Bill Summary – FastDemocracy

Stricken language would be deleted from and underlined language would be added to present law.
                                           Act 634 of the Regular Session
 State of Arkansas             As Engrossed:       S2/23/21 S3/17/21
 93rd General Assembly                        A Bill
 Regular Session, 2021                                                             SENATE BILL 152
 4
 By: Senator K. Hammer
 By: Representative Springer
 7
                                   For An Act To Be Entitled
                AN ACT TO AMEND THE MEMBERSHIP OF THE ARKANSAS STATE
                MEDICAL BOARD; TO AMEND THE SUPERVISION AND
                PRESCRIPTIVE AUTHORITY OF PHYSICIAN ASSISTANTS; AND
                FOR OTHER PURPOSES.
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                                               Subtitle
                         TO AMEND THE MEMBERSHIP OF THE ARKANSAS
                         STATE MEDICAL BOARD; AND TO AMEND THE
                         SUPERVISION AND PRESCRIPTIVE AUTHORITY
                         OF PHYSICIAN ASSISTANTS.
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 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:
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          SECTION 1.     Arkansas Code  17-95-301(b), concerning the creation and
 members of the Arkansas State Medical Board, is amended to read as follows:
          (b)(1)(A)      The board shall consist of fourteen (14) fifteen (15)
 members appointed by the Governor for terms of six (6) years.
                         (B)   The Governor shall consider diversity of practice
 specialties and geographical areas of practice in making appointments to the
 board.
                (2)(A)(i)      Ten (10) members shall be duly qualified, licensed,
 and active medical practitioners and appointed by the Governor after
 consulting the Governor has consulted the Arkansas Medical Society, Inc., and
 shall be subject to confirmation by the Senate.
                                (ii)    At least two (2) members shall be appointed
 from each of the state's four (4) congressional districts.
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                            (iii)   Two (2) members shall be appointed at large.
                     (B)   Congressional district representation required under
 this subdivision (b)(2) shall be achieved by appointment as vacancies occur.
            (3)    One (1) member shall be a licensed practicing physician in
 this state and shall be appointed by the Governor consulting the Governor has
 consulted the Physicians' Section of the Arkansas Medical, Dental, and
 Pharmaceutical Association, Inc. and shall be subject to confirmation by the
 Senate.
            (4)(A)     Two (2) members of the board shall not be actively
 engaged in or retired from the practice of medicine.
                     (B)   One (1) member shall represent consumers, and one (1)
 member shall be sixty (60) years of age or older and shall represent the
 elderly.
                     (C)   Both shall be appointed from the state at large
 subject to confirmation by the Senate.
                     (D)   The two (2) positions may not be held by the same
 person.
                     (E)   Both shall be full voting members but shall not
 participate in the grading of examinations.
            (5)    One (1) member shall be a duly qualified, licensed, and
 practicing osteopathic physician and appointed after consulting the Arkansas
 Osteopathic Medical Association and shall be subject to confirmation by the
 Senate.
            (6)    One (1) member shall be a qualified, licensed, and
 practicing physician assistant appointed by the Governor after the Governor
 has consulted with the Arkansas Academy of Physician Assistants and shall be
 subject to confirmation by the Senate.
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      SECTION 2.     Arkansas Code  17-95-301(d), concerning the creation and
 members of the Arkansas State Medical Board, is amended to add an additional
 subdivision to read as follows:
            (5)    In the event that a vacancy exists in the position of the
 licensed physician assistant appointed under subsection (b) of this section
 due to death, resignation, or other causes, a successor to the position shall
 be appointed by the Governor for the remainder of the term of the licensed
 physician assistant in the same manner as provided in this subchapter for the
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 initial appointment.
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      SECTION 3.       Arkansas Code  17-95-301(h)(1)(C)(i), concerning the
 creation and members of the Arkansas State Medical Board, is amended to read
 as follows:
                       (C)(i)     For any reason that would justify probation,
 suspension, or revocation of a physician's license to practice medicine under
 the Arkansas Medical Practices Act,  17-95-201 et seq.,  17-95-301 et seq.,
 and  17-95-401 et seq., or for any reason that would justify probation,
 suspension, or revocation of a physician assistant's license to practice
 under  17-105-101 et seq., which shall be referred directly to the Division
 of Pharmacy Services and Drug Control of the Department of Health by the
 Governor for investigation as provided in  17-80-106.
