May 24, 2012, Introduced by Senator MARLEAU and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 17048 and 17548 (MCL 333.17048 and 333.17548),
as amended by 2011 PA 210.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 17048. (1) Except as otherwise provided in this section
and section 17049(5), a physician who is a sole practitioner or who
practices in a group of physicians and treats patients on an
outpatient basis shall not supervise more than 4 physician's
assistants. If a physician described in this subsection supervises
physician's assistants at more than 1 practice site, the physician
shall not supervise more than 2 physician's assistants by a method
other than the physician's actual physical presence at the practice
site.
(2) A physician who is employed by, under contract or
subcontract to, or has privileges at a health facility or agency
licensed under article 17 or a state correctional facility may
supervise more than 4 physician's assistants at the health facility
or agency or state correctional facility.
(3) To the extent that a particular selected medical care
service requires extensive medical training, education, or ability
or poses serious risks to the health and safety of patients, the
board may prohibit or otherwise restrict the delegation of that
medical care service or may require higher levels of supervision.
(4) A physician shall not delegate ultimate responsibility for
the quality of medical care services, even if the medical care
services are provided by a physician's assistant.
(5)
The Subject to section
17076(3) and (4), the board may
promulgate rules for the delegation by a supervising physician to a
physician's assistant of the function of prescription of drugs. The
rules may define the drugs or classes of drugs the prescription of
which shall not be delegated and other procedures and protocols
necessary to promote consistency with federal and state drug
control
and enforcement laws. When delegated prescription occurs,
both
the physician's assistant's name and the supervising
physician's
name shall be used, recorded, or otherwise indicated in
connection
with each individual prescription.
(6) A supervising physician may delegate in writing to a
physician's assistant the ordering, receipt, and dispensing of
complimentary starter dose drugs including controlled substances
that are included in schedules 2 to 5 of part 72. When the
delegated ordering, receipt, or dispensing of complimentary starter
dose drugs occurs, both the physician's assistant's name and the
supervising physician's name shall be used, recorded, or otherwise
indicated in connection with each order, receipt, or dispensing.
When the delegated ordering, receipt, or dispensing of
complimentary starter dose drugs that are included in schedules 2
to 5 occurs, both the physician's assistant's and the supervising
physician's DEA registration numbers shall be used, recorded, or
otherwise indicated in connection with each order, receipt, or
dispensing. As used in this subsection, "complimentary starter
dose" means that term as defined in section 17745. It is the intent
of the legislature in enacting this subsection to allow a
pharmaceutical manufacturer or wholesale distributor, as those
terms are defined in part 177, to distribute complimentary starter
dose drugs to a physician's assistant, as described in this
subsection, in compliance with section 503(d) of the federal food,
drug, and cosmetic act, 21 USC 353.
(7) Beginning on July 19, 2010, if 1 or more individuals
licensed under part 170 to engage in the practice of medicine,
licensed under part 175 to engage in the practice of osteopathic
medicine and surgery, or licensed under part 180 to engage in the
practice of podiatric medicine and surgery, and 1 or more
physician's assistants organize a professional service corporation
pursuant to section 4 of the professional service corporation act,
1962 PA 192, MCL 450.224, or a professional limited liability
company pursuant to section 904 of the Michigan limited liability
company act, 1993 PA 23, MCL 450.4904, the individuals who are the
supervising physicians of the physician's assistants shall be
shareholders in the same professional service corporation or
members in the same professional limited liability company as the
physician's assistants and shall meet all of the applicable
requirements of part 170, 175, or 180. If 1 or more physician's
assistants organized a professional service corporation pursuant to
section 4 of the professional service corporation act, 1962 PA 192,
MCL 450.224, or a professional limited liability company pursuant
to section 904 of the Michigan limited liability company act, 1993
PA 23, MCL 450.4904, before July 19, 2010 that has only physician's
assistants as shareholders or members, the individuals who are the
supervising physicians of the physician's assistants shall meet all
of the applicable requirements of part 170, 175, or 180.
(8) In addition to the requirements of section 17068 and
beginning on July 19, 2010, the department shall include on the
form used for renewal of licensure a space for a physician's
assistant to disclose whether he or she is a shareholder in a
professional service corporation pursuant to section 4 of the
professional service corporation act, 1962 PA 192, MCL 450.224, or
a member in a professional limited liability company pursuant to
section 904 of the Michigan limited liability company act, 1993 PA
23, MCL 450.4904, which corporation or company was organized before
July 19, 2010. A physician's assistant who is a shareholder in a
professional service corporation or a member in a professional
limited liability company described in this subsection shall
disclose all of the following in the form used for renewal of
licensure provided by the department:
(a) Whether any individuals licensed under part 170 to engage
in the practice of medicine, licensed under part 175 to engage in
the practice of osteopathic medicine and surgery, or licensed under
part 180 to engage in the practice of podiatric medicine and
surgery are shareholders in the professional service corporation or
members in the professional limited liability company.
