HLT-08-14-00001-RP Physician Assistants and Specialist Assistants
10/29/14 N.Y. St. Reg. HLT-08-14-00001-RP
NEW YORK STATE REGISTER
VOLUME XXXVI, ISSUE 43
October 29, 2014
RULE MAKING ACTIVITIES
DEPARTMENT OF HEALTH
REVISED RULE MAKING
NO HEARING(S) SCHEDULED
I.D No. HLT-08-14-00001-RP
Physician Assistants and Specialist Assistants
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following revised rule:
Proposed Action:
Amendment of Part 94 of Title 10 NYCRR.
Statutory authority:
Public Health Law, sections 3308, 3701 and 3702
Subject:
Physician Assistants and Specialist Assistants.
Purpose:
Allows LPAs to prescribe controlled substances (including Schedule II) to patients under the care of the supervising physician.
Text of revised rule:
PART 94
PHYSICIAN[’S] ASSISTANTS AND SPECIALIST[’S] ASSISTANTS
Section 94.1 Definitions.
(a) [Registered] Licensed physician[’s] assistant means an individual who is currently [registered] licensed as a physician[’s] assistant by the New York State Department of Education.
(b) Registered specialist[’s] assistant means an individual who is currently registered as a specialist[’s] assistant by the New York State Department of Education.
(c) Hospital means an institution or facility possessing a valid operating certificate issued pursuant to article 28 of the Public Health Law and authorized to employ physician[’s] assistants pursuant to part 707 of the State Hospital Code.
(d) Physician means a practitioner of medicine licensed to practice medicine pursuant to article 131 of the Education Law.
94.2 Supervision and scope of duties.
(a) A [registered] licensed physician[’s] assistant or a registered specialist[’s] assistant may perform medical services but only when under the supervision of a physician. Such supervision shall be continuous but shall not necessarily require the physical presence of the supervising physician at the time and place where the services are performed. The licensed physician assistant or registered specialist assistant shall retain records documenting the continuous supervision by the physician who is responsible for such supervision.
(b) Medical acts, duties and responsibilities performed by a [registered] licensed physician[’s] assistant or registered specialist[’s] assistant must:
(1) be assigned to him or her by the supervising physician;
(2) be within the scope of practice of the supervising physician; and
(3) be appropriate to the education, training and experience of the [registered] licensed physician[’s] assistant or registered specialist[’s] assistant.
(c) No physician may employ or supervise more than [two] four [registered] licensed physician[’s] assistants and two registered specialist[’s] assistants in his or her private practice.
(d) No physician may supervise more than six [registered] licensed physician[’s] assistants or registered specialist[’s] assistants or any combination thereof [employed by] in a hospital setting, no matter if the licensed physician assistants or registered specialist assistants are employed or contracted by a hospital.
(e) Prescriptions and medical orders may be [written] issued by a [registered] licensed physician[’s] assistant as provided in this subdivision when assigned by the supervising physician.
(1) A [registered] licensed physician[’s] assistant may [write]issue prescriptions for a patient who is under the care of the physician responsible for the supervision of the [registered] licensed physician[’s] assistant. The prescription shall be issued in accordance with Section 281 and Article 33 of the Public Health Law and Part 80 of this Title, written on the blank form of the supervising physician and shall include the name, address and telephone number of the supervising physician and the name of the licensed physician assistant. The prescription shall also bear the name, the address, the age of the patient and the date on which the prescription was [written] issued.
(2) [Prescriptions for controlled substances not listed under section 80.67 of this Part shall be written on the blank form of the supervising physician and shall include all other information required by Article 28 of the Public Health Law and Part 80 of this Title.] A licensed physician assistant, in good faith and acting within his or her lawful scope of practice, and to the extent assigned by his or her supervising physician, may prescribe controlled substances as a practitioner under Article 33 of the Public Health Law, to patients under the care of such physician responsible for his or her supervision. Licensed physician assistants may issue prescriptions for controlled substances under section 3306 of the Public Health Law provided that such prescriptions shall be issued in accordance with Section 281 and Article 33 of the Public Health Law and Part 80 of this Title.
(3) [Registered physician’s assistants may write prescriptions for those controlled substances listed under section 80.67 of this Part which are not classified as Schedule II controlled substances, provided that such prescriptions shall be written on official New York State forms issued to the physician’s assistant.] The licensed physician assistant shall sign all such prescriptions with his or her own name followed by the letters L.P.A. and his or her State Education Department registration number, except that an electronic prescription must contain the electronic signature of the licensed physician assistant and shall include the name, address and telephone number of the supervising physician.