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      SECTION 4.       Arkansas Code  17-95-301, concerning the creation and
 members of the Arkansas State Medical Board, is amended to add an additional
 subsection to read as follows:
      (i)   A physician assistant appointed to the board shall:
               (1)    Remain in active practice for the full term of the
 appointment; or
               (2)    Resign if, with more than one (1) year remaining of the
 appointed term, the physician assistant is no longer actively practicing as a
 physician assistant.
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      SECTION 5.       Arkansas Code  17-95-801(a)(2)(A), concerning the members
 of the Physician Assistant Committee, is amended to read as follows:
                       (A)   Three (3) members who shall be members of the board.
                                (i)    Two (2) members as described in this subdivision
 (a)(2)(A) shall be physicians.
                                (ii)   One (1) member as described in this subdivision
 (a)(2)(A) shall be a physician assistant; and
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      SECTION 6.       Arkansas Code  17-95-802 is amended to read as follows:
      17-95-802.       Duties of Physician Assistant Committee.
      The Physician Assistant Committee shall review and make recommendations
 at the request of the Arkansas State Medical Board regarding all matters
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 relating to physician assistants, including without limitation:
            (1)     Review all applications for physician assistants' licensure
 and for renewal of physician assistants' licensure;
            (2)     Review protocols between a physician assistant and a
 supervising physician;
            (3)     Recommend to the Arkansas State Medical Board approval or
 disapproval of applications submitted under subdivision (1) of this section
 and of protocols reviewed under subdivision (2) of this section; and
            (4)     Recommend the approval, disapproval, or modification of the
 application for prescriptive privileges for a physician assistant.
            (1)     Applications for licensure and renewal;
            (2)     Disciplinary proceedings; and
            (3)     Any other issues pertaining to the regulation and practice
 of physician assistants.
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       SECTION 7.    Arkansas Code  17-105-101(1), concerning the definition of
 "physician assistant", is amended to read as follows:
            (1)(A)     Physician assistant means a person healthcare
 professional qualified by academic and clinical education and licensed by the
 Arkansas State Medical Board to provide healthcare services and who has:
                              (i)(A)     Graduated from a physician assistant or
 surgeon assistant program accredited by the American Medical Association's
 Committee on Allied Health Education and Accreditation or the Commission on
 Accreditation of Allied Health Education Programs for the education and
 training of physician assistants that has been approved by the Accreditation
 Review Commission on Education for the Physician Assistant or its successors;
 and
                              (ii)(B)     Passed the certifying examination
 administered by the National Commission on Certification of Physician
 Assistants.;
                     (B)(C)     The physician assistant is a dependent medical
 practitioner who:
                              (i)    Provides healthcare services under the
 supervision of a physician; and
                              (ii)     Works under a physician-drafted protocol
 approved by the Arkansas State Medical Board, which describes how the
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 physician assistant and the physician will work together and any practice
 guidelines required by the supervising physician a delegation agreement with
 a physician;
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      SECTION 8.       Arkansas Code  17-105-102(b)(3), concerning the
 qualifications for licensure as a physician assistant, is amended to read as
 follows:
               (3)    Has successfully completed an educational program for
 physician assistants or surgeon assistants accredited by the Accreditation
 Review Commission on Education for the Physician Assistant or by its
 successor agency and has passed the Physician Assistant National Certifying
 Examination administered by the National Commission on Certification of
 Physician Assistants;
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      SECTION 9.       Arkansas Code  17-105-106(1), concerning the exemption
 from licensure as a physician assistant, is amended to read as follows:
               (1)    A physician assistant student enrolled in a physician
 assistant or surgeon assistant educational program accredited by the
 Commission on Accreditation of Allied Health Education Programs Accreditation
 Review Commission on Education for the Physician Assistant or by its
 successor agency;
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      SECTION 10.       Arkansas Code  17-105-107 and 17-105-108 are amended to
 read as follows:
      17-105-107.       Scope of authority  Delegatory authority  Agent of
 supervising physician.
      (a)(1)     Physician assistants provide healthcare services with physician
 supervision A physician assistant may provide healthcare services a physician
 assistant is licensed or otherwise authorized to perform under an agreement
 with a supervising physician. The supervising physician shall be identified
 on all prescriptions and orders.
               (2)    Physician assistants A physician assistant may perform those
 duties and responsibilities, including prescribing, ordering, and
 administering drugs and medical devices, that are delegated by their
 supervising physicians a supervising physician under an agreement determined
 at the practice level.
