reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-081 - How to return to active status when a license has expired

Current through Register Vol. 24-14, July 15, 2024
(1) To return to
				active status the physician assistant must meet the requirements of chapter
				246-12 WAC, Part 2, which includes paying the applicable fees under WAC
				246-918-990 and meeting the
				continuing medical education requirements under WAC
				246-918-180.
(2) If the license has expired for over three
				years, the physician assistant must meet requirements in subsection (1) of this
				section and the current licensure requirements under WAC
				246-918-080.
Statutory Authority:
					 RCW
					 43.70.280. 98-05-060, § 246-918-081,
					 filed 2/13/98, effective 3/16/98.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-090 - Physician assistant and certified physician assistant utilization (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					 18.71.017 and
					 18.71A.020. 96-03-073, §
					 246-918-090, filed 1/17/96, effective 2/17/96. Statutory Authority:
					 RCW
					 18.71.017. 92-12-089 (Order 278B), §
					 246-918-090, filed 6/3/92, effective 7/4/92; 91-06-030 (Order 147B), recodified
					 as § 246-918-090, filed 2/26/91, effective 3/29/91. Statutory Authority:
					 RCW
					 18.71A.020. 88-06-008 (Order PM 706), §
					 308-52-140, filed 2/23/88; 86-16-054 (Order PM 609), § 308-52-140, filed
					 8/1/86; 86-12-031 (Order PM 599), § 308-52-140, filed 5/29/86; 83-07-014
					 (Order PL 428 ), § 308-52-140, filed 3/10/83; 82-24-013 (Order PL 412 ),
					 § 308-52-140, filed 11/19/82; 82-03-022 (Order PL 390 ), §
					 308-52-140, filed 1/14/82; 81-03-078 (Order PL 368 ), § 308-52-140, filed
					 1/21/81; 78-04-029 (Order PL 285, Resolution No. 78-140), § 308-52-140,
					 filed 3/14/78.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-095

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					 18.71.017 and
					 18.71A.020. 96-03-073, §
					 246-918-095, filed 1/17/96, effective 2/17/96. Statutory Authority:
					 RCW
					 18.71A.020,
					 18.71A.040 and
					 18.130.186(2).
					 94-15-065, § 246-918-095, filed 7/19/94, effective
					 8/19/94.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-105 - Practice limitations due to disciplinary action

Current through Register Vol. 24-14, July 15, 2024
(1) To the extent a supervising physician's
				prescribing privileges have been limited by any state or federal authority,
				either involuntarily or by the physician's agreement to such limitation, the
				physician assistant will be similarly limited in their prescribing privileges,
				unless otherwise authorized in writing by the commission.
(2) The physician assistant shall notify
				their supervising physician whenever the physician assistant is the subject of
				an investigation or disciplinary action by the commission. The commission may
				notify the supervising physician or other supervising physicians of such
				matters as appropriate.
Statutory Authority:
					 RCW
					 18.71A.020,
					 18.71A.040 and
					 18.130.186(2).
					 94-15-065, § 246-918-105, filed 7/19/94, effective
					 8/19/94.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-110 - Termination of sponsorship or supervision (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					 18.71.017 and
					 18.71A.020. 96-03-073, §
					 246-918-110, filed 1/17/96, effective 2/17/96. Statutory Authority:
					 RCW
					 18.71.017. 92-12-089 (Order 278B), §
					 246-918-110, filed 6/3/92, effective 7/4/92; 91-06-030 (Order 147B), recodified
					 as § 246-918-110, filed 2/26/91, effective 3/29/91. Statutory Authority:
					 RCW
					 18.71A.020. 86-24-068 (Order PM 627), §
					 308-52-146, filed 12/3/86.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-120

