Maine Proposes Documentation Rules for PA Practice Freedom

Posted By American Med Spa Association, Thursday, October 1, 2020

The Maine Board of Licensure in Medicine and the state’s Board of Osteopathic Licensure have proposed a joint rule for physician assistants (PAs) regarding the documentation needed to practice with less physician oversight and independently own their own practices. These rules were created in response to a bill that was quickly passed in response to the pandemic. The bill is known as Legislative Document 1660 (LD 1660); we originally covered it here (the final bill contained several amendments), and you can review the text in full here. The proposed rules are available here and are currently in a public comment period until October 30, 2020.
LD 1660 allows PAs to practice without strict physician oversight and even own their own clinics in certain circumstances. To briefly recap, prior to this, PAs needed a written supervision agreement with a physician; this agreement determined their delegated scope of practice and ability to prescribe. Now, PAs who have fewer than 4,000 hours of clinical practice will need to enter a board-approved collaborative practice agreement with a physician or a scope of practice agreement with a health care system employer.
PAs with more than 4,000 hours of clinical practice would be able to enter a practice agreement with a physician. The practice agreement, as defined in this law, provides substantially more freedom to the PA. PAs who are able to work under a practice agreement can be the principal clinical provider and owner of the clinic. The agreement is for the purpose of collaboration or consultation with a physician, but it does not require their physical presence when services are being rendered. These agreements allow the PA to have a scope of practice that includes any medical service for which the PA has the education, training and experience, and is competent to perform.
Both collaborative and practice agreements require board approval. This approval process involves reviewing and verifying the PA’s credentials supporting their scope of practice. The acceptable documentation is the main subject of these proposed rules and includes:
LD 1660 provided a major step for Maine PAs to have greater practice freedom. As is often the case, the details and rules have a significant effect on how easy that freedom is to exercise. That also applies to these proposed rules and their definition of acceptable documentation. The proposed rules (see here) are open for public comment now. Comments can be made to Dennis E. Smith (, executive director of the Board of Licensure in Medicine, at 137 State House Station, Augusta, ME 04333; and Susan E. Strout (, executive secretary of the Board of Osteopathic Licensure, at 142 State House Station, Augusta, ME 04333. Currently, there is no public hearing planned, but one can be requested. The comment window closes on October 30, 2020.