On March 22, 2017, Michigan’s Public Act 379 of 2016 (the Act) will take effect, altering the practice requirements for physician assistants (PAs) within the state. The Act will require PAs to enter into and comply with a written practice agreement with a “participating physician.” The Act will thus affect not only PAs, but also participating physicians and other healthcare entitles.
A “participating physician” is defined as a physician, a physician designated by a group of physicians to represent that group, or a physician designated by a health facility or agency to represent that health facility or agency.
Another important aspect to note about the Act is that it limits the ability of PAs to practice within Michigan, requiring a written agreement which fulfills the statutory requirements. A practice agreement must include:
- details of a process for communication and decision-making when treating patients, which is tailored to the specific education, training, and experience of both the PA and the participating physician;
- information regarding designation of an alternate consulting physician when the primary participating physician is unavailable;
- a description of the duties and responsibilities of the PA and participating physician, which must be limited by applicable laws to not include any duties outside the scope or expertise of the party;
- a covenant that the participating physician has or will verify the PA’s credentials.
- a termination clause allowing either party to terminate the agreement with 30 days notice; and
- the signatures of the PA and the participating physician.
The practice agreements will therefore define the PA-participating physician relationship, and set out a framework for the PA’s practice as a healthcare professional. While nothing contained within the agreement will be likely to change the day-to-day responsibilities of PAs, the fact that the duties must be memorialized and signed by a physician will be an added administrative requirement. The signed agreement will be binding upon the parties, and failure to comply with its terms will constitute unprofessional conduct, which is a grounds for sanctions up to and including revocation of medical license. It is also very likely that the written agreements will be utilized in Medicare and Medicaid contexts, and that violation of the agreements may constitute a grounds for non-payment.
However, the Act does allow healthcare actors some additional autonomy. First, the Act removes limits on how many PAs may work under a single participating physician. The ratio is removed from the law, therefore allowing more PAs to operate within a single office or entity. In addition, the Act grants PAs new authority to prescribe drugs and to make calls to private homes as well as health care facilities without limits on time or frequency of visits.
No matter what the long term effect of the Act is, it is important for PAs and other healthcare providers within Michigan to understand what the Act requires and to enter into a written practice agreement as soon as possible. And going forward, it will be important for all healthcare entitles to observe how these practice agreements interact with existing healthcare laws and programs.
Wachler & Associates has been a leader in the field of healthcare law since 1985, with a specialty in healthcare compliance matters. If you or your health care entity have questions or concerns about Michigan’s new PA law or other compliance issues, please contact an experienced healthcare attorney at (248) 544-0888, or via email at wapc@wachler.com. You may also subscribe to our health law blog by adding your email at the top right of this page.