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					 18.71A.020 and
					 chapter
					 18.71A RCW. 04-11-100,
					 § 246-918-120, filed 5/19/04, effective 6/30/04. Statutory Authority:
					 RCW
					 18.71.017 and
					 18.71A.020. 96-03-073, §
					 246-918-120, filed 1/17/96, effective 2/17/96. Statutory Authority:
					 RCW
					 18.71.017. 92-12-089 (Order 278B), §
					 246-918-120, filed 6/3/92, effective 7/4/92; 91-06-030 (Order 147B), recodified
					 as § 246-918-120, filed 2/26/91, effective 3/29/91. Statutory Authority:
					 RCW
					 18.71A.020. 88-06-008 (Order PM 706), §
					 308-52-147, filed 2/23/88.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-125 - Use of laser, light, radiofrequency, and plasma devices as applied to the skin

Current through Register Vol. 24-14, July 15, 2024
(1) For the
				purposes of this rule, laser, light, radiofrequency, and plasma devices
				(hereafter LLRP devices) are medical devices that:
(a) Use a laser, noncoherent light, intense
				pulsed light, radiofrequency, or plasma to topically penetrate skin and alter
				human tissue; and
(b) Are
				classified by the federal Food and Drug Administration as prescription
				devices.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-126 - Nonsurgical medical cosmetic procedures

Current through Register Vol. 24-14, July 15, 2024
(1) The purpose of this rule is to establish
				the duties and responsibilities of a physician assistant who injects medication
				or substances for cosmetic purposes or uses prescription devices for cosmetic
				purposes. These procedures can result in complications such as visual
				impairment, blindness, inflammation, burns, scarring, disfiguration,
				hypopigmentation and hyperpigmentation. The performance of these procedures is
				the practice of medicine under
				RCW
				18.71.011.
(2) This section does not apply to:
(a) Surgery;
(b) The use of prescription lasers,
				noncoherent light, intense pulsed light, radiofrequency, or plasma as applied
				to the skin; this is covered in WAC
				246-919-605
				and
				246-918-125;
(c) The practice of a profession by a
				licensed health care professional under methods or means within the scope of
				practice permitted by such license;
(d) The use of nonprescription devices;
				and
(e) Intravenous
				therapy.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-130 - Physician assistant identification

Current through Register Vol. 24-14, July 15, 2024
(1)
				A physician assistant must clearly identify himself or herself as a physician
				assistant and must appropriately display on their person identification as a
				physician assistant.
(2) A
				physician assistant must not present himself or herself in any manner which
				would tend to mislead the public as to their title.
Statutory Authority:
					 RCW
					 18.71.017 and
					 18.71A.020. 96-03-073, §
					 246-918-130, filed 1/17/96, effective 2/17/96. Statutory Authority:
					 RCW
					 18.71.017. 92-12-089 (Order 278B), §
					 246-918-130, filed 6/3/92, effective 7/4/92; 91-06-030 (Order 147B), recodified
					 as § 246-918-130, filed 2/26/91, effective 3/29/91. Statutory Authority:
					 RCW
					 18.71A.020. 88-06-008 (Order PM 706), §
					 308-52-148, filed 2/23/88.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-140 - Certified physician assistants (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					 18.71.017 and
					 18.71A.020. 96-03-073, §
					 246-918-140, filed 1/17/96, effective 2/17/96. Statutory Authority:
					 RCW
					 18.71.017. 92-12-089 (Order 278B), §
					 246-918-140, filed 6/3/92, effective 7/4/92; 91-06-030 (Order 147B), recodified
					 as § 246-918-140, filed 2/26/91, effective 3/29/91. Statutory Authority:
					 RCW
					 18.71A.020. 88-06-008 (Order PM 706), §
					 308-52-149, filed 2/23/88.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-150 - Assistance or consultation with other physicians (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					 18.71.017. 91-06-030 (Order 147B), recodified
					 as § 246-918-150, filed 2/26/91, effective 3/29/91. Statutory Authority:
					 RCW
					 18.71A.020. 83-03-031 (Order PL 421 ), §
					 308-52-150, filed 1/14/83.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-170 - Physician assistant and certified physician assistant AIDS prevention and information education requirements (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					 43.70.280. 98-05-060, § 246-918-170,
					 filed 2/13/98, effective 3/16/98. Statutory Authority:
					 RCW
					 18.71.017 and
					 18.71A.020. 96-03-073, §
					 246-918-170, filed 1/17/96, effective 2/17/96. Statutory Authority:
					 RCW
					 18.71.017. 92-12-089 (Order 278B), §
					 246-918-170, filed 6/3/92, effective 7/4/92; 91-06-030 (Order 147B), recodified
					 as § 246-918-170, filed 2/26/91, effective 3/29/91. Statutory Authority:
					 RCW
					 70.24.270. 89-08-063 (Order PM 831), §
					 308-52-190, filed 4/3/89.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-171 - Renewal and continuing medical education cycle

