Bill Name: House Bill 190 (SB 190)

Primary Sponsor: Senator Ed Charbonneau

Status: 1/10/2023 referred to Committee on Health and Provider Services

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 their 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 higher likelihood of passing. The sponsor is in the majority party and serves as the chair of the committee this bill has been assigned to.

Analysis: Currently, Indiana physician assistants (PAs) practice under the supervision of a physician. This supervising physician delegates the health care tasks that the PA may perform. The relationship is formalized using a supervision agreement, which lays out what is authorized. If passed, SB 190 would create a two-tier practice for PAs. PAs in all types of clinical practice would be in a dependent practice with a collaborative physician, as defined in a written collaboration agreement. These agreements would define any practice limitations and a method for the physician and PA to collaborate; they would be signed and updated annually.

PAs who are employed at a health care facility, a physician-owned or private medical facility, or a federally qualified health center or rural health clinic are not required to have a written collaborative agreement. Instead, the PA needs to enter a practice agreement with their employing entity. This agreement sets forth how the PA shall cooperate, coordinate and consult with other health care workers in treating the patient.

While this bill would allow greater practice freedom for some PAs in specific situations, it maintains the same physician-PA relationship in most areas. 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. SB 190 is squarely within this trend. 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.