As Introduced
133rd General Assembly
Regular Session H. B. No. 492
2019-2020
Representatives Wiggam, Miller, J.
Cosponsors: Representatives Manning, D., Lepore-Hagan, Lang, Crossman,
Baldridge, Galonski
A BILL
To amend sections 1.64, 2108.61, 2133.211, 1
3701.351, 3727.06, 4730.02, 4730.03, 4730.04, 2
4730.05, 4730.06, 4730.07, 4730.08, 4730.11, 3
4730.14, 4730.19, 4730.20, 4730.201, 4730.203, 4
4730.21, 4730.22, 4730.25, 4730.26, 4730.32, 5
4730.41, 4730.411, 4730.42, 4731.22, 4761.17, 6
4773.02, 5122.01, and 5122.10; to enact section 7
4730.204; and to repeal sections 4730.111 and 8
4730.44 of the Revised Code to modify the laws 9
regarding physician assistants. 10
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 1.64, 2108.61, 2133.211, 11
3701.351, 3727.06, 4730.02, 4730.03, 4730.04, 4730.05, 4730.06, 12
4730.07, 4730.08, 4730.11, 4730.14, 4730.19, 4730.20, 4730.201, 13
4730.203, 4730.21, 4730.22, 4730.25, 4730.26, 4730.32, 4730.41, 14
4730.411, 4730.42, 4731.22, 4761.17, 4773.02, 5122.01, and 15
5122.10 be amended and section 4730.204 of the Revised Code be 16
enacted to read as follows: 17
Sec. 1.64. As used in the Revised Code: 18
H. B. No. 492 Page 2
As Introduced
(A) "Certified nurse-midwife" means an advanced practice 19
registered nurse who holds a current, valid license issued under 20
Chapter 4723. of the Revised Code and is designated as a 21
certified nurse-midwife in accordance with section 4723.42 of 22
the Revised Code and rules adopted by the board of nursing. 23
(B) "Certified nurse practitioner" means an advanced 24
practice registered nurse who holds a current, valid license 25
issued under Chapter 4723. of the Revised Code and is designated 26
as a certified nurse practitioner in accordance with section 27
4723.42 of the Revised Code and rules adopted by the board of 28
nursing. 29
(C) "Clinical nurse specialist" means an advanced practice 30
registered nurse who holds a current, valid license issued under 31
Chapter 4723. of the Revised Code and is designated as a 32
clinical nurse specialist in accordance with section 4723.42 of 33
the Revised Code and rules adopted by the board of nursing. 34
(D) "Physician assistant" means an individual who is 35
licensed under Chapter 4730. of the Revised Code to provide 36
services as a physician assistant to patients under with the 37
supervision, control, collaboration and direction of one or more 38
physicians. 39
Sec. 2108.61. (A) As used in this section and sections 40
2108.62 and 2108.63 of the Revised Code: 41
(1) "Health care institution" means a hospital registered 42
as such under section 3701.07 of the Revised Code or a 43
freestanding birthing center. 44
(2) "Health care professional" means a physician 45
authorized under Chapter 4731. of the Revised Code to practice 46
medicine and surgery or osteopathic medicine and surgery; a 47
H. B. No. 492 Page 3
As Introduced
registered nurse, including a certified nurse-midwife, 48
authorized to practice under Chapter 4723. of the Revised Code; 49
or a physician assistant authorized to practice under Chapter 50
4130. 4730. of the Revised Code. 51
(3) "Umbilical cord blood" means the blood that remains in 52
the umbilical cord and placenta after the birth of a newborn 53
child. 54
(B) The department of health shall encourage health care 55
professionals who provide health care services that are directly 56
related to a woman's pregnancy to provide a woman before her 57
third trimester of pregnancy with the publications described in 58
section 2108.62 of the Revised Code. 59
Sec. 2133.211. A person who holds a current, valid license 60
issued under Chapter 4723. of the Revised Code to practice as an 61
advanced practice registered nurse may take any action that may 62
be taken by an attending physician under sections 2133.21 to 63
2133.26 of the Revised Code and has the immunity provided by 64
section 2133.22 of the Revised Code if the action is taken 65
pursuant to a standard care arrangement with a collaborating 66
physician. 67
A person who holds a license to practice as a physician 68
assistant issued under Chapter 4730. of the Revised Code may 69
take any action that may be taken by an attending physician 70
under sections 2133.21 to 2133.26 of the Revised Code and has 71
