Laws Ease Physician Assistant Countersignature Rules

Read PAMED’s regulatory analysis, which outlines changes to the new law, what physicians need to know, and includes questions and answers.

Two laws, which went into effect Jan. 26, 2014, allow a physician the option of relaxing current physician assistant (PA) countersignature requirements.

The passage of these bills is a great example of how physician-led, team-based health care can be streamlined, increasing productivity and access to care, while at the same time preserving patient safety.

Act 100 and Act 101 permit a physician, if he or she chooses and believes it is safe, to ease the current requirement that he or she countersign 100 percent of all patient records completed by a PA once certain criteria are met.

Physicians will still be required to countersign 100 percent of a PA’s patient records within 10 days:

  • During the first 12 months the PA is practicing post-graduation and licensure, and when the PA is practicing in a new specialty
  • During the first six months the PA is practicing in the same specialty under the supervision of a physician, unless the PA has multiple approved physicians (physicians approved to reduce the number of charts they must countersign with the appropriate medical board) and the PA has practiced under the supervision of at least one of those approved physicians for at least six months.

Once those periods are over, physicians can choose to reduce, but not eliminate, the number of records completed by a PA that they must countersign by submitting a written agreement to either the State Board of Medicine (for MDs, per Act 100) or the State Board of Osteopathic Medicine (for DOs, per Act 101) for approval.

In order to obtain Board approval, the written agreement must require physicians to personally review a selected number of patient records completed by the PA on a regular basis. The records to be reviewed are determined by written criteria set by the physician and PA in the agreement and must include enough to assure adequate review of the PA’s scope of practice.

Recognizing the essential role of advanced practice providers on the health care team, PAMED previously worked with the Pennsylvania Society of Physician Assistants to reach an agreement on language included in this new law.

The new laws, which were signed into law by Gov. Tom Corbett on Nov. 27, 2013, will ease the administrative burden on physicians where appropriate, while still requiring sufficient oversight to assure patient safety.