Current through Register Vol. 24-14, July 15, 2024
(1) Under WAC
				246-12-020,
				an initial credential issued within ninety days of the physician assistant's
				birthday does not expire until the physician assistant's next
				birthday.
(2) A physician assistant
				must renew their license every two years on their birthday. Renewal fees are
				accepted no sooner than ninety days prior to the expiration date.
(3) Each physician assistant will have two
				years to meet the continuing medical education requirements in WAC
				246-918-180.
				The review period begins on the first birthday after receiving the initial
				license.
Statutory Authority:
					 RCW
					 18.71.017,
					 18.130.050(1),
					 18.130.040(4),
					 18.130.050(12) 
					 and 18.130.340. 99-23-090, §
					 246-918-171, filed 11/16/99, effective
					 1/1/00.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-175 - Retired active license

Current through Register Vol. 24-14, July 15, 2024
(1) To
				obtain a retired active license a physician assistant must comply with chapter
				246-12 WAC, excluding WAC
				246-12-120(2)(c)
				and (d).
(2) A physician assistant with a retired
				active license must have a practice agreement on file with the commission in
				order to practice except when serving as a "covered volunteer emergency worker"
				as defined in
				RCW
				38.52.180(5)(a) and engaged
				in authorized emergency management activities or serving under chapter 70.15
				RCW.
(3) A physician assistant with
				a retired active license may not receive compensation for health care
				services.
(4) A physician assistant
				with a retired active license may practice under the following conditions:
(a) In emergent circumstances calling for
				immediate action; or
(b)
				Intermittent circumstances on a part-time or full-time nonpermanent
				basis.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-180 - Continuing medical education requirements

Current through Register Vol. 24-14, July 15, 2024
(1) A physician assistant must complete one
				hundred hours of continuing education every two years as required in chapter
				246-12 WAC, Part 7, which may be audited for compliance at the discretion of
				the commission.
(2) In lieu of one
				hundred hours of continuing medical education the commission will accept :
(a) Current certification with the NCCPA;
				or
(b) Compliance with a continuing
				maintenance of competency program through the American Academy of Physician
				Assistants (AAPA) or the NCCPA; or
(c) Other programs approved by the
				commission.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-185 - Training in suicide assessment, treatment, and management

Current through Register Vol. 24-14, July 15, 2024
(1) A licensed physician assistant must
				complete a one-time training in suicide assessment, treatment, and management.
				The training must be at least six hours in length and may be completed in one
				or more sessions.
(2) The training
				must be completed by the end of the first full continuing education reporting
				period after January 1, 2016, or during the first full continuing education
				period after initial licensure, whichever occurs later, or during the first
				full continuing education reporting period after the exemption in subsection
				(6) of this section no longer applies. The commission accepts training
				completed between June 12, 2014, and January 1, 2016, that meets the
				requirements of
				RCW
				43.70.442 as meeting the one-time training
				requirement.
(3) The training must
				be on the model list developed by the department of health under
				RCW
				43.70.442. The establishment of the model
				list does not affect the validity of training completed prior to July 1,
				2017.
(4) The hours spent
				completing training in suicide assessment, treatment, and management count
				toward meeting applicable continuing education requirements in the same
				category specified in WAC
				246-918-180.
(5) The commission exempts any licensed
				physician assistant from the training requirements of this section if the
				physician assistant has only brief. limited. or no patient contact.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-195 - Health equity continuing education training requirements

