1.
General
A physician assistant may provide any medical service for
which the physician assistant has been prepared by education, training and
experience and is competent to perform. The scope of practice of a physician
assistant is determined by the practice setting. Physician assistant scope of
practice delineated in collaborative agreements or practice agreements are
subject to review and approval by the Board.
2.
Practice Setting
A physician assistant may render medical services in the
following settings including, but not limited to a physician employer setting,
physician group practice setting or independent private practice setting, or in
a health care facility setting, by a system of credentialing and granting of
privileges.
3.
Consultation
Physician assistants shall, as indicated by a patient's
condition, the education, competencies and experience of the physician
assistant and the standards of care, consult with, collaborate with or refer
the patient to an appropriate physician or other health care professional. The
level of consultation required is determined by the practice setting, including
a physician employer, physician group practice, or private practice, or by the
system of credentialing and granting of privileges of a health care facility. A
physician must be accessible to the physician assistant at all times for
consultation. Consultation may occur electronically or through
telecommunication and includes communication, task sharing and education among
all members of a health care team. Upon request of the Board, a physician
assistant shall identify the physician who is currently available or was
available for consultation with the physician assistant.
4.
Delegation by Physician
Assistants
A physician assistant may delegate to the physician
assistant's employees or support staff or members of a health care team,
including medical assistants, certain activities relating to medical care and
treatment carried out by custom and usage when the activities are under the
control of the physician assistant. The physician assistant who delegates an
activity is legally liable for the activity performed by the employee, medical
assistant, support staff or a member of a health care team.
5.
Dispensing Drugs
Except for distributing a professional sample of a
prescription or legend drug, a physician assistant who dispenses a prescription
or legend drug:
A. Shall comply with
all relevant federal and state laws and federal regulations and state rules;
and
B. May dispense the
prescription or legend drug only when:
(1) A
pharmacy service is not reasonably available;
(2) Dispensing the drug is in the best
interests of the patient; or
(3) An
emergency exists.
6.
Legal Liability
A physician assistant is legally liable for any medical
service rendered by the physician assistant.
7.
Collaborative Agreements/Practice
Agreements
Physician assistants who are required to have either a
collaborative agreement or a practice agreement with an actively licensed Maine
physician shall conform their scope of practice to that which has been reviewed
and approved by the Board. Such agreements must be kept on file at the
physician assistant's main location of practice and be made available to the
Board or the Board's representative upon request. Upon any change to the
parties in a practice agreement or other substantive change to the practice
agreement, the physician assistant shall submit the revised practice agreement
to the Board for review and approval.
8.
Criteria for Requiring Collaborative
Agreements or Practice Agreements
A.
Collaborative Agreement.Physician assistants with less than 4,000
hours of documented clinical practice must have one (1) of the following in
order to render medical services under their Maine license:
(1) A Board-approved collaborative practice
agreement with a Maine physician holding an active, unrestricted physician
license; or
(2) A scope of practice
agreement through employment with a health care system or physician group
practice as defined by this rule that has a system of credentialing and
granting of privileges.
B.
Practice Agreement. Physician
assistants with more than 4,000 hours of documented clinical practice as
determined by the Board and who are the principal clinical provider without a
physician partner or who own and/or operate an independent practice must have
the following in order to render medical services under their Maine license:
(1) A Board-approved practice agreement with
a Maine physician holding an active, unrestricted physician license.
C. Physician assistants with more
than 4,000 hours of documented clinical practice as determined by the Board and
are employed with a health care facility or with a practice that includes a
physician partner - regardless of whether or not the facility or practice have
a system of credentialing and granting of privileges - are not required to have
either a collaborative agreement or practice agreement.
D. Acceptable documentation of clinical
practice includes, but is not limited to the following:
(1) Copies of previous plans of supervision,
together with physician reviews;
(2) Copies of any credentialing and
privileging scope of practice agreements, together with any employment or
practice reviews;
(3) Letter(s)
from a physician(s) attesting to the physician assistant's competency to render
the medical services proposed;
(4)
Attestation of completion of 4,000 hours of clinical practice, together with an
employment history;
(5)
Verification of active licensure in the State of Maine or another jurisdiction
for 24 months or longer.
9.
Criteria for Reviewing Scope of
Practice for Physician Assistants in Collaborative Agreements or Practice
Agreements
A. In reviewing a proposed
scope of practice delineated in a collaborative agreement or a practice
agreement, the Board may request any of the following from the physician
assistant:
(1) Documentation of at least 24
months of clinical practice within a particular medical specialty during the 48
months immediately preceding the date of the collaborative agreement or
practice agreement;
(2) Copies of
previous plans of supervision, together with physician reviews;
(3) Copies of any credentialing and
privileging scope of practice agreements, together with any employment or
practice reviews;
(4) Letter(s)
from a physician(s) attesting to the physician assistant's competency to render
the medical services proposed;
(5)
Completion of Specialty Certificates of Added Qualifications (CAQs) in a
medical specialty obtained through the NCCPA or its successor organization;
(6) Preparation of a plan for
rendering medical services for a period of time under the supervision of a
physician;
(7) Successful
completion of an educational and/or training program approved by the Board.
B. Physician assistants
who work outside of a health care facility or physician group practice may not
render medical services until their scope of practice is reviewed and approved
by the Board.
