Section 373-2-6 - UNIFORM SCOPE OF PRACTICE FOR PHYSICIAN ASSISTANTS1.GeneralA physician assistant may provide any medical service for which the physician assistant has been prepared by education, training and experience and is competent to perform. The scope of practice of a physician assistant is determined by the practice setting. Physician assistant scope of practice delineated in collaborative agreements or practice agreements are subject to review and approval by the Board.
2.Practice SettingA physician assistant may render medical services in the following settings including, but not limited to a physician employer setting, physician group practice setting or independent private practice setting, or in a health care facility setting, by a system of credentialing and granting of privileges.
3. ConsultationPhysician assistants shall, as indicated by a patient's condition, the education, competencies and experience of the physician assistant and the standards of care, consult with, collaborate with or refer the patient to an appropriate physician or other health care professional. The level of consultation required is determined by the practice setting, including a physician employer, physician group practice, or private practice, or by the system of credentialing and granting of privileges of a health care facility. A physician must be accessible to the physician assistant at all times for consultation. Consultation may occur electronically or through telecommunication and includes communication, task sharing and education among all members of a health care team. Upon request of the Board, a physician assistant shall identify the physician who is currently available or was available for consultation with the physician assistant.
4.Delegation by Physician AssistantsA physician assistant may delegate to the physician assistant's employees or support staff or members of a health care team, including medical assistants, certain activities relating to medical care and treatment carried out by custom and usage when the activities are under the control of the physician assistant. The physician assistant who delegates an activity is legally liable for the activity performed by the employee, medical assistant, support staff or a member of a health care team.
5.Dispensing DrugsExcept for distributing a professional sample of a prescription or legend drug, a physician assistant who dispenses a prescription or legend drug:
A. Shall comply with all relevant federal and state laws and federal regulations and state rules; and B. May dispense the prescription or legend drug only when: (1) A pharmacy service is not reasonably available;(2) Dispensing the drug is in the best interests of the patient; or6.Legal LiabilityA physician assistant is legally liable for any medical service rendered by the physician assistant.
7.Collaborative Agreements/Practice AgreementsPhysician assistants who are required to have either a collaborative agreement or a practice agreement with an actively licensed Maine physician shall conform their scope of practice to that which has been reviewed and approved by the Board. Such agreements must be kept on file at the physician assistant's main location of practice and be made available to the Board or the Board's representative upon request. Upon any change to the parties in a practice agreement or other substantive change to the practice agreement, the physician assistant shall submit the revised practice agreement to the Board for review and approval.
8.Criteria for Requiring Collaborative Agreements or Practice AgreementsA.Collaborative Agreement.Physician assistants with less than 4,000 hours of documented clinical practice must have one (1) of the following in order to render medical services under their Maine license: (1) A Board-approved collaborative practice agreement with a Maine physician holding an active, unrestricted physician license; or(2) A scope of practice agreement through employment with a health care system or physician group practice as defined by this rule that has a system of credentialing and granting of privileges.B.Practice Agreement. Physician assistants with more than 4,000 hours of documented clinical practice as determined by the Board and who are the principal clinical provider without a physician partner or who own and/or operate an independent practice must have the following in order to render medical services under their Maine license: (1) A Board-approved practice agreement with a Maine physician holding an active, unrestricted physician license. C. Physician assistants with more than 4,000 hours of documented clinical practice as determined by the Board and are employed with a health care facility or with a practice that includes a physician partner - regardless of whether or not the facility or practice have a system of credentialing and granting of privileges - are not required to have either a collaborative agreement or practice agreement. D. Acceptable documentation of clinical practice includes, but is not limited to the following: (1) Copies of previous plans of supervision, together with physician reviews; (2) Copies of any credentialing and privileging scope of practice agreements, together with any employment or practice reviews; (3) Letter(s) from a physician(s) attesting to the physician assistant's competency to render the medical services proposed;(4) Attestation of completion of 4,000 hours of clinical practice, together with an employment history;(5) Verification of active licensure in the State of Maine or another jurisdiction for 24 months or longer. 9.Criteria for Reviewing Scope of Practice for Physician Assistants in Collaborative Agreements or Practice AgreementsA. In reviewing a proposed scope of practice delineated in a collaborative agreement or a practice agreement, the Board may request any of the following from the physician assistant:(1) Documentation of at least 24 months of clinical practice within a particular medical specialty during the 48 months immediately preceding the date of the collaborative agreement or practice agreement;(2) Copies of previous plans of supervision, together with physician reviews; (3) Copies of any credentialing and privileging scope of practice agreements, together with any employment or practice reviews; (4) Letter(s) from a physician(s) attesting to the physician assistant's competency to render the medical services proposed;(5) Completion of Specialty Certificates of Added Qualifications (CAQs) in a medical specialty obtained through the NCCPA or its successor organization; (6) Preparation of a plan for rendering medical services for a period of time under the supervision of a physician;(7) Successful completion of an educational and/or training program approved by the Board. B. Physician assistants who work outside of a health care facility or physician group practice may not render medical services until their scope of practice is reviewed and approved by the Board.