Current through Register Vol. 24-14, July 15, 2024
(1) A physician
				assistant must complete two hours of health equity continuing education
				training every four years as described in WAC
				246-12-800 through
				246-12-830.
(2) The two hours of health equity continuing
				education a physician assistant completes count toward meeting applicable
				continuing education requirements in the same category specified in WAC
				246-918-180.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-230 - Practice of medicine-Surgical procedures (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					 18.71.017. 91-06-030 (Order 147B), recodified
					 as § 246-918-230, filed 2/26/91, effective 3/29/91. Statutory Authority:
					 RCW
					 18.71A.020. 89-13-002 (Order PM 850), §
					 308-52-630, filed 6/8/89, effective
					 9/30/89.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-250 - Basic physician assistant-surgical assistant (PASA) duties

Current through Register Vol. 24-14, July 15, 2024
The physician assistant-surgical assistant (PASA) who is not
				  eligible to take the NCCPA certifying exam shall:
(1) Function only in the operating room as
				approved by the commission;
(2)
				Only be allowed to close skin and subcutaneous tissue, placing suture
				ligatures, clamping, tying and clipping of blood vessels, and cauterizing for
				hemostasis under direct supervision;
(3) Only be allowed to assist the operating
				surgeon. The PASA may not perform any independent surgical procedures, even
				under direct supervision;
(4) Have
				no prescriptive authority; and
(5)
				Only write operative notes. The PASA may not write any progress notes or
				order(s) on hospitalized patients.
Statutory Authority:
					 RCW
					 18.71.017 and
					 18.71A.020. 96-03-073, §
					 246-918-250, filed 1/17/96, effective 2/17/96. Statutory Authority:
					 RCW
					 18.71A.020 and
					 18.71.060. 93-21-016, §
					 246-918-250, filed 10/11/93, effective 11/11/93. Statutory Authority:
					 RCW
					 18.71.017. 92-12-089 (Order 278B), §
					 246-918-250, filed 6/3/92, effective 7/4/92; 91-06-030 (Order 147B), recodified
					 as § 246-918-250, filed 2/26/91, effective 3/29/91. Statutory Authority:
					 RCW
					 18.71A.020. 89-13-002 (Order PM 850), §
					 308-52-650, filed 6/8/89, effective
					 9/30/89.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-260 - Physician assistant-surgical assistant (PASA)-Use and supervision

Current through Register Vol. 24-14, July 15, 2024
The following section applies to the physician
				  assistant-surgical assistant (PASA) who is not eligible to take the NCCPA
				  certification exam.
(1) Responsibility
				of PASA. The PASA is responsible for performing only those tasks authorized by
				the supervising physician(s) and within the scope of PASA practice described in
				WAC
				246-918-250.
				The PASA is responsible for ensuring their compliance with the rules regulating
				PASA practice and failure to comply may constitute grounds for disciplinary
				action.
(2) Limitations,
				geographic. No PASA may be used in a place geographically separated from the
				institution in which the PASA and the supervising physician are authorized to
				practice.
(3) Responsibility of
				supervising physician(s). Each PASA shall perform those tasks they are
				authorized to perform only under the supervision and control of the supervising
				physician(s). Such supervision and control may not be construed to necessarily
				require the personal presence of the supervising physician at the place where
				the services are rendered. It is the responsibility of the supervising
				physician(s) to ensure that:
(a) The operating
				surgeon in each case directly supervises and reviews the work of the PASA. Such
				supervision and review shall include remaining in the surgical suite until the
				surgical procedure is complete;
(b)
				The PASA shall wear identification as a "physician assistant-surgical
				assistant" or "PASA." In all written documents and other communication
				modalities pertaining to their professional activities as a PASA, the PASA
				shall clearly denominate their profession as a "physician assistant-surgical
				assistant" or "PASA";
(c) The PASA
				is not presented in any manner which would tend to mislead the public as to
				their title.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-310 - Acupuncture-Definition (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
					 RCW
					 18.71.017 and
					 18.71A.020. 96-03-073, §
					 246-918-310, filed 1/17/96, effective 2/17/96. Statutory Authority:
					 RCW
					 18.71.017. 91-06-030 (Order 147B), recodified
					 as § 246-918-310, filed 2/26/91, effective 3/29/91. Statutory Authority:
					 RCW
					 18.71A.020. 83-07-014 (Order PL 428 ), §
					 308-52-504, filed 3/10/83; 82-24-013 (Order PL 412 ), § 308-52-504, filed
					 11/19/82.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-410 - Sexual misconduct

