21.570.12 96th Legislative Session 0
Introduced by: Representative Chris Johnson
An Act to revise provisions related to physician assistants.
Be it enacted by the Legislature of the State of South Dakota:
Section 1. That § 36-4A-1 be AMENDED.
36-4A-1. Definition of terms.
Terms as used in this chapter mean:
(1) "Board," the State Board of Medical and Osteopathic Examiners;
(2) "Physician assistant," a health professional who meets the qualifications defined in this chapter and is licensed by the board;
physician," a doctor of medicine or doctor of osteopathy
licensed by the board who
a physician assistant;
the act of overseeing the activities of, and accepting responsibility
for, the medical services rendered by a physician
the act of communicating pertinent information or consulting with a
licensed physician or other health care provider, with each
contributing the person's expertise to optimize the overall care
delivered to the patient.
Section 2. That § 36-4A-1.1 be AMENDED.
36-4A-1.1. Collaborative agreement defined--Required terms--Filing.
agreement, as used in this chapter, means a written agreement
authored and signed by
and the supervising physician
who has not met the required five hundred twenty practice hours and a
physician, licensed pursuant to chapter 36-4,
or a physician assistant, licensed under this chapter.
prescribe the delegated activities which the physician assistant may
perform, consistent with § 36-4A-26.1
and contain such other information as required by the board to
describe the physician assistant's level of competence and the
supervision provided by the physician
set forth the terms and conditions of the collaboration and such
other information as required by the board.
A signed copy of the
agreement shall be kept on file at the
primary practice site
of the physician assistant who has not met the practice hour
filed with and approved by the board prior to beginning practice. No
physician assistant may practice without an approved practice
provided to the board upon request.
Section 3. That § 36-4A-4 be AMENDED.
36-4A-4. Unlawful practice as misdemeanor--Each violation as separate offense.
Except as provided in §§ 36-4A-5
any person who practices as a physician assistant in this state
without a license issued by the board and a
approved by the board
as required by this chapter
is guilty of a Class 1 misdemeanor. Each violation shall be
considered a separate offense.
A person who meets the qualifications for licensure under this chapter but does not possess a current license may use the title, physician assistant, but may not act or practice as a physician assistant unless licensed under this chapter.
Section 4. That § 36-4A-8 be AMENDED.
36-4A-8. Issuance of license--Qualifications.
The board may grant a license to an applicant who:
(1) Is of good moral character;
(2) Has successfully completed an educational program for physician assistants accredited by the Accreditation Review Commission on Education for the Physician Assistant or its successor agency, or, prior to 2001, either by the Committee on Allied Health Education and Accreditation or the Commission on Accreditation of Allied Health Education Program;
(3) Has passed the Physician
Assistant National Certification Examination administered by the
National Committee on Education for Physician Assistants;
(4) Has submitted verification that the physician assistant applicant is not subject to any disciplinary proceeding or pending complaint before any medical or other licensing board unless the board considers such proceedings or complaint and agrees to licensure; and
(5) Has completed a minimum of five hundred twenty practice hours as a licensed physician assistant or has in place a collaborative agreement.
Section 5. That § 36-4A-8.1 be AMENDED.
36-4A-8.1. Temporary license--Expiration.
The board may issue a temporary license to an applicant who has successfully completed an approved program and has submitted evidence to the board that the applicant is a candidate accepted to write the examination required by § 36-4A-8 or is awaiting the results of the first examination for which the applicant is eligible after graduation from an approved physician assistant program. A temporary license may be issued only once and is effective for a term of not more than one hundred twenty days. A temporary license expires on the occurrence of the following:
(1) Issuance of a regular license;
(2) Failure to pass the licensing examination; or
(3) Expiration of the term for which the temporary license was issued.
The limitation on the term of a temporary license does not apply to an applicant who has passed the licensing examination, has a collaborative agreement in place, and has an application for a regular license pending before the board.
The evidence of examination requirement and limitation on the term of a temporary license do not apply to an applicant otherwise eligible to write the examination after graduation from an approved physician assistant program but for the cancelation or delay of such examination due to national disaster or emergency.
Section 6. That § 36-4A-8.2 be AMENDED.