the immunity provided by section 2133.22 of the Revised Code if 72
the action is taken pursuant to a supervision collaboration 73
agreement entered into under section 4730.19 of the Revised 74
Code, including, if applicable, the policies of a health care 75
facility in which the physician assistant is practicing. 76
H. B. No. 492 Page 4
As Introduced
Sec. 3701.351. (A) The governing body of every hospital 77
shall set standards and procedures to be applied by the hospital 78
and its medical staff in considering and acting upon 79
applications for staff membership or professional privileges. 80
These standards and procedures shall be available for public 81
inspection. 82
(B) The governing body of any hospital, in considering and 83
acting upon applications for staff membership or professional 84
privileges within the scope of the applicants' respective 85
licensures, shall not discriminate against a qualified person 86
solely on the basis of whether that person is licensed to 87
practice medicine, osteopathic medicine, or podiatry, is 88
licensed to practice as a physician assistant, is licensed to 89
practice dentistry or psychology, or is licensed to practice 90
nursing as an advanced practice registered nurse. Staff 91
membership or professional privileges shall be considered and 92
acted on in accordance with standards and procedures established 93
under division (A) of this section. This section does not permit 94
a psychologist to admit a patient to a hospital in violation of 95
section 3727.06 of the Revised Code. 96
(C) The governing body of any hospital that is licensed to 97
provide maternity services, in considering and acting upon 98
applications for clinical privileges, shall not discriminate 99
against a qualified person solely on the basis that the person 100
is authorized to practice nurse-midwifery. An application from a 101
certified nurse-midwife who is not employed by the hospital 102
shall contain the name of a physician member of the hospital's 103
medical staff who holds clinical privileges in obstetrics at 104
that hospital and who has agreed to be the collaborating 105
physician for the applicant in accordance with section 4723.43 106
of the Revised Code. 107
H. B. No. 492 Page 5
As Introduced
(D) Any person may apply to the court of common pleas for 108
temporary or permanent injunctions restraining a violation of 109
division (A), (B), or (C) of this section. This action is an 110
additional remedy not dependent on the adequacy of the remedy at 111
law. 112
(E)(1) If a hospital does not provide or permit the 113
provision of any diagnostic or treatment service for mental or 114
emotional disorders or any other service that may be legally 115
performed by a psychologist licensed under Chapter 4732. of the 116
Revised Code, this section does not require the hospital to 117
provide or permit the provision of any such service and the 118
hospital shall be exempt from requirements of this section 119
pertaining to psychologists. 120
(2) This section does not impair the right of a hospital 121
to enter into an employment, personal service, or any other kind 122
of contract with a licensed psychologist, upon any such terms as 123
the parties may mutually agree, for the provision of any service 124
that may be legally performed by a licensed psychologist. 125
Sec. 3727.06. (A) As used in this section: 126
(1) "Doctor" means an individual authorized to practice 127
medicine and surgery or osteopathic medicine and surgery. 128
(2) "Podiatrist" means an individual authorized to 129
practice podiatric medicine and surgery. 130
(B)(1) Only the following may admit a patient to a 131
hospital: 132
(a) A doctor who is a member of the hospital's medical 133
staff; 134
(b) A dentist who is a member of the hospital's medical 135
H. B. No. 492 Page 6
As Introduced
staff; 136
(c) A podiatrist who is a member of the hospital's medical 137
staff; 138
(d) A clinical nurse specialist, certified nurse-midwife, 139
or certified nurse practitioner if all of the following 140
conditions are met: 141
(i) The clinical nurse specialist, certified nurse- 142
midwife, or certified nurse practitioner has a standard care 143
arrangement entered into pursuant to section 4723.431 of the 144