Current through Register Vol. 24-14, July 15, 2024
(1) The
				following definitions apply throughout this section unless the context clearly
				requires otherwise.
(a) "Patient" means a
				person who is receiving health care or treatment, or has received health care
				or treatment without a termination of the physician assistant-patient
				relationship. The determination of when a person is a patient is made on a
				case-by-case basis with consideration given to a number of factors, including
				the nature, extent and context of the professional relationship between the
				physician assistant and the person. The fact that a person is not actively
				receiving treatment or professional services is not the sole determining
				factor.
(b) "Physician assistant"
				means a person licensed to practice as a physician assistant under chapter
				18.71A RCW.
(c) "Key third party"
				means a person in a close personal relationship with the patient and includes,
				but is not limited to, spouses, partners, parents, siblings, children,
				guardians and proxies.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › Section 246-918-420 - Abuse

Current through Register Vol. 24-14, July 15, 2024
(1) A physician
				assistant commits unprofessional conduct if the physician assistant abuses a
				patient. A physician assistant abuses a patient when he or she:
(a) Makes statements regarding the patient's
				body, appearance, sexual history, or sexual orientation that have no legitimate
				medical or therapeutic purpose;
(b)
				Removes a patient's clothing or gown without consent;
(c) Fails to treat an unconscious or deceased
				patient's body or property respectfully; or
(d) Engages in any conduct, whether verbal or
				physical, which unreasonably demeans, humiliates, embarrasses, threatens, or
				harms a patient.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-801 - Exclusions

Current through Register Vol. 24-14, July 15, 2024
WAC
					 246-918-800
					 through
					 246-918-935
					 do not apply to:
(1) The treatment of
				  patients with cancer-related pain;
(2) The provision of palliative, hospice, or
				  other end-of-life care;
(3) The
				  provision of procedural medications;
(4) The treatment of patients who have been
				  admitted to any of the following facilities for more than 24 hours:
(a) Acute care hospitals licensed under
				  chapter 70.41 RCW;
(b) Psychiatric
				  hospitals licensed under chapter 71.12 RCW;
(c) Nursing homes licensed under chapter
				  18.51 RCW and nursing facilities as defined in WAC
				  388-97-0001;
(d) Long-term acute care hospitals as defined
				  in
				  RCW
				  74.60.010; or
(e) Residential treatment facilities as
				  defined in
				  RCW
				  71.12.455; or
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-803

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-803, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-804

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-804, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-805

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-805, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-806

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-806, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-807

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-807, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-808

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-808, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-809

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-809, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-810

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-810, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-811

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-811, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-812

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-812, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-813

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						18.71.450,
						18.71A.100,
						18.71.017, and
						18.71A.020. 11-12-025, §
						246-918-813, filed 5/24/11, effective
						1/2/12.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-815 - Patient notification, secure storage, and disposal

Current through Register Vol. 24-14, July 15, 2024
(1) The physician assistant shall discuss
				  with the patient the following information at the first issuance of a
				  prescription for opioids and at the transition from acute to subacute, and
				  subacute to chronic:
(a) Risks associated
				  with the use of opioids, including the risk of dependence and overdose, as
				  appropriate to the medical condition, the type of patient, and the phase of
				  treatment;
(b) Pain management
				  alternatives to opioids, including nonopioid pharmacological and
				  nonpharmacological treatments, whenever reasonable, clinically appropriate,
				  evidence-based alternatives exist;
(c) The safe and secure storage of opioid
				  prescriptions;
(d) The proper
				  disposal of unused opioid medications including, but not limited to, the
				  availability of recognized drug take-back programs; and
(e) That the patient has the right to refuse
				  an opioid prescription or order for any reason. If a patient indicates a desire
				  to not receive an opioid, the physician assistant must document the patient's
				  request and avoid prescribing or ordering opioids, unless the request is
				  revoked by the patient.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-820 - Use of alternative modalities for pain treatment

