House File 424 H-1059 Amend House File 424 as follows: 1 1. Page 1, by striking line 8 and inserting < assistant 2 licensed for two or more years or licensed for less than two 3 years and practicing under a supervising physician > 4 2. Page 1, by striking lines 25 through 27 and inserting: 5 < 8. “Physician assistant” means a person licensed to 6 practice under the supervision of a physician as authorized 7 in chapters 147 and 148C or licensed as a physician assistant 8 under chapter 148C for two or more years . > 9 3. Page 1, by striking lines 32 and 33 and inserting 10 < licensed and practicing under a supervising physician pursuant 11 to chapter 148C or licensed as a physician assistant under 12 chapter 148C for two or more years , a podiatrist licensed under 13 chapter 149, a > 14 4. By striking page 2, line 35, through page 3, line 1. 15 5. Page 3, line 8, by striking < and practicing under a > and 16 inserting < and practicing under a > 17 6. Page 3, by striking line 9 and inserting < supervising 18 physician under chapter 148C or licensed as a physician 19 assistant under chapter 148C for two or more years , a 20 podiatrist licensed > 21 7. By striking page 3, line 21, through page 5, line 20, and 22 inserting: 23 < Sec. ___. Section 148C.1, subsection 5, Code 2023, is 24 amended to read as follows: 25 5. “Licensed physician assistant” or “licensed P.A.” means a 26 person who is licensed by the board to practice as a physician 27 assistant under the supervision of one or more physicians or 28 who has been licensed by the board to practice as a physician 29 assistant for two or more years . “Supervision” does not require 30 the personal presence of the supervising physician at the 31 place where medical services are rendered except insofar as 32 the personal presence is expressly required by this chapter 33 or required by rules of the board adopted pursuant to this 34 chapter . 35 -1- HF 424.555 (3) 90 ss/rh 1/ 4 #1. #2. #3. #4. #5. #6. #7.

Sec. ___. Section 148C.3, subsection 2, Code 2023, is 1 amended to read as follows: 2 2. Rules shall be adopted by the board pursuant to 3 