Changes to Ohio Physician Assistant Practice coming March 20th

Posted By American Med Spa Association, Wednesday, February 20, 2019

Nationally, we have seen many states move towards allowing physician assistants (PA) and advanced practice registered nurses (APRN) greater practice freedom. The traditional model has been for these mid-level practitioners to derive their authority to practice and prescribe directly from a supervising physician via a written practice agreement. A mid-level’s authority to prescribe may be further constrained in some states by a drug formulary. These formularies are maintained by the licensing boards and include or exclude certain drugs or classes of drugs that may be prescribed. The national trend has been to relax or do away with many of these requirements for midlevel practitioners.  Last fall, Ohio passed a bill that does away with some of these restrictions on PAs. Specifically, it does away with the PA formulary and allows a physician to oversee more PAs at a time.
Senate Bill 259 (SB 259) was voted on and passed both the House and Senate in December of 2018. Most of the provisions of SB 259 will become effective on March 20, 2019 and you can read the full text of SB 259 here. A fair portion of SB 259 is devoted to expanding the practice of dentists and dental hygienists.  Of interest to us today are the changes that SB 259 makes to PAs practice. 
SB 259 rescinds the current PA formulary and instead only requires that the Board of Medicine adopt rules governing the physician-delegated prescriptive authority.  PA’s prescriptive authority will now be determined only by the supervising physician who is able expand or restrict that authority with few limitations. The limitations include that PAs are explicitly prohibited from prescribing in violation of state or federal law and the supervising physician may not grant the PA greater prescriptive authority than themselves nor may they allow the PA to prescribe any drug or device that may be used to induce an abortion. The other major change that SB 259 makes for PAs is to allow physicians to oversee five PAs at any one time. Previously, physicians were limited to only three PAs at a time. This would allow for greater flexibility and growth in PA practice as it will increase the number of physicians available to supervise them and may make it easier to find a supervisor who is closer to their chosen scope and location.  
These portions of SB 259 will go into effect in March and while these may seem like modest changes to the law together they provide a significant step towards greater practice freedom for physician assistants. Perhaps in the future Ohio will grant PAs further practice independence by adopting the collaborative practice model that others states have implemented. If you would like to learn about how PAs practice in your state please refer to your AmSpa state legal summary.