S T A T E O F N E W Y O R K
________________________________________________________________________
8378
2023-2024 Regular Sessions
I N A S S E M B L Y
December 13, 2023
___________
Introduced by M. of A. PAULIN -- read once and referred to the Committee
on Higher Education
AN ACT to amend the education law and the public health law, in relation
to amending physician assistant practice standards
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 6542 of the education law, as amended by chapter 48
of the laws of 2012, subdivisions 3 and 5 as amended by section 1 of
part T of chapter 57 of the laws of 2013, is amended to read as follows:
§ 6542. Performance of medical services. 1. Notwithstanding any other
provision of law, a physician assistant may perform medical services,
but only when under the supervision of a physician and only when such
acts and duties as are assigned to him or her are within the scope of
practice of such supervising physician UNLESS OTHERWISE PERMITTED BY
THIS SECTION.
2. [Supervision shall be continuous but shall not be construed as
necessarily requiring the physical presence of the supervising physician
at the time and place where such services are performed] A PHYSICIAN
ASSISTANT MAY PRACTICE WITHOUT THE SUPERVISION OF A PHYSICIAN UNDER THE
FOLLOWING CIRCUMSTANCES:
(A) WHERE THE PHYSICIAN ASSISTANT, LICENSED UNDER SECTION SIXTY-FIVE
HUNDRED FORTY-ONE OF THIS ARTICLE HAS PRACTICED FOR MORE THAN EIGHT
THOUSAND HOURS; AND
(I) IS PRACTICING IN PRIMARY CARE. FOR THE PURPOSES OF THIS PARAGRAPH,
"PRIMARY CARE" SHALL MEAN NON-SURGICAL CARE IN THE FIELDS OF GENERAL
PEDIATRICS, GENERAL ADULT MEDICINE, GENERAL GERIATRIC MEDICINE, GENERAL
INTERNAL MEDICINE, OBSTETRICS AND GYNECOLOGY, FAMILY MEDICINE, OR SUCH
OTHER RELATED AREAS AS DETERMINED BY THE COMMISSIONER OF HEALTH; OR
(II) IS EMPLOYED BY A HEALTH SYSTEM OR HOSPITAL ESTABLISHED UNDER
ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW, AND THE HEALTH SYSTEM OR
HOSPITAL DETERMINES THE PHYSICIAN ASSISTANT MEETS THE QUALIFICATIONS OF
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD13627-01-3
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THE MEDICAL STAFF BYLAWS AND THE HEALTH SYSTEM OR HOSPITAL GIVES THE
PHYSICIAN ASSISTANT PRIVILEGES; AND
(B) WHERE A PHYSICIAN ASSISTANT LICENSED UNDER SECTION SIXTY-FIVE
HUNDRED FORTY-ONE OF THIS ARTICLE HAS COMPLETED A PROGRAM APPROVED BY
THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, WHEN SUCH
SERVICES ARE PERFORMED WITHIN THE SCOPE OF SUCH PROGRAM.
3. [No physician shall employ or supervise more than four physician
assistants in his or her private practice] WHERE SUPERVISION IS REQUIRED
BY THIS SECTION, IT SHALL BE CONTINUOUS BUT SHALL NOT BE CONSTRUED AS
NECESSARILY REQUIRING THE PHYSICAL PRESENCE OF THE SUPERVISING PHYSICIAN
AT THE TIME AND PLACE WHERE SUCH SERVICES ARE PERFORMED.
4. Nothing in this article shall prohibit a hospital from employing
physician assistants provided they [work under the supervision of a
physician designated by the hospital and not beyond the scope of prac-
tice of such physician. The numerical limitation of subdivision three of
this section shall not apply to services performed in a hospital] MEET
THE QUALIFICATIONS OF THE MEDICAL STAFF BYLAWS AND ARE GIVEN PRIVILEGES
AND OTHERWISE MEET THE REQUIREMENTS OF THIS SECTION.
