A new bill introduced in North Carolina would allow physician assistants/associates (PAs) to practice without the need for physician supervision. The bill is known as Senate Bill 345 (SB 345), and its primary sponsor is Senator Todd Johnson. SB 345 has passed the Senate and is currently with the House Committee on Rules for further consideration.
SB 345 proposes sweeping changes to North Carolina’s current PA practice laws. Currently, PAs in the state require a supervisory agreement with a physician to authorize their practice and to order prescriptions. SB 345 would allow PAs to practice without a supervisory relationship provided they have:
1. Practiced under supervision agreements for more than 4,000 hours;
2. Have at least 1,000 hours of practice in their current specialty; and
3. Practice in a “team-based setting.”
A “team-based setting” would include a medical practice organized as a professional corporation, a physician-owned practice where there is meaningful participation by the physician, and a licensed health facility with a credentialing program and physician participation. PAs who do not yet qualify for this would still need to maintain a supervisory arrangement; however, it may now be in writing or kept electronically. The PA would submit an “Intent to Practice Notification” to the North Carolina Medical Board providing some of the supervisory arrangement details.
The national trend has been moving toward allowing PAs to practice with reduced oversight by physicians. While they would still work closely with physicians if SB 345 is passed, the bill would give North Carolina PAs significantly reduced practice requirements.
We will be monitoring SB 345 as it works its way through North Carolina’s legislative process this year.