Kan. Admin. Regs. § 100-28a-9 - Physician request form; content

The responsible physician request form to be presented to the board pursuant to K.S.A. 2000 Supp. 65-28a03, and amendments thereto, shall contain the following information:

(a) The date and signatures of the responsible physician and the physician assistant;

(b) the license numbers of the responsible physician and the physician assistant;

(c) a description of the physician's practice and the way in which the physician assistant is to be utilized;

(d) a statement that the responsible physician will always be available for communication with the physician assistant within 30 minutes of the performance of patient service by the physician assistant;

(e) a completed drug prescription protocol on a form provided by the board specifying categories of drugs, medicines, and pharmaceuticals that the physician assistant will be allowed to prescribe, and the drugs within any category that the physician assistant will not be allowed to supply, prescribe, receive, or distribute;

(f) the name and address of each practice location, including hospitals, where the physician assistant will routinely perform acts that constitute the practice of medicine and surgery;

(g) signatures of all designated physicians who routinely provide direction and supervision to the physician assistant in the temporary absence of the responsible physician, and a description of the procedures to be followed to notify a designated physician in the responsible physician's absence;

(h) an acknowledgment that failure to adequately direct and supervise the physician assistant in accordance with K.S.A. 2000 Supp. 65-28a01 through K.S.A. 65-28a09, and amendments thereto, or regulations adopted under these statutes by the board, shall constitute grounds for revocation, suspension, limitation, or censure of the responsible physician's license to practice medicine and surgery in the state of Kansas;

(i) a statement that a current copy of the form will be maintained at each practice location of the responsible physician and the physician assistant and that any changes to the form will be provided to the board within 10 days; and

(j) an acknowledgment that the responsible physician has established and implemented a method for initial and periodic evaluation of the professional competency of the physician assistant and that evaluations will be performed at least annually.

Notes

Kan. Admin. Regs. § 100-28a-9

Authorized by and implementing K.S.A. 2000 Supp. 65-28a03; effective, T-100-2-13-01, Feb. 13, 2001; effective June 1, 2001.