			 within six (6) months before the physician assistant issues a prescription; and
			 the prescription by the physician assistant is to treat the same condition as
			 the original prescription.
b. The physician assistant will make an entry
			 in the patient chart noting the name of the medication, the strength, the
			 dosage, the quantity prescribed, the directions, the number of refills,
			 together with the signature of the physician assistant and the printed name of
			 the supervising physician for every prescription written for a patient by the
			 physician assistant.
c. Patient
			 care orders generated by a physician assistant shall be construed as having the
			 same medical, health, and legal force and effect as if the orders were
			 generated by the physician assistant's supervising physician. The orders shall
			 be complied with and carried out as if the orders has been issued by the
			 physician assistant's supervising physician.
d. Physician assistants who prescribe
			 controlled substances shall register with the Drug Enforcement Administration
			 as part of the Drug Enforcement Administration's Mid-Level Practitioner
			 Registry, 21 C.F.R. Part
			 1300, 58 FR 3 1 171-31175, and the Controlled
			 Substances Act.
6. A
			 supervising physician and/or back-up supervising physician(s) should be
			 available for immediate telephone contact with the physician assistant any time
			 the physician assistant is rendering services to the public.
7.
a.
			 Physician assistants provide medical services to patients consistent with the
			 physician assistant's license, area of practice, or authorized under the
			 delegation agreement. Physician assistants will have to provide medical
			 services to the patients consistent with the standards that a licensed
			 physician would provide to a patient. As such, the physician assistant must
			 comply with the standards of medical care of a licensed physician as stated in
			 the Medical Practices Act, the Rules of the Board and the Orders of the
			 Arkansas State Medical Board. A violation of said standards can result in the
			 revocation or suspension of the license when ordered by the Board after
			 disciplinary charges are brought.
b. A physician assistant must clearly
			 identify himself or herself to the patient by displaying an appropriate
			 designation, that is a badge, name plate with the words "physician assistant"
			 appearing thereon.
c. A physician
			 assistant will not receive directly from a patient or an insurance provider of
			 a patient any monies for the services he or she renders the patient. Payment of
			 any bills or fees for labor performed by the physician assistant will be paid
			 to the employer of the physician assistant and not directly to the physician
			 assistant.
d. A physician assistant
			 may pronounce death and may authenticate with his or her signature a form that
			 may be authenticated by a supervising physician's signature as authorized under
			 A.C.A. §
										17-80-120.
e. A physician assistant may render care
			 within his or her scope of practice when responding to a need for medical care
			 created by an emergency or a state or local disaster if the physician assistant
			 is:
(1) licensed in this state;
(2) licensed or authorized to practice in
			 another state or territory; or
(3)
			 credentialed as a physician assistant by a federal employer. A physician
			 assistant who voluntarily and gratuitously, other than in the ordinary course
			 of his or her employment or practice, renders emergency medical assistance is
			 not liable for civil damages for personal injuries that result from acts or
			 omissions of the physician assistant that may constitute ordinary
			 negligence.
8.
			 The supervising physician is liable for the acts of a physician assistant whom
			 he or she is supervising if said acts of the physician assistant arise out of
			 the powers granted the physician assistant by the supervising physician. The
			 supervising physician may have charges brought against him by the Arkansas
			 State Medical Board and receive sanctions if the physician assistant should
			 violate the standards of medical practice as set forth in the Medical Practices
			 Act, the Rules of the Board and the standards of the medical community.
A supervising physician will notify the Arkansas State Medical
				Board within 10 days after notification of a claim or filing of a lawsuit for
				medical malpractice against a Physician Assistant, whom he supervises. Notice
				to the Board shall be sent to the office of the Board and upon such forms as
				may be approved by the Board. If the malpractice claim is in the form of a
				complaint in a filed lawsuit, a copy of the complaint shall be furnished to the
				Board along with the notification required by this Section.
9. Continuing Medical Education:
a. A physician assistant who holds an active
			 license to practice in the State of Arkansas shall complete 20 credit hours per
			 year continuing medical education.
b. If a person holding an active license as a
			 physician assistant in this State fails to meet the foregoing requirement
			 because of illness, military service, medical or religious missionary activity,
			 residence in a foreign country, or other extenuating circumstances, the Board
			 upon appropriate written application may grant an extension of time to complete
			 the same on an individual basis.
c.
			 Each year, with the application for renewal of an active license as a physician
			 assistant in this state, the Board will include a form which requires the
			 person holding the license to certify by signature, under penalty of perjury,
			 and disciplined by the Board, that he or she has met the stipulating continuing
			 medical education requirements. In addition, the Board may randomly require
			 physician assistants submitting such a certification to demonstrate, prior to
			 renewal of license, satisfaction of continuing medical education requirements
			 stated in his or her certification.
d. Continuing medical education records must
			 be kept by the licensee in an orderly manner.
All records relative to continuing medical education must be
				maintained by the licensee for at least three years from the end of the
				reporting period. The records or copies of the forms must be provided or made
				available to the Arkansas State Medical Board.
e. Failure to complete continuing education
			 hours as required or failure to be able to produce records reflecting that one
			 has completed the required minimum medical education hours shall be a violation
			 and may result in the licensee having his license suspended and/or
			 revoked.
f. A physician assistant
			 who is authorized to prescribe Schedule II hydrocodone combination products
			 reclassified from Schedule 3 to Schedule 2 as of October 6, 2014, must complete
			 at least five (5) continuing education hours in the area of pain
			 management.
g. Each year, each
			 physician assistant shall obtain at least one (1) hour of CME credit
			 specifically regarding the prescribing of opioids and benzodiazepines. The one
			 hour may be included in the twenty (20) credit hours per year of continuing
			 medical education required and shall not constitute an additional hour of CME
			 per year.
10. Physician
			 Assistants, HIV, HBV and HCV: Physicians assistants shall adhere to Rule 16
			 concerning HIV, HBV, and HCV.
History: Adopted December 7, 1977; Amended October 9,1999;
				Amended December 10,1999; Amended February 4, 2000; Amended April 8, 2005;
				Amended June 5, 2008; Amended April 12, 2012; Amended October 1, 2015,
				Effective December 14, 2015; Amended December 7, 2017, Effective June 12, 2018;
				Amended June 4, 2020, Effective August 7, 2020; Amended June 28, 2022,
				Effective November 19, 2022.
Replaced Regulation
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