87R8740 ANG-F
 
  By: Beckley H.B. No. 4352
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the scope of practice of physician assistants.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Sections 204.202(a), (b), and (c), Occupations
  Code, are amended to read as follows:
         (a)  The practice of a physician assistant includes
  providing medical and surgical services delegated by a
  collaborating [supervising] physician that are within the skills
  [education, training, and experience] of the physician assistant, a
  component of the physician assistant's scope of practice, and
  provided through collaboration with a physician.
         (b)  Medical and surgical services provided by a physician
  assistant may include:
               (1)  obtaining patient histories and performing
  physical examinations;
               (2)  evaluating, diagnosing, managing, and providing
  medical treatment;
               (3)  ordering, [or] performing, and interpreting
  diagnostic studies and therapeutic procedures;
               [(3)  formulating a working diagnosis;]
               (4)  educating patients on health promotion and disease
  prevention [developing and implementing a treatment plan];
               (5)  providing consultation on request [monitoring the
  effectiveness of therapeutic interventions]; and
               (6)  writing medical orders [assisting at surgery;
               [(7)  offering counseling and education to meet patient
  needs;
               [(8)  requesting, receiving, and signing for the
  receipt of pharmaceutical sample prescription medications and
  distributing the samples to patients in a specific practice setting
  in which the physician assistant is authorized to prescribe
  pharmaceutical medications and sign prescription drug orders as
  provided by Section 157.0512 or 157.054;
               [(9)  prescribing or ordering a drug or device as
  provided by Subchapter B, Chapter 157; and
               [(10)  making appropriate referrals].
         (c)  The activities listed by Subsection (b) may be performed
  in a health care facility or other location [any place authorized by
  a supervising physician], including a clinic, hospital, ambulatory
  surgical center, patient home, nursing home, or other institutional
  setting.
         SECTION 2.  Section 204.204, Occupations Code, is amended to
  read as follows:
         Sec. 204.204.  COLLABORATION [SUPERVISION] REQUIREMENTS.  
  (a)  A physician assistant shall collaborate with [be supervised
  by] a collaborating [supervising] physician. A physician assistant
  may have more than one collaborating [supervising] physician. The
  collaborating [supervising] physician oversees the [activities of,
  and accepts responsibility for,] medical services provided by the
  physician assistant.
         (b)  Collaboration with [Supervision of] a physician
  assistant by a collaborating [supervising] physician must be
  continuous. The collaboration [supervision] does not require the
  constant physical presence of the collaborating [supervising]
  physician where physician assistant services are being performed,
  but, if a collaborating [supervising] physician is not present, the
  collaborating [supervising] physician and the physician assistant
  must be, or must be able to easily be, in contact with one another by
  radio, telephone, or another telecommunication device.
         (c)  The number of physician assistants a physician may
  collaborate with [supervise] in a practice setting may not be less
  than the number of physician assistants to whom a physician may
  delegate the authority to prescribe or order a drug or device in
  that practice setting under Subchapter B, Chapter 157.
         SECTION 3.  Sections 204.2045(a) and (c), Occupations Code,
  are amended to read as follows:
         (a)  The collaboration [supervision] and delegation
  requirements of this chapter and Subtitle B do not apply to medical
  tasks performed by a physician assistant:
               (1)  during a disaster under the state emergency
  management plan adopted under Section 418.042, Government Code;
               (2)  during a disaster declared by the governor or
  United States government; or
               (3)  as a volunteer for a charitable organization or at
  a public or private event, including a religious event, sporting
  event, community event, or health fair.
         (c)  A physician assistant may perform tasks described by
  this section:
               (1)  by collaborating with [under the supervision of]
  any physician who is also performing volunteer work in the
  disaster, for the charitable organization, or at the public or
  private event; or
               (2)  without collaborating with [the supervision of] a
  physician, if a physician is not available to provide supervision.
         SECTION 4.  Section 204.205, Occupations Code, is amended to
  read as follows:
         Sec. 204.205.  REQUIREMENTS FOR COLLABORATING [SUPERVISING]
  PHYSICIAN.  A collaborating [supervising] physician must have a
  practice agreement with the physician assistant with whom the
  physician will collaborate regarding the scope of practice of the
  physician assistant that is based on the physician assistant's
  practice level and taking into consideration the physician
  assistant's education, training, and experience[:
               [(1)  hold an unrestricted and active license as a
  physician in this state;
               [(2)  notify the medical board of the physician's
  intent to supervise a physician assistant;
               [(3)  submit to the medical board a statement that the
  physician will:
                     [(A)  supervise the physician assistant according
  to medical board rule; and
                     [(B)  retain professional and legal
  responsibility for the care provided by the physician assistant;
  and
               [(4)  receive approval from the medical board to
  supervise the physician assistant].
         SECTION 5.  Section 204.206, Occupations Code, is amended to
  read as follows:
         Sec. 204.206.  ESTABLISHMENT OF CERTAIN FUNCTIONS AND
  STANDARDS. Each physician assistant and the physician assistant's
  collaborating [supervising] physician shall ensure that:
               (1)  the physician assistant's scope of function is
  identified;
               (2)  delegation of medical tasks is appropriate to the
  physician assistant's level of education, training, and experience
  [competence];
               (3)  the relationship between the physician assistant
  and the collaborating [supervising] physician and the access of the
  physician assistant to the supervising physician are defined; and
               (4)  a process is established for evaluating the
  physician assistant's performance.
         SECTION 6.  Section 204.207, Occupations Code, is amended to
  read as follows:
         Sec. 204.207.  ASSUMPTION OF PROFESSIONAL LIABILITY.  A
  physician assistant shall be legally responsible for the care
  provided by the physician assistant [(a) Each supervising physician
  retains legal responsibility for a physician assistant's patient
  care activities, including the provision of care and treatment to a
  patient in a health care facility].
         [(b)  If a physician assistant is employed by an entity,
  including a health care facility, the entity shares the legal
  responsibility for the physician assistant's acts or omissions with
  the physician assistant's supervising physician.]
         SECTION 7.  This Act takes effect September 1, 2021.