Current through Register Vol. 24-14, July 15, 2024
The physician assistant shall exercise their professional
					 judgment in selecting appropriate treatment modalities for acute nonoperative,
					 acute perioperative, sub-acute, or chronic pain including the use of multimodal
					 pharmacologic and nonpharmacologic therapy as an alternative to opioids
					 whenever reasonable, clinically appropriate, evidence-based alternatives
					 exist.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-918-825 - Continuing education requirements for opioid prescribing

Current through Register Vol. 24-14, July 15, 2024
(1) To prescribe an opioid in Washington
				  state, a physician assistant licensed to prescribe opioids shall complete a
				  one-time continuing education requirement regarding best practices in the
				  prescribing of opioids or the opioid prescribing rules in this chapter. The
				  continuing education must be at least one hour in length.
(2) The physician assistant shall complete
				  the one-time continuing education requirement described in subsection (1) of
				  this section by the end of the physician assistant's first full continuing
				  education reporting period after January 1, 2019, or during the first full
				  continuing education reporting period after initial licensure, whichever is
				  later.
(3) The hours spent
				  completing training in prescribing of opioids count toward meeting applicable
				  continuing education requirements in the same category specified in WAC
				  246-919-460.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-ACUTE NONOPERATIVE PAIN AND ACUTE PERIOPERATIVE PAIN › Section 246-918-830 - Patient evaluation and patient record-Acute nonoperative pain

Current through Register Vol. 24-14, July 15, 2024
Prior to issuing an opioid prescription for acute
					 nonoperative pain or acute perioperative pain, the physician assistant
					 shall:
(1) Conduct and document an
				  appropriate history and physical examination, including screening for risk
				  factors for overdose and severe postoperative pain;
(2) Evaluate the nature and intensity of the
				  pain or anticipated pain following surgery; and
(3) Inquire about any other medications the
				  patient is prescribed or is taking.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-ACUTE NONOPERATIVE PAIN AND ACUTE PERIOPERATIVE PAIN › Section 246-918-835 - Treatment plan-Acute nonoperative pain

Current through Register Vol. 24-14, July 15, 2024
The physician assistant shall comply with the requirements
					 in this section when prescribing opioids for acute nonoperative pain.
(1) The physician assistant should consider
				  prescribing nonopioids as the first line of pain control in patients unless not
				  clinically appropriate in accordance with the provisions of WAC
				  246-918-820.
(2) The physician
				  assistant, or their designee, shall conduct queries of the PMP in accordance
				  with the provisions of WAC 246-918-935.
(3) If the physician assistant prescribes
				  opioids for effective pain control, such prescription must not be in a greater
				  quantity than needed for the expected duration of pain severe enough to require
				  opioids. A three-day supply or less will often be sufficient. The physician
				  assistant shall not prescribe beyond a seven-day supply without clinical
				  documentation in the patient record to justify the need for such a
				  quantity.
(4) The physician
				  assistant shall reevaluate the patient who does not follow the expected course
				  of recovery, and reconsider the continued use of opioids or whether tapering or
				  discontinuing opioids is clinically indicated.
(5) Follow-up visits for pain control must
				  include objectives or metrics to be used to determine treatment success if
				  opioids are to be continued. This may include:
(a) Change in pain level;
(b) Change in physical function;
(c) Change in psychosocial function;
				  and
(d) Additional indicated
				  diagnostic evaluations.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-ACUTE NONOPERATIVE PAIN AND ACUTE PERIOPERATIVE PAIN › Section 246-918-840 - Treatment plan-Acute perioperative pain

