|PA 379 FAQs|
Public Act 379 of 2016
Frequently Asked Questions
Q. Was a new practice law recently passed that changes the way PAs and physicians work together?
Yes. Public Act 379 of 2016 was just signed into law which more clearly defines the relationship between a PA and a participating physician by creating a written Practice Agreement. The Practice Agreement requires each provider to consider education, training and experience in order to ensure the highest quality patient care.
Q. When does this new law go into effect?
PA 379 will go into effect on March 22, 2017. A PA and their participating physician must have a new practice agreement in place by that date.
Q. Does the new law remove the terms "supervision" and "delegation"?
Yes. PAs in Michigan are no longer required to work under supervision or delegation of a physician according to the new law. PAs will now be required to work with a "participating physician" according to the terms in a "practice agreement."
Q. Can a PA practice without a physician?
No. The new law continues to support the PA and physician team. PAs will now be required to work with a "participating physician" according to the terms in a "practice agreement."
Q. How is a "participating physician" defined in law?
A "participating physician" means "a physician, a physician designated by a group of physicians under section 333.17049 to represent that group, or a physician designated by a health facility or agency under section 333.20174 to represent that health facility or agency."
Q. What is a Practice Agreement?
A Practice Agreement is a written agreement between a PA and a participating physician that is now required by law under Public Act 379. This agreement generally defines the communication and decision making process by which the PA and the participating physician provide medical care to their patients. The Practice Agreement may also place conditions on specific duties, procedures or drugs, if the parties of the agreement choose to do so. It is not intended to be a burdensome or lengthy document, but rather, provide a general understanding of each professional's knowledge and skills utilized in each unique practice setting.
Q. What information is required within a Practice Agreement?
The new law [Public Act 379] requires the following provisions to be addressed in a Practice Agreement:
"(a) A process between the physician assistant and participating physician for communication, availability and decision making when providing medical treatment to a patient. The process must utilize the knowledge and skills of the physician assistant and participating physician based on their education, training and experience.
(b) A protocol for designating an alternative physician for consultation in situations in which the participating physician is not available for consultation.
(c) The signature of the physician assistant and the participating physician.
(d) A termination provision that allows the physician assistant or participating physician to terminate the practice agreement by providing written notice at least 30 days before the date of termination."
Q. Can credentialing documents qualify as a Practice Agreement?
The document must contain, in some form, the information required by law (as outlined above) in order to qualify as a practice agreement.
Q. How will PAs be able to prescribe medications without delegation from a physician?
Physician Assistants are now defined in PA 379 as independent "Prescribers" (within a practice agreement). This is an exclusive designation in law that, in addition to PAs, includes physicians, dentists, veterinarians, optometrists (limited to therapeutic pharmaceutical agents) and advance practice registered nurses (excluding schedule 2-5 which must be delegated by a physician according to Public Act 499 of 2016).
Q. Does this mean that a PA must now obtain their own state Controlled Substance License (CSL)?
Yes, a PA who intends to prescribe controlled substances must now purchase a State of Michigan Controlled Substance License (CSL) in addition to maintaining their DEA license. CSL applications are available now but will not be approved before March 22, 2017. Click here to apply now for the State of Michigan Controlled Substance License.
Q. Are there any new limitations on the drugs a PA can prescribe?
No, the new law does not place any additional limitations on drugs a PA can prescribe. Michigan law still prohibits PAs from prescribing medical marijuana and abortive drugs.
Q. Are there any new limitations on a PA's scope of practice?
No, the new law does not place any additional scope of practice limitations on PAs.
Q. Does the new Practice Agreement need to be filed with the state or any other government entity?
No. The Practice Agreement must be signed and dated by both the PA and the participating physician prior to a PA providing patient care. The Practice Agreement needs to be readily available for inspection if necessary.
Q. What happens if the conditions of the Practice Agreement change?
If the conditions of the Practice Agreement change, the updated Practice Agreement must be signed and dated by both the PA and participating physician.
Q. Does the Practice Agreement need to be updated annually?
No. The agreement only needs to be updated if the conditions of the Practice Agreement change (see above).
Q. Are there any restrictions in the number of PAs that can enter into a practice agreement with a participating physician?
The new law [Public Act 379] removes the previous PA/physician ratios in law and creates new language that triggers disciplinary action by the Board of Medicine, Board of Osteopathic Medicine or the Podiatric Board of Medicine if the number of PAs per physician exceeds a reasonable standard-of-practice threshold.
Q. Does the new law impact liability or reimbursement for PAs?
There are no predicted changes to liability or reimbursement as a result of the new law. This FAQ will be updated if we expect any impact on liability or reimbursement for PAs.
On March 31-April 1, 2017, MAPA is holding its annual Spring CME Conference in Midland, Michigan. We have invited an exciting array of speakers to lecture on clinical and professional issues. AAPA's Vice President of Reimbursement Michael Powe will be speaking. There will be a panel discussion with MAPA's leadership on PA 379 and a speaker from BCBS to talk about Medical Fraud. We hope you can attend. For more information and to register, please click here.
MAPA is working every day to ensure that Michigan is a great place for PAs to practice medicine! Are you a member? Whether you own a practice or just graduated PA school, stay up to date with issues and laws that affect you. Join MAPA today!