CHAPTER 21
PHYSICIAN SUPERVISION OF A PHYSICIAN ASSISTANT
653—21.1(148,272C) Ineligibility determinants. A physician with an active permanent, special, or temporary Iowa license who is actively engaged in the practice of medicine in Iowa may supervise a physician assistant. A physician is ineligible to supervise a physician assistant for any of the following reasons:
	21.1(1) The physician does not hold an active, permanent, special or temporary Iowa medical license.
	21.1(2) The physician is subject to a disciplinary order of the board that restricts or rescinds the physician’s authority to supervise a physician assistant. The physician may supervise a physician assistant to the extent that the order allows.
653—21.2(148,272C) Exemptions from this chapter. This chapter shall not apply to the following:
	21.2(1) A physician working in a federal facility or under federal authority when the provisions of this chapter conflict with federal regulations.
	21.2(2) A physician who supervises a physician assistant providing medical care created by an emergency or a state or local disaster pursuant to Iowa Code section 148C.4 as amended by 2003 Iowa Acts, chapter 93, section 10.
653—21.3(148) Board notification. A physician who supervises a physician assistant shall notify the board of the supervisory relationship at the time of the physician’s license renewal.
653—21.4(148,272C) Grounds for discipline. A physician may be subject to disciplinary action for supervising a physician assistant in violation of these rules or the rules found in 653—Chapter 23 or 645—Chapters 326 and 327, which relate to duties and responsibilities for physician supervision of physician assistants. Grounds for discipline also include:
	21.4(1) The physician supervises a physician assistant when the physician does not have sufficient training or experience to supervise a physician assistant in the area of medical practice in which a physician assistant is to be utilized.
	21.4(2) A physician supervises more than five physician assistants at the same time.
	21.4(3) The physician fails to ensure that the physician assistant is adequately supervised, including being available in person or by telecommunication to respond to the physician assistant.
[ARC 0870C, IAB 7/24/13, effective 8/28/13]
653—21.5(148,272C) Disciplinary sanction. The board may restrict or rescind a physician’s authority to supervise a physician assistant as part of a disciplinary sanction following a contested case proceeding, if the reason for the disciplinary action impacts the ability of the physician to supervise a physician assistant. The board shall notify the board of physician assistants when it takes a disciplinary action against a physician’s license that affects the physician’s authority to supervise a physician assistant.
653—21.6(148,272C) Communication with physician assistant supervisees. The physician shall notify all physician assistant supervisees within one workday upon receiving disciplinary action from the board or any other change in status that affects the physician’s eligibility to supervise a physician assistant.
653—21.7(17A,147,148,272C) Waiver or variance requests. Waiver or variance requests shall be submitted in conformance with 653—Chapter 3.
These rules are intended to implement Iowa Code sections 148.13 and 272C.3.
[Filed 1/4/89, Notice 11/16/88—published 1/25/89, effective 3/1/89123]
[Filed 8/31/89, Notice 5/31/89—published 9/20/89, effective 10/25/89]
[Filed 2/23/96, Notice 1/3/96—published 3/13/96, effective 4/17/964]
[Filed emergency 10/4/96—published 10/23/96, effective 10/4/96]
[Filed 9/29/00, Notice 8/23/00—published 10/18/00, effective 11/22/00]
[Filed 12/4/03, Notice 8/20/03—published 12/24/03, effective 1/28/045]
[Filed emergency 3/9/04—published 3/31/04, effective 3/9/04]
[Filed ARC 0870C (Notice ARC 0692C, IAB 4/17/13), IAB 7/24/13, effective 8/28/13]
1	Effective date of 3/1/89 delayed 70 days by Administrative Rules Review Committee at its February 13, 1989, meeting.
2	Effective date of 3/1/89 delayed until adjournment of the 1990 Session of the General Assembly at its May 9, 1989, meeting.
3	Delay until adjournment of the 1990 G.A. lifted by the Administrative Rules Review Committee at its August 3, 1989, meeting which allowed the rules to become effective August 4, 1989.
4	Effective date of 4/17/96 delayed 70 days by the Administrative Rules Review Committee at its meeting held April 16, 1996. Effective date delayed until adjournment of the 1997 General Assembly by the Administrative Rules Review Committee at its meeting held June 11, 1996.
5	Effective date of 1/28/04 delayed 70 days by the Administrative Rules Review Committee at its January 6, 2004, meeting; at its meeting held March 8, 2004, the Committee lifted the delay, effective March 9, 2004.