Bill Name: House Bill 2043 (HB2043)

Primary Sponsor: Representative Selina Bliss

Status: 4/17/2023 Signed by Governor into law

AmSpa’s Take: Reducing the amount of regulation and paperwork that advanced practitioners, such as physician assistants (PAs) and nurse practitioners (NPs) need to comply with to practice frees up time and resources that can be better spent seeing patients, improving skills and developing their practices.

Outlook: This bill is in the first steps of the process and, based on the sponsor’s past record, it has a lower likelihood of passing. While the sponsors are in the majority party, none currently hold leadership positions or sit on the committees where this bill has been assigned.

Analysis: Currently, Arizona physician assistants (PAs) practice under the supervision of a physician. This supervising physician delegates the health care tasks the PA may perform. The relationship is formalized using a supervision agreement that lays out what PAs are authorized to do. If passed, HB 2043 would create a two-tier practice for PAs. PAs with fewer than 6,000 hours of clinical practice would practice largely the same way they do now, although they would need a written supervision agreement. With 6,000 hours of practice, the PA becomes eligible to practice in “collaboration” instead of under supervision. PAs who practice under collaboration no longer need to maintain a written practice agreement; instead, they are required to consult and make referrals to other health professionals. The PA can provide services that they have the education, experience and competency to provide and that are within the listed areas of practice. In both cases, the other professionals they consult with do not need to be physically present.

While this may appear similar to what is called “full practice authority” for nurse practitioners, it is not quite the same. The PA would still need to be employed by a physician, group practice or a licensed health care institution. So, the PA will have much greater day-to-day autonomy but will still need to work within a similar physician-led practice.

The majority of states allow nurse practitioners to practice independently. More recently, many states have been giving more freedom and autonomy to PAs as well. HB 2043 is squarely within this trend. It does not go as far toward independence as some other state efforts, but it provides substantially more freedom than the majority of other state’s practices. If you would like additional information, to read the language of the bill, or to contact the sponsors or committee, you can find the information you need through this link.