Current through Register Vol. 24-14, July 15, 2024
The physician assistant shall comply with the requirements
					 in this section when prescribing opioids for perioperative pain.
(1) The physician assistant should consider
				  prescribing nonopioids as the first line of pain control in patients unless not
				  clinically appropriate in accordance with the provisions of WAC
				  246-918-820.
(2) The physician
				  assistant, or their designee, shall conduct queries of the PMP in accordance
				  with the provisions of WAC 246-918-935.
(3) If the physician assistant prescribes
				  opioids for effective pain control, such prescription must not be in a greater
				  quantity than needed for the expected duration of pain severe enough to require
				  opioids. A three-day supply or less will often be sufficient. The physician
				  assistant shall not prescribe beyond a fourteen-day supply from the time of
				  discharge without clinical documentation in the patient record to justify the
				  need for such a quantity.
(4) The
				  physician assistant shall reevaluate a patient who does not follow the expected
				  course of recovery and reconsider the continued use of opioids or whether
				  tapering or discontinuing opioids is clinically indicated.
(5) Follow-up visits for pain control should
				  include objectives or metrics to be used to determine treatment success if
				  opioids are to be continued. This may include:
(a) Change in pain level;
(b) Change in physical function;
(c) Change in psychosocial function;
				  and
(d) Additional indicated
				  diagnostic evaluations or other treatments.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-SUBACUTE PAIN › Section 246-918-845 - Patient evaluation and patient record-Subacute pain

Current through Register Vol. 24-14, July 15, 2024
The physician assistant shall comply with the requirements
					 in this section when prescribing opioids for subacute pain.
(1) Prior to issuing an opioid prescription
				  for subacute pain, the physician assistant shall assess the rationale for
				  continuing opioid therapy:
(a) Conduct an
				  appropriate history and physical examination;
(b) Reevaluate the nature and intensity of
				  the pain;
(c) Conduct, or cause
				  their designee to conduct, a query of the PMP in accordance with the provisions
				  of WAC 246-918-935;
(d) Screen the
				  patient's level of risk for aberrant behavior and adverse events related to
				  opioid therapy;
(e) Obtain a
				  biological specimen test if the patient's functional status is deteriorating or
				  if pain is escalating; and
(f)
				  Screen or refer the patient for further consultation for psychosocial factors
				  if the patient's functional status is deteriorating or if pain is
				  escalating.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-SUBACUTE PAIN › Section 246-918-850 - Treatment plan-Subacute pain

Current through Register Vol. 24-14, July 15, 2024
The physician assistant, having recognized the progression
					 of a patient from the acute nonoperative or acute perioperative phase to the
					 subacute phase shall develop an opioid treatment plan.
(1) If tapering has not begun prior to the
				  six- to twelve-week subacute phase, the physician assistant shall reevaluate
				  the patient. Based on effect on function or pain control, the physician
				  assistant shall consider whether opioids will be continued, tapered, or
				  discontinued.
(2) If the physician
				  assistant prescribes opioids for effective pain control, such prescription must
				  not be in a greater quantity than needed for the expected duration of pain that
				  is severe enough to require opioids. During the subacute phase the physician
				  assistant shall not prescribe beyond a fourteen-day supply of opioids without
				  clinical documentation to justify the need for such a quantity.
(3) If a prescription results in the patient
				  receiving a combination of opioids with a sedative medication listed in WAC
				  246-918-920, such prescribing must be in accordance with WAC
				  246-918-920.
(4) If the physician
				  assistant elects to treat a patient with opioids beyond the six- to twelve-week
				  subacute phase, the physician assistant shall document in the patient record
				  that the patient is transitioning from subacute pain to chronic pain. Rules
				  governing the treatment of chronic pain, WAC 246-918-855 through 246-918-905,
				  shall apply.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-CHRONIC PAIN MANAGEMENT › Section 246-918-855 - Patient evaluation and patient record-Chronic pain

Current through Register Vol. 24-14, July 15, 2024
When the patient enters the chronic pain phase, the
					 patient shall be reevaluated as if presenting with a new disease. The physician
					 assistant shall include in the patient's record:
(1) An appropriate history including:
(a) The nature and intensity of the
				  pain;
(b) The effect of pain on
				  physical and psychosocial function;
(c) Current and relevant past treatments for
				  pain, including opioids and other medications and their efficacy; and
(d) Review of comorbidities with particular
				  attention to psychiatric and substance use.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-CHRONIC PAIN MANAGEMENT › Section 246-918-860 - Treatment plan-Chronic pain