(4) [The registered physician’s assistant shall sign all such prescriptions by printing the name of the supervising physician, printing his/her own name and additionally signing his/her own name followed by the letters R.P.A. and his/her State Education Department registration number.] A licensed physician assistant employed or extended privileges by a hospital may, if permissible under the bylaws, policies and procedures of the hospital, issue prescriptions for controlled substances listed under section 3306 of the Public Health Law on official New York State prescription forms issued to the hospital. Such prescriptions shall be issued in accordance with Section 281 and Article 33 of the Public Health Law and Part 80 of this Title and must include the imprinted name of the licensed physician assistant and the name of the physician responsible for his or her supervision.
[(5) Registered physician’s assistants may not write prescriptions for controlled substances listed under section 3306 of the Public Health Law as Schedule II controlled substances.
(6)] (5) A [registered] licensed physician[’s] assistant employed or extended privileges by a hospital may, if permissible under the bylaws, [rules and regulations] policies and procedures of the hospital, write medical orders, including those for controlled substances, for inpatients under the care of the physician responsible for his supervision. Countersignature of such orders may be required if deemed necessary and appropriate by the supervising physician or the hospital, but in no event shall countersignature be required prior to execution.
(f) A physician supervising or employing a [registered] licensed physician[’s] assistant or registered specialist[’s] assistant shall remain medically responsible for the medical services performed by the [registered] licensed physician[’s] assistant or registered specialist[’s] assistant whom such physician supervises or employs.
(g) Qualified individuals may be registered as specialist[’s] assistants in the following categories:
(1) Orthopedic assistant. A specialist[’s] assistant registered in this category is an individual:
(i) who satisfactorily completed a program for the training of orthopedic assistants approved by the New York State Department of Education; or
(ii) who possesses equivalent education, training and experience. Training and experience while in military service which led to an orthopedic specialist, orthopedic cast room technician, or orthopedic clinic technician rating and two years of satisfactory experience as an orthopedic assistant working under the supervision of an orthopedic surgeon within the past five years; or completion of medical corps school and five years of satisfactory experience as an orthopedic assistant working under the supervision of an orthopedic surgeon within the past eight years may be considered equivalent education, training and experience for the purpose of registration in this category.
(2) Urologic assistant. A specialist[’s] assistant registered in this category is an individual:
(i) who satisfactorily completed a program for the training of urologic assistants approved by the New York State Department of Education; or
(ii) who possesses equivalent education, training and experience. Training and experience while in military service which led to a urology surgical technician or urological technician or clinical specialist rating and two years of satisfactory experience as a urologic assistant working under the supervision of an urologist within the past five years; or completion of medical corps school and five years of satisfactory experience as an urologic assistant working under the supervision of an urologist within the past eight years may be considered equivalent education, training and experience for the purpose of registration in this category.
(3) Acupuncture. A specialist[’s] assistant registered in this category shall be employed or supervised only by a physician authorized to administer acupuncture in accordance with the rules and regulations of the New York State Department of Education and is an individual:
(i) who satisfactorily completed a program of training in acupuncture approved by the New York State Department of Education; or
(ii) who possesses equivalent education and training acceptable to the New York State Department of Education; and
(iii) in addition to satisfying the requirements of subparagraphs (i) and (ii) of this paragraph has completed at least five years of experience in the use of acupuncture acceptable to the New York State Department of Education.
(4) Radiologic assistant. A specialist[’s] assistant in this category is an individual:
(i) who is licensed as a radiologic technologist by the New York State Department of Health; and
(ii) who satisfactorily completed a program for the training of radiologic assistants approved by the New York State Education Department.
Revised rule compared with proposed rule:
Substantive revisions were made in section 94.2(a), (c), (d), (e), (e)(1) and (4).
Text of revised proposed rule and any required statements and analyses may be obtained from
Katherine Ceroalo, DOH, Bureau of House Counsel, Reg. Affairs Unit, Room 2438, ESP Tower Building, Albany, NY 12237, (518) 473-7488, email: regsqna@health.ny.gov
Data, views or arguments may be submitted to:
Same as above.
Public comment will be received until:
30 days after publication of this notice.
Revised Regulatory Impact Statement, Regulatory Flexibility Analysis, Rural Area Flexibility Analysis and Job Impact Statement
Changes made to the last published rule do not necessitate revision to the previously published RIS, RFA, RAFA and JIS.