36-4A-8.2. Licensure by endorsement--Temporary licensure awaiting endorsement.
applicant for licensure as a physician assistant in this state shall
submit to a state and federal criminal background investigation by
means of fingerprint checks by the Division of Criminal Investigation
and the Federal Bureau of Investigation. Upon application, the board
shall submit completed fingerprint cards to the Division of Criminal
Investigation. Upon completion of the criminal background check, the
Division of Criminal Investigation shall forward to the board all
information obtained as a result of the criminal background check.
This information shall be obtained prior to permanent licensure of
the applicant. The board may require a state and federal criminal
background check for any licensee who is the subject of a
disciplinary investigation by the board. Failure to submit or
cooperate with the criminal background investigation is grounds for
denial of an application or may result in revocation of a license.
The applicant shall pay for any fees charged for the cost of
fingerprinting or the criminal background investigation.
Upon application and payment of the required fee, the board may issue
a license to practice as a physician assistant to a person licensed
under the laws of another state, territory, or country if the
requirements for licensure of the other state, territory, or country
are at least as stringent as those of this state and the applicant is
not otherwise disqualified under § 36-4A-8.
Upon application and payment of the required fee, the board may issue
a temporary license to a person awaiting licensure by endorsement
under this section. A temporary license issued under this section
shall state the dates between which it is valid. The period during
which the temporary license is valid may not exceed one hundred
The limitation on the term of a temporary license does not apply during a period of statewide disaster or emergency declared by the Governor under the authority of chapter 34-48A.
Section 7. That a NEW SECTION be added:
36-4A-8.3. Criminal background investigation--Applicants and licensees under investigation--Fees.
Each applicant for licensure as a physician assistant in this state shall submit to a state and federal criminal background investigation by means of fingerprint checks by the Division of Criminal Investigation and the Federal Bureau of Investigation. Upon application, the board shall submit completed fingerprint cards to the Division of Criminal Investigation. Upon completion of the criminal background check, the Division of Criminal Investigation shall forward to the board all information obtained as a result of the criminal background check. This information shall be obtained prior to permanent licensure of the applicant. The board may require a state and federal criminal background check for any licensee who is the subject of a disciplinary investigation by the board. Failure to submit to or cooperate with the criminal background investigation is grounds for denial of an application or may result in revocation of a license. The applicant shall pay for any fees charged for the cost of fingerprinting or the criminal background investigation.
Section 8. That § 36-4A-20.1 be AMENDED.
36-4A-20.1. Abortion restricted.
board may not approve any practice agreement that includes abortion
as a permitted procedure
Nothing in this chapter authorizes a physician assistant to perform
Section 9. That § 36-4A-26.1 be AMENDED.
36-4A-26.1. Scope of practice--Collaboration required.
physician assistant shall be considered an agent of the supervising
physician in the performance of all practice-related activities. A
physician assistant may provide those medical services that are
delegated by the supervising physician pursuant to § 36-4A-1.1
if the service is within the physician assistant's skills, forms a
component of the physician's scope of practice, and is provided with
A physician assistant may provide any medical service permitted under
this chapter for which the physician assistant has been prepared by
education, training, and experience, and for which the physician
assistant is competent to perform. A physician assistant may provide
the following medical services:
(1) Initial medical diagnosis and institution of a plan of therapy or referral;
(2) Prescribing and provision of
drug samples or a limited supply of labeled medications, including
controlled substances listed on Schedule II in chapter 34-20B
for one period of not more than thirty days,
for treatment of causative factors and symptoms. Medications or
sample drugs provided to patients shall be accompanied with written
administration instructions and appropriate documentation shall be
entered in the patient's record. Physician assistants may request,
receive, and sign for professional samples of drugs provided by the
(3) Responding to emergencies and the institution of emergency treatment measures including the writing of a chemical or physical restraint order when the patient may do personal harm or harm others;
(4) Completing and signing of official documents such as birth and death certificates and similar documents required by law;
(5) Taking X rays and performing
(6) Performing physical examinations for participation in athletics and certifying that the patient is healthy and able to participate in athletics; and
(7) Delegating and assigning therapeutic measures to assistive personnel.
A physician assistant shall collaborate with other health care providers and refer or transfer patients as necessary and appropriate.
Section 10. That § 36-4A-26.2 be AMENDED.
36-4A-26.2. Emergency or disaster services--Physician supervision.
