As of July 1, 2015, physicians in Indiana can expect their duties for supervising their physician assistants (PAs) to be lessened under revised state law. House Enrolled Act No. 1183 amends the language of Indiana Code § 25-27.5-6-1 by decreasing requirements on the physician for review of PA patient encounters, in addition to decreasing chart review requirements. Under the amended law, physicians are no longer required to review all of their PA’s patient encounters within 72 hours. Rather, physicians will now be required to review patient encounters within 10 business days and within a reasonable time, as established in the supervising agreement, after the PA has seen the patient. The change to Indiana law requires that the timing of review be appropriate for the maintenance of quality medical care for the patient. Further, chart review requirements remain tiered based on the number of years the physician assistant has been employed; however, the number of charts required to be reviewed by the physician will decrease under the amended law. Physicians were previously required to review 100% of their PA’s charts for the first year of employment. Beginning July 1st, physicians will only be required to review 25% of the PA’s charts during the PA’s first year of practice. After the PA’s first year of practice, the number of charts required to be reviewed by the physician is determined by the physician based on what is “reasonable for the particular practice setting and level of experience of the physician assistant, as stated in the supervising agreement, that is appropriate for the maintenance of quality medical care.” If a PA’s employment changes to a different practice specialty, the first year chart review requirements will apply to the PA during the first year of practice in the new specialty.
For physicians who authorize their PA to prescribe or dispense controlled substances under their supervising agreement, physicians will be required to review 50% of the PA’s patient records for which a Schedule II controlled substance is prescribed or dispensed during the first year in which the PA has authority to prescribe and/or dispense Schedule II drugs. Under previous Indiana law, physicians were required to review 100% of patient records in which any controlled substance was prescribed or dispensed by the PA. This includes Schedule II, III, IV or V drugs, as PAs in Indiana are not authorized under state law to prescribe or dispense Schedule I controlled substances.
House Enrolled Act No. 1183 further decreases limitations on physicians under Indiana Code § 25-27.5-6-2 by allowing physicians to supervise up to four PAs at the same time, as opposed to the previous limitation of supervising two PAs at the same time.
To review additional changes to Indiana law under House Enrolled Act 1183, access the full text here.
Ashley Leonard is an associate in the Health Care and Life Sciences Group at Plews Shadley Racher & Braun LLP. Ashley has experience advising physicians, hospitals, specialty practice groups, and various healthcare organizations on regulatory compliance matters involving state and federal healthcare laws, as well as assisting healthcare clients on corporate and transactional matters.
If you have any questions regarding physician scope of practice or supervision requirements for physician assistants or advance practice nurses under Indiana or Illinois law, please contact Ashley at firstname.lastname@example.org or 317.637.0700.