(b) The name and license number of the individual licensed
under part 170 to engage in the practice of medicine, licensed
under part 175 to engage in the practice of osteopathic medicine
and surgery, or licensed under part 180 to engage in the practice
of podiatric medicine and surgery who supervises the physician's
assistant.
(c) Whether the individual licensed under part 170 to engage
in the practice of medicine, licensed under part 175 to engage in
the practice of osteopathic medicine and surgery, or licensed under
part 180 to engage in the practice of podiatric medicine and
surgery disclosed in subdivision (b) is a shareholder in the same
professional service corporation or member in a professional
limited liability company as the physician's assistant.
Sec. 17548. (1) Except as otherwise provided in this
subsection and section 17549(5), a physician who is a sole
practitioner or who practices in a group of physicians and treats
patients on an outpatient basis shall not supervise more than 4
physician's assistants. If a physician described in this subsection
supervises physician's assistants at more than 1 practice site, the
physician shall not supervise more than 2 physician's assistants by
a method other than the physician's actual physical presence at the
practice site.
(2) A physician who is employed by or under contract or
subcontract to or has privileges at a health facility licensed
under article 17 or a state correctional facility may supervise
more than 4 physician's assistants at the health facility or agency
or state correctional facility.
(3) To the extent that a particular selected medical care
service requires extensive medical training, education, or ability
or pose serious risks to the health and safety of patients, the
board may prohibit or otherwise restrict the delegation of that
medical care service or may require higher levels of supervision.
(4) A physician shall not delegate ultimate responsibility for
the quality of medical care services, even if the medical care
services are provided by a physician's assistant.
(5) A physician's assistant may make calls or go on rounds
under the supervision of a physician in private homes, public
institutions, emergency vehicles, ambulatory care clinics,
hospitals, intermediate or extended care facilities, health
maintenance organizations, nursing homes, or other health care
facilities. Notwithstanding any law or rule to the contrary, a
physician's assistant may make calls or go on rounds as provided in
this subsection without restrictions on the time or frequency of
visits by the physician or the physician's assistant.
(6) (5)
The Subject to subsections
(7) and (8), the board may
promulgate rules for the delegation by a supervising physician to a
physician's
assistant of the function of prescription of drugs. The
Subject to subsections (7) and (8), the rules may define the drugs
or classes of drugs the prescription of which shall not be
delegated and other procedures and protocols necessary to promote
consistency with federal and state drug control and enforcement
laws.
When delegated prescription occurs, both the physician's
assistant's
name and the supervising physician's name shall be
used,
recorded, or otherwise indicated in connection with each
individual
prescription.
(7) A physician's assistant may prescribe drugs as a delegated
act of a supervising physician in accordance with procedures and
protocol for the prescription established by rule of the
appropriate board. A physician's assistant may prescribe a drug,
including a controlled substance that is included in schedules 2 to
5 of part 72, as a delegated act of the supervising physician. When
delegated prescription occurs, both the physician's assistant's
name and the supervising physician's name shall be used, recorded,
or otherwise indicated in connection with each individual
prescription so that the individual who dispenses or administers
the prescription knows under whose delegated authority the
physician's assistant is prescribing. When delegated prescription
of drugs that are included in schedules 2 to 5 occurs, both the
physician's assistant's and the supervising physician's DEA
registration numbers shall be used, recorded, or otherwise
indicated in connection with each individual prescription.
(8)(6)
A supervising physician may
delegate in writing to a
physician's assistant the ordering, receipt, and dispensing of
complimentary starter dose drugs including controlled substances
that are included in schedules 2 to 5 of part 72. When the
delegated ordering, receipt, or dispensing of complimentary starter
dose drugs occurs, both the physician's assistant's name and the
supervising physician's name shall be used, recorded, or otherwise
indicated in connection with each order, receipt, or dispensing.
When the delegated ordering, receipt, or dispensing of
complimentary starter dose drugs that are included in schedules 2
to 5 occurs, both the physician's assistant's and the supervising
physician's DEA registration numbers shall be used, recorded, or
otherwise indicated in connection with each order, receipt, or
dispensing. As used in this subsection, "complimentary starter
dose" means that term as defined in section 17745. It is the intent
of the legislature in enacting this subsection to allow a
pharmaceutical manufacturer or wholesale distributor, as those
terms are defined in part 177, to distribute complimentary starter
dose drugs to a physician's assistant, as described in this
subsection, in compliance with section 503(d) of the federal food,
drug, and cosmetic act, 21 USC 353.