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New PA supervision rules take effect March 1

Recent changes to Wisconsin Administrative Code Med 8 (Med 8) related to physician supervision of physician assistants (PAs) take effect March 1, 2014. These changes include a combination of revisions, additions and deletions to Med 8. It is important that physicians be aware of these changes and the impact they may have on their practice. An overview of the key changes that take effect on March 1 is provided below.

  • Supervision Ratio: The number of PAs a physician can supervise concurrently has been increased from two to four. The changes make clear that there is not a limit to the number of PAs a physician can supervise over time and that a PA may be supervised by more than one physician while on duty. The option for physicians to request authorization from the Medical Examining Board (MEB) to supervise more PAs than currently allowed under Med 8 has been retained.
  • PA Prescribing: The requirements related to PA prescribing have been simplified. Under the new requirements a PA may prescribe if the PA has had an initial review of his or her prescriptive practices by a supervising physician and such a review is conducted annually thereafter. Such reviews must be documented in writing and signed by the supervising physician conducting the review and the PA. The documentation of the review should be retained and made available to the MEB upon request. The details of the review process are no longer established in the rules and are left to the discretion of the supervising physician and PA, providing flexibility to develop a review process that suits their practice arrangement.
  • Identification of Supervising Physician: There is now a requirement that the supervising physician be readily identifiable by the PA through procedures commonly employed in PA practice. This means that PAs must be able to identify the supervising physician for every patient encounter. The rule does not require this be done in any specific manner. PAs can meet this requirement in a variety of ways, such as documenting the supervising physician in the patient’s chart.
  • Substitute Supervising Physicians: Supervising physicians no longer need to notify the MEB of any substitute supervising physicians.
  • On-site Visit and Review of PA Practice Locations: Supervising physicians are no longer required to visit and conduct on-site review of all facilities where the PA practices once a month.

Contact Mark Grapentine, JD, in the Society’s Government Relations department with any questions.

Back to February 27, 2014 Medigram