New Bill in North Dakota House Would Give Physician Assistants More Practice Freedom

Posted By American Med Spa Association, Wednesday, January 9, 2019

A new bill introduced in the North Dakota House would bring the practice of physician assistants (PA) more aligned with current national trends. This bill was pre-filed for the 2019 legislative session and has been initially referred to the Human Service Committee for further discussion. It is, of course, too early to tell if it will pass, but it was introduced with eight sponsoring members. House Bill 1175’s (HB 1175) sponsors include Representatives Devlin, Holman, Kading, and Vigesaa and Senators Bekkedahl, Heckaman, O. Larsen, and Unruh. You can review the text of HB 1175 in full here.
To start, HB 1175 makes a number of small changes modernizing the language of North Dakota’s Medical Practice Act but that otherwise don’t make any substantive changes. However, the meat of the changes in HB 1175 is that it completely rewrites the section that currently covers limitations on prescribing for PAs. In its place it leaves a section entitled “Physician Assistant-Scope of Practice.” This section still requires that PAs operate under a written collaborative agreement with a physician but only if they have less than four thousand hours of practice. Once the PA has exceeded four thousand hours of practice they are no longer required to operate under a written agreement. This would not make PAs completely independent: they may only work at a licensed healthcare facility or one owned by a physician and they must work collaboratively as a member of a healthcare team. But now their scope of practice includes among other things performing exams, prescribing medication, and writing orders all without the need for physician oversight. In essence, HB 1175 redefines the title of physician assistant from someone who practices under the delegated authority of a physician to an independent medical professional who may practice within their statutory scope of practice. In keeping with this new responsibility HB 1175 also adds physician assistants alongside physicians as licensees who are subject to discipline by the Board of Medicine. 
We will be monitoring HB 1175 as it works its way through the legislative process this year. If you would like to contact HB 1175’s sponsors, their contact information can be located from the Legislature’s webpage.