Revised Code with a collaborating doctor or podiatrist who is a 145
member of the medical staff; 146
(ii) The patient will be under the medical supervision of 147
the collaborating doctor or podiatrist; 148
(iii) The hospital has granted the clinical nurse 149
specialist, certified nurse-midwife, or certified nurse 150
practitioner admitting privileges and appropriate credentials. 151
(e) A physician assistant if all of the following 152
conditions are met: 153
(i) The physician assistant is listed on a supervision 154
collaboration agreement entered into under section 4730.19 of 155
the Revised Code for a doctor or podiatrist who is a member of 156
the hospital's medical staff. 157
(ii) The patient will be under the medical supervision of 158
the supervising collaborating doctor or podiatrist. 159
(iii) The hospital has granted the physician assistant 160
admitting privileges and appropriate credentials. 161
(2) Prior to admitting a patient, a clinical nurse 162
H. B. No. 492 Page 7
As Introduced
specialist, certified nurse-midwife, certified nurse 163
practitioner, or physician assistant shall notify the 164
collaborating or supervising doctor or podiatrist of the planned 165
admission. 166
(C) All hospital patients shall be under the medical 167
supervision of a doctor, except that services that may be 168
rendered by a licensed dentist pursuant to Chapter 4715. of the 169
Revised Code provided to patients admitted solely for the 170
purpose of receiving such services shall be under the 171
supervision of the admitting dentist and that services that may 172
be rendered by a podiatrist pursuant to section 4731.51 of the 173
Revised Code provided to patients admitted solely for the 174
purpose of receiving such services shall be under the 175
supervision of the admitting podiatrist. If treatment not within 176
the scope of Chapter 4715. or section 4731.51 of the Revised 177
Code is required at the time of admission by a dentist or 178
podiatrist, or becomes necessary during the course of hospital 179
treatment by a dentist or podiatrist, such treatment shall be 180
under the supervision of a doctor who is a member of the medical 181
staff. It shall be the responsibility of the admitting dentist 182
or podiatrist to make arrangements with a doctor who is a member 183
of the medical staff to be responsible for the patient's 184
treatment outside the scope of Chapter 4715. or section 4731.51 185
of the Revised Code when necessary during the patient's stay in 186
the hospital. 187
Sec. 4730.02. (A) No person shall hold that person out as 188
being able to function as a physician assistant, or use any 189
words or letters indicating or implying that the person is a 190
physician assistant, without a current, valid license to 191
practice as a physician assistant issued pursuant to this 192
chapter. 193
H. B. No. 492 Page 8
As Introduced
(B) No person shall practice as a physician assistant 194
without the supervision, control, collaboration and direction of 195
a physician. 196
(C) No person shall practice as a physician assistant 197
without having entered into a supervision collaboration 198
agreement with a supervising collaborating physician under 199
section 4730.19 of the Revised Code. 200
(D) No person acting as the supervising collaborating 201
physician of a physician assistant shall authorize the physician 202
assistant to perform services if either of the following is the 203
case: 204
(1) The services are not within the physician's normal 205
course of practice and expertise; 206
(2) The services are inconsistent with the supervision 207
collaboration agreement under which the physician assistant is 208
being supervisedpracticing, including, if applicable, the 209
policies of the health care facility in which the physician and 210
physician assistant are practicing. 211
(E) No person practicing as a physician assistant shall 212
prescribe any drug or device to perform or induce an abortion, 213
or otherwise perform or induce an abortion. 214
(F) No person shall advertise to provide services as a 215
physician assistant, except for the purpose of seeking 216
employment. 217
(G) No person practicing as a physician assistant shall 218
fail to wear at all times when on duty a placard, plate, or