A physician assistant licensed in
this state or licensed or authorized to practice in any other United
States jurisdiction or who is credentialed as a physician assistant
by a federal employer who is responding to a need for medical care
created by an emergency or a state or local disaster,
to be defined as
that occurs in
the place of one's employment ),
may render such care that
he or she
the physician assistant
is able to provide
without supervision as it is defined in this chapter, or with such
supervision as is available. No
physician who supervises a physician assistant providing medical care
in response to such an emergency or state or local disaster is
required to meet the requirements set forth in this chapter for a
Section 11. That § 36-4A-26.3 be AMENDED.
36-4A-26.3. Civil liability for voluntary or gratuitous emergency medical assistance.
No physician assistant licensed
in this state or licensed or authorized to practice in other states
of the United States who voluntarily and gratuitously, and other than
in the ordinary course of employment or practice, renders emergency
medical assistance is liable for civil damages for any personal
injuries which result from acts or omissions by those persons in
rendering emergency care which constitute ordinary negligence. The
immunity granted by this section does not apply to acts or omissions
constituting willful, or wanton negligence or if the medical
assistance is rendered at any hospital, physician's office, or other
health care delivery entity where those services are normally
rendered. No physician who
a physician assistant voluntarily and gratuitously providing
emergency care as described in this section is liable for civil
damages for any personal injuries which result from acts or omissions
by the physician assistant rendering emergency care.
Section 12. That § 36-4A-29 be REPEALED.
36-4A-29. Physician supervision--Methods.
Section 13. That § 36-4A-29.1 be REPEALED.
36-4A-29.1. Modification of method and frequency of supervision--Number of physician assistants--Application.
Section 14. That § 36-4A-29.2 be AMENDED.
36-4A-29.2. Conditions for physician or physician assistant collaboration.
order to supervise
To collaborate with
a physician assistant, a physician or
physician assistant shall:
(1) Be licensed as a physician by the board pursuant to chapter 36-4, or as a physician assistant under this chapter, respectively;
(2) Be free from any restriction
on his or her ability
a physician assistant that has been imposed by board disciplinary
(3) Maintain a written
agreement with the physician assistant as described in § 36-4A-1.1.
Section 15. That § 36-4A-30 be AMENDED.
36-4A-30. Physician not responsible--Physician assistant care.
in this chapter relieves the
of the professional or legal responsibility
is not professionally or legally responsible
for the specific
patients cared for by the
actually provides to a patient.
Section 16. That § 36-4A-37 be AMENDED.
36-4A-37. Nonrenewal, suspension, or revocation of license--Other disciplinary action.
The board may deny the issuance or renewal of a license. The board may suspend, revoke, or impose other disciplinary actions upon the license of any physician assistant issued under this chapter upon satisfactory proof, in compliance with chapter 1-26, of the licensee's:
(1) Professional incompetence or unprofessional or dishonorable conduct as defined in §§ 36-4-29 and 36-4-30;
(2) Violation of this chapter in any respect;
(3) Failure to maintain
on file with the board a copy of each practice agreement containing
the current information regarding the licensee's practice status
or provide upon request a collaborative agreement
as required by
(4) Rendering medical services
delegated to the physician assistant in the practice agreement; or (5) Rendering
medical services without supervision of a physician as required by
law and the rules of the board
permitted under this chapter.
Section 17. That a NEW SECTION be added:
36-4A-50. Primary care provider.
Notwithstanding any other provision of law or regulation, a physician assistant is considered to be a primary care provider if the physician assistant is practicing in the medical specialties required for a physician to be a primary care provider.
Section 18. That a NEW SECTION be added:
36-4A-51. Coverage of services.
Payment for services within the physician assistant's scope of practice shall be made when ordered or performed by a physician assistant, if the same service would have been covered if ordered or performed by a physician. A physician assistant may bill for and receive direct payment for any medically necessary service delivered.
A physician assistant shall be identified as the rendering professional in the billing and claims process when a physician assistant delivers medical or surgical services to a patient. No insurance company or third-party payor may impose a practice, education, or collaboration requirement inconsistent with or more restrictive than existing law or rule applicable to physician assistants.
Catchlines are not law. (§ 2-16-13.1) Underscores indicate new language.
indicate deleted language.