5. [Notwithstanding any other provision of this article, nothing shall
prohibit a physician employed by or rendering services to the department
of corrections and community supervision under contract from supervising
no more than six physician assistants in his or her practice for the
department of corrections and community supervision] A PHYSICIAN ASSIST-
ANT SHALL BE AUTHORIZED TO PRESCRIBE, DISPENSE, ORDER, OR PROCURE ITEMS
TO COMMENCE OR COMPLETE A COURSE OF THERAPY.
6. [Notwithstanding any other provision of law, a trainee in an
approved program may perform medical services when such services are
performed within the scope of such program] (A) A PHYSICIAN ASSISTANT
MAY PRESCRIBE AND ORDER A PATIENT SPECIFIC ORDER OR NON-PATIENT SPECIFIC
REGIMEN TO A LICENSED PHARMACIST OR REGISTERED PROFESSIONAL NURSE,
PURSUANT TO REGULATIONS PROMULGATED BY THE COMMISSIONER OF HEALTH, AND
CONSISTENT WITH THE PUBLIC HEALTH LAW, FOR:
(I) ADMINISTERING IMMUNIZATIONS;
(II) THE EMERGENCY TREATMENT OF ANAPHYLAXIS;
(III) ADMINISTERING PURIFIED PROTEIN DERIVED (PPD) TESTS OR OTHER
TESTS TO DETECT OR SCREEN FOR TUBERCULOSIS INFECTIONS;
(IV) ADMINISTERING TESTS TO DETERMINE THE PRESENCE OF THE HUMAN IMMU-
NODEFICIENCY VIRUS;
(V) ADMINISTERING TESTS TO DETERMINE THE PRESENCE OF THE HEPATITIS C
VIRUS;
(VI) THE URGENT OR EMERGENCY TREATMENT OF OPIOID RELATED OVERDOSE OR
SUSPECTED OPIOID RELATED OVERDOSE;
(VII) SCREENING OF PERSONS AT INCREASED RISK OF SYPHILIS, GONORRHEA,
AND CHLAMYDIA;
(VIII) ADMINISTERING ELECTROCARDIOGRAM TESTS TO DETECT SIGNS AND SYMP-
TOMS OF ACUTE CORONARY SYNDROME;
(IX) ADMINISTERING POINT-OF-CARE BLOOD GLUCOSE TESTS TO EVALUATE ACUTE
MENTAL STATUS CHANGES IN PERSONS WITH SUSPECTED HYPOGLYCEMIA;
(X) ADMINISTERING TESTS AND INTRAVENOUS LINES TO PERSONS THAT MEET
SEVERE SEPSIS AND SEPTIC SHOCK CRITERIA; AND
(XI) ADMINISTERING TESTS TO DETERMINE PREGNANCY.
(B) NOTHING IN THIS SUBDIVISION SHALL AUTHORIZE UNLICENSED PERSONS TO
ADMINISTER IMMUNIZATIONS, VACCINES, OR OTHER DRUGS.
7. WHERE A PHYSICIAN ASSISTANT LICENSED UNDER SECTION SIXTY-FIVE
HUNDRED FORTY-ONE OF THIS ARTICLE HAS COMPLETED A PROGRAM APPROVED BY
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THE DEPARTMENT OF HEALTH, IN CONSULTATION WITH THE DEPARTMENT, WHEN SUCH
SERVICES ARE PERFORMED WITHIN THE SCOPE OF SUCH PROGRAM.
8. Nothing in this article, or in article thirty-seven of the public
health law, shall be construed to authorize physician assistants to
perform those specific functions and duties specifically delegated by
law to those persons licensed as allied health professionals under the
public health law or this chapter.
