Sample Delegation of Services Agreement Physician Assistant
Written by Wendy Garraty
(3)… [A]dopt[ing] protocols to regulate the performance of a physician‘s assistant for some or all of the tasks … The protocols are prepared by the doctor, taken from texts or other sources or referenced. Protocols must be signed and dated by the attending physician and the physician‘s assistant. . ; The new law further provides that “nothing in the regulation requires a physician and surgeon to review or countersign a medical record of a patient being treated by a medical assistant, unless required by the agreement of practice.” Bus. & Prof. Code § 3502©, amended by SB 697 (valid from 1 January 2020). To this end, section 3502.3 of the Business and Professions Code, as amended, provides that the agreement with the practitioner must cover “policies and procedures to ensure adequate supervision of the physician assistant, including, but not limited to, appropriate communication, availability, consultations and references between a physician and surgeon and the physician assistant in the provision of medical services.” Bus. & Prof.
Code § 3502.3(a)(1)(B), amended by SB 697 (valid from 1 January 2020). Under the new Act, a practice agreement is defined as “the letter developed in the course of collaboration between one or more physicians and surgeons and one or more physician assistants, defining the medical services to which the physician assistant is entitled under section 3502 and authorizing physicians and surgeons to be staffed by an organized health care system, supervise one or more medical assistants in the organized health system. » Bus & Prof. Code § 3501 (k), amended by SB 697 (valid from 1 January 2020). An “organized health care system” is defined as licensed clinics, ambulatory care facilities, a “health facility” within the meaning of section 1250 of the Health and Safety Code, a doctor‘s office or “any other entity that lawfully provides medical services …”. Bus & Prof. Code § 3501(j), amended by SB 697 (valid from 1 January 2020). In addition, section 3502.3, as amended, provides that the contract of practice must be signed by “one or more physicians and surgeons or a physician and surgeon authorized to approve the contract of practice on behalf of the staff of physicians and surgeons of the personnel of an organized health care system.” Bus & Prof. Code § 3502.3(a)(2)(B), amended by SB 697 (valid from 1 January 2020).
The new law eliminates these requirements. Instead, it states: “Supervision as defined in this subsection shall not be construed as requiring the physical presence of the physician, but shall require: (A) compliance with appropriate supervision as agreed to in the agreement with the practitioner. B) The physician and surgeon are available by telephone or other electronic means of communication when the PA examines the patient. » Bus. & Prof. Code § 3501(f)(1), amended by SB 697 (valid from 1 January 2020). Finally, SB 697 expands the prescribing authority of PAs by eliminating specific medical surveillance requirements and eliminating the requirement that the name and contact information of the supervising physician be included on a PA‘s prescriptions. See Bus. & Prof.
Code § 3502.1, amended by SB 697 (valid from 1 January 2020). Instead, the practice agreement should specify the supervision to be given to the PA when prescribing medications, although a supervising physician “must be available by telephone or other means of electronic communication at the time of the patient‘s examination.” Bus. & Prof. Code § 3502.1©(2). (2) the countersignature and dating of all medical records written by the physician assistant within thirty (30) days after the treatment provided by the physician assistant; Under applicable law, PAs are required to enter into a delegation of service agreements that designate “any supervising physician.” Title 16 JRC Article 1399.540(b). The scope of activity of each agent is limited by the specific tasks assigned to the agent by their agreement on the delegation of services. Id. See also Bus. & Prof.
Code §§ 3501(a)(10), 3502.3. The new law, as amended by SB 697, removes the requirement for an agreement on the delegation of services and replaces it with a requirement for a “practical agreement”. See Bus & Prof. Code §§ 3501(k), 3502.3, amended by SB 697 (valid from 1 January 2020). The current law requires physicians to supervise PAs in one of four ways: It is important to note that the new law does not require health systems to replace their existing delegation of services agreements with practice agreements. See Bus & Prof. Code § 3502.3(a)(3), as amended by SB 697 (valid from 1 January 2020). Instead, practice agreements are only required if new PA agreements are concluded after 1 January 2020. However, for the above reasons, health systems could consider replacing all their existing service delegation agreements with PA agreements and avoid different types of paA agreements within the same health system being based solely on the date of drafting of the PA agreement.
Thus, instead of requiring an agreement between a particular PA and certain treating physicians, the new legislation simplifies PA agreements by allowing the use of the same practice agreement for multiple PAs, not requiring specific supervising physicians to be appointed, and not requiring the agreement to be signed by pa supervising physicians. This should lead to a significant simplification of THE PRACTICE OF PA in health systems, where PAs are often monitored by multiple physicians and, in the past, were required to delegate service agreements in which each of these physicians was appointed. (1) the examination of the patient by a supervising physician on the same day the treatment is carried out by the physician‘s assistant; (i) The attending physician and the surgeon shall, within 30 days after the date of treatment by the physician‘s assistant, examine, countersign and date a sample consisting of at least 5% of the medical records of patients processed by the physician‘s assistant working in accordance with the protocols. (ii) The attending physician, surgeon and physician‘s assistant shall hold a medical record review meeting at least once a month for at least 10 months of the year. Does anyone have an example of a practice contract that I can edit and create for my office? At first, I used and modified Capa‘s old delegation convention to meet our private practice needs. Thanks in advance! Taken together, these new regulations mean significant changes that will give health systems much more flexibility to decide how PAs are supervised in their organization. Instead of PAs and physicians being limited to one of the four forms of oversight set out in the existing legislation, each health care system is free to create a single structure for PA oversight that makes the most sense in the context of the organization (provided it meets the oversight requirements contained in the amended legislation). This brings the practice of PA much closer to the practice of nurses (“NPs”), whose oversight is determined by standard procedures developed by each health care system.
(iii) The attending physician and surgeon review a sample of at least 10 medical records per month, but not less than 10 months per year, using a combination of the countersignature mechanism described in section (i) and the medical record review mechanism described in section (ii). . Senate Bill 697 (“SB 697″), a bill that significantly changes the oversight requirements for medical assistants (“PAs”) in California, was signed into law by California Governor Gavin Newsom on October 9, 2019 and takes effect on January 1, 2020. Among the most significant changes made by SB 697 is 1. the cancellation of the requirement for a delegation of services agreement with a panel physician and the requirement for a “practice agreement” with an organized health care system as a whole; 2. the removal of most of the previous specific supervisory requirements for paying agencies and the establishment of appropriate supervisory arrangements for the organised health system; and 3. Approval of PAs to prescribe medications without specific medical supervision or medical contact information on the prescription. The net impact of these changes is to increase the independence of PaAs and bring their field of activity closer to that of nurses (“NPs”), who have long enjoyed a more independent field of activity. Hospitals and other providers working with PAs must be prepared to implement the new “practice agreements” under SB 697 as of January 1, 2020 for all PAs with whom they enter into new agreements.