Current through Register Vol. 24-14, July 15, 2024
The physician assistant, having recognized the progression
					 of a patient from the subacute phase to the chronic phase, shall develop an
					 opioid treatment plan as follows:
(1)
				  Treatment plan and objectives including:
(a)
				  Documentation of any medication prescribed;
(b) Biologic specimen testing
				  ordered;
(c) Any labs, diagnostic
				  evaluations, referrals, or imaging ordered;
(d) Other planned treatments; and
(e) Written agreement for treatment as
				  provided in WAC 246-918-865.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-CHRONIC PAIN MANAGEMENT › Section 246-918-865 - Written agreement for treatment-Chronic pain

Current through Register Vol. 24-14, July 15, 2024
The physician assistant shall use a written agreement that
					 outlines the patient's responsibilities for opioid therapy. This written
					 agreement for treatment must include the following provisions:
(1) The patient's agreement to provide
				  samples for biological specimen testing when requested by the physician
				  assistant;
(2) The patient's
				  agreement to take medications at the dose and frequency prescribed with a
				  specific protocol for lost prescriptions and early refills;
(3) Reasons for which opioid therapy may be
				  discontinued;
(4) The requirement
				  that all opioid prescriptions for chronic pain are provided by a single
				  prescriber or a single clinic, except as provided in WAC 246-918-915 for
				  episodic care;
(5) The requirement
				  that all opioid prescriptions for chronic pain are to be dispensed by a single
				  pharmacy or pharmacy system whenever possible;
(6) The patient's agreement to not abuse
				  alcohol or use other medically unauthorized substances;
(7) A violation of the agreement may result
				  in a tapering or discontinuation of the prescription; and
(8) The patient's responsibility to safeguard
				  all medications and keep them in a secure location.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-CHRONIC PAIN MANAGEMENT › Section 246-918-870 - Periodic review-Chronic pain

Current through Register Vol. 24-14, July 15, 2024
(1)
				  The physician assistant shall periodically review the course of treatment for
				  chronic pain. The frequency of visits, biological testing, and PMP queries in
				  accordance with the provisions of WAC 246-918-935, must be determined based on
				  the patient's risk category:
(a) For a
				  high-risk patient, at least quarterly;
(b) For a moderate-risk patient, at least
				  semiannually;
(c) For a low-risk
				  patient, at least annually;
(d)
				  Immediately upon indication of concerning aberrant behavior; and
(e) More frequently at the physician
				  assistant's discretion.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-CHRONIC PAIN MANAGEMENT › Section 246-918-875 - Long-acting opioids-Chronic pain

Current through Register Vol. 24-14, July 15, 2024
Long-acting opioids should only be prescribed by a
					 physician assistant who is familiar with its risks and use, and who is prepared
					 to conduct the necessary careful monitoring. Special attention should be given
					 to patients who are initiating such treatment. The physician assistant
					 prescribing long-acting opioids should have a one-time completion of at least
					 four hours of continuing education relating to this topic.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-918 - Physician assistants Washington medical commission › OPIOID PRESCRIBING-CHRONIC PAIN MANAGEMENT › Section 246-918-880 - Consultation-Recommendations and requirements-Chronic pain

Current through Register Vol. 24-14, July 15, 2024
(1) The physician assistant shall consider
				  referring the patient for additional evaluation and treatment as needed to
				  achieve treatment objectives. Special attention should be given to those
				  chronic pain patients who are under eighteen years of age or who are potential
				  high-risk patients.
(2) The
				  mandatory consultation threshold is one hundred twenty milligrams MED. In the
				  event a physician assistant prescribes a dosage amount that meets or exceeds
				  the consultation threshold of one hundred twenty milligrams MED per day, a
				  consultation with a pain management specialist as described in WAC 246-918-895
				  is required, unless the consultation is exempted under WAC 246-918-885 or
				  246-918-890.
(3) The mandatory
				  consultation must consist of at least one of the following:
(a) An office visit with the patient and the
				  pain management specialist;
(b) A
				  telephone, electronic, or in-person consultation between the pain management
				  specialist and the physician assistant;
(c) An audio-visual evaluation conducted by
				  the pain management specialist remotely where the patient is present with
				  either the physician assistant or a licensed health care practitioner
				  designated by the physician assistant or the pain management specialist;
				  or
(d) Other chronic pain
				  evaluation services as approved by the commission.