§ 2. Subdivision 1 of section 3701 of the public health law, as
amended by chapter 48 of the laws of 2012, is amended to read as
follows:
1. to promulgate regulations defining and restricting the duties
[which may be assigned to] OF physician assistants [by their supervising
physician, the degree of supervision required and the manner in which
such duties may be performed] CONSISTENT WITH SECTION SIXTY-FIVE HUNDRED
FORTY-TWO OF THE EDUCATION LAW;
§ 3. Subdivisions 1 and 3 of section 3702 of the public health law, as
amended by chapter 48 of the laws of 2012, are amended to read as
follows:
1. Inpatient medical orders. A licensed physician assistant employed
or extended privileges by a hospital may, if permissible under the
bylaws, rules and regulations of the hospital, write medical orders,
including those for controlled substances AND DURABLE MEDICAL EQUIPMENT,
for inpatients [under the care of the physician responsible for his or
her 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].
3. Prescriptions for controlled substances. 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, AS APPLICABLE PURSUANT TO SECTION SIXTY-FIVE HUNDRED FORTY-
TWO OF THE EDUCATION LAW, may prescribe controlled substances as a prac-
titioner under article thirty-three of this chapter, to patients under
the care of such physician responsible for his or her supervision. The
commissioner, in consultation with the commissioner of education, may
promulgate such regulations as are necessary to carry out the purposes
of this section.
§ 4. Section 3703 of the public health law, as amended by chapter 48
of the laws of 2012, is amended to read as follows:
§ 3703. Statutory construction. A physician assistant may perform any
function in conjunction with a medical service lawfully performed by the
physician assistant, in any health care setting, that a statute author-
izes or directs a physician to perform and that is appropriate to the
education, training and experience of the licensed physician assistant
and within the ordinary practice of the supervising physician, AS APPLI-
CABLE PURSUANT TO SECTION SIXTY-FIVE HUNDRED FORTY-TWO OF THE EDUCATION
LAW. This section shall not be construed to increase or decrease the
lawful scope of practice of a physician assistant under the education
law.
§ 5. Paragraph a of subdivision 2 of section 902 of the education law,
as amended by chapter 376 of the laws of 2015, is amended to read as
follows:
a. The board of education, and the trustee or board of trustees of
each school district, shall employ, at a compensation to be agreed upon
by the parties, a qualified physician, A PHYSICIAN ASSISTANT, or a nurse
practitioner to the extent authorized by the nurse practice act and
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consistent with subdivision three of section six thousand nine hundred
two of this chapter, to perform the duties of the director of school
health services, including any duties conferred on the school physician
or school medical inspector under any provision of law, to perform and
coordinate the provision of health services in the public schools and to
provide health appraisals of students attending the public schools in
the city or district. The physicians, PHYSICIANS ASSISTANTS, or nurse
practitioners so employed shall be duly licensed pursuant to applicable
law.
§ 6. Subdivision 5 of section 6810 of the education law, as added by
chapter 881 of the laws of 1972, is amended to read as follows:
5. Records of all prescriptions filled or refilled shall be maintained
for a period of at least five years and upon request made available for
inspection and copying by a representative of the department. Such
records shall indicate date of filling or refilling, [doctor's]
PRESCRIBER'S name, patient's name and address and the name or initials
of the pharmacist who prepared, compounded, or dispensed the
prescription. Records of prescriptions for controlled substances shall
be maintained pursuant to requirements of article thirty-three of the
public health law.
§ 7. Subdivision 27 of section 3302 of the public health law, as
amended by chapter 92 of the laws of 2021, is amended to read as
follows:
27. "Practitioner" means:
A physician, PHYSICIAN ASSISTANT, dentist, podiatrist, veterinarian,
scientific investigator, or other person licensed, or otherwise permit-
ted to dispense, administer or conduct research with respect to a
controlled substance in the course of a licensed professional practice
or research licensed pursuant to this article. Such person shall be
deemed a "practitioner" only as to such substances, or conduct relating
to such substances, as is permitted by [his] THEIR license, permit or
otherwise permitted by law.
§ 8. This act shall take effect on the one hundred twentieth day after
it shall have become a law. Effective immediately, the department of
education and the department of health are authorized to promulgate,
amend and/or repeal any rule or regulation necessary for the implementa-
tion of section one of this act on or before such effective date.
This is a necessary change to the healthcare system and to how PAs practice!