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               (3)    A supervising physician shall not delegate to a physician
 assistant the duty or responsibility to perform or induce an abortion.
      (b)(1)     Physician assistants shall be considered the agents of their
 supervising physicians in the performance of all practice-related activities,
 including, but not limited to, the ordering of diagnostic, therapeutic, and
 other medical services.
               (2)    A physician assistant may provide medical services delegated
 by a supervising physician when the service is within the skills of the
 physician assistant, forms a component of the supervising physician's scope
 of practice, and is conducted under the supervision of the supervising
 physician.
      (c)     Physician assistants may perform healthcare services in any
 setting authorized by the supervising physician in accordance with any
 applicable facility policy.
      (d)     Nothing in this chapter shall be construed to authorize a
 physician assistant to:
               (1)    Examine the human eye or visual system for the purpose of
 prescribing glasses or contact lenses or the determination of the refractive
 power for surgical procedures;
               (2)    Adapt, fill, duplicate, modify, supply, or sell contact
 lenses or prescription eye glasses; or
               (3)    Prescribe, direct the use of, or use any optical device in
 connection with ocular exercises, vision training, or orthoptics.
      (d)     A physician assistant may pronounce death and may authenticate
 with his or her signature a form that may be authenticated by a supervising
 physician's signature as authorized under  17-80-120.
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      17-105-108.       Prescriptive authority.
      (a)(1)     Physicians supervising physician assistants may delegate
 prescriptive authority to physician assistants to include receiving,
 prescribing, ordering, and administering Schedule III-V Schedule II-V
 controlled substances as described in the Uniform Controlled Substances Act,
  5-64-101 et seq., and 21 C.F.R. Part 1300, all legend drugs, and all
 nonschedule prescription medications and medical devices. All prescriptions
 and orders issued by a physician assistant shall identify his or her
 supervising physician.
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               (2)    A physician assistant's prescriptive authority extends to
 drugs listed in Schedule II only if the prescription is for:
                        (A)   An opioid, if the prescription is only for a five-day
 period or less; or
                        (B)   A stimulant, if the prescription meets the following
 criteria:
                               (i)     The prescription was originally initiated by a
 physician;
                               (ii)    The physician has evaluated the patient within
 six (6) months before the physician assistant issues a prescription; and
                               (iii)    The prescription by the physician assistant is
 to treat the same condition as the original prescription.
      (b)     A physician assistant may prescribe hydrocodone combination
 products reclassified from Schedule III to Schedule II as of October 6, 2014,
 if authorized by the physician assistant's supervising physician and in
 accordance with other requirements of this section.
      (c)     At no time shall a physician assistant's level of prescriptive
 authority exceed that of the supervising physician.
      (d)     Physician assistants who prescribe controlled substances shall
 register with the United States Drug Enforcement Administration as part of
 the United States Drug Enforcement Administration's Mid-Level Practitioner
 Registry, 21 C.F.R. Part 1300, 58 FR 31171-31175, and the Controlled
 Substances Act.
      (e)     The Arkansas State Medical Board shall promptly adopt rules
 concerning physician assistants that are consistent with the board's rules
 governing the prescription of dangerous drugs and controlled substances by
 physicians.
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      SECTION 11.        Arkansas Code  17-105-110 is amended to read as follows:
      17-105-110.        Supervising physician.
      A physician desiring to supervise a physician assistant must:
               (1)    Be licensed in this state; and
               (2)(A)     Notify the Arkansas State Medical Board of his or her
 intent to supervise a physician assistant; and Enter into and maintain a
 written agreement with the physician assistant.
                        (B)   The agreement shall state that the physician shall:
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                           (i)    Exercise supervision over the physician
 assistant in accordance with this section and rules adopted by the Arkansas
 State Medical Board; and
                           (ii)   Retain professional and legal responsibility
 for the care provided by the physician assistant.
                    (C)   The agreement shall be signed by the physician and the
 physician assistant and updated annually.
            (3)    Submit a statement to the board that he or she will exercise
 supervision over the physician assistant in accordance with any rules adopted
 by the board.
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      SECTION 12.    Arkansas Code  17-105-111 is amended to read as follows:
      17-105-111.    Notification of intent to practice.
      (a)   Before initiating practice, a physician assistant licensed in this
 state must submit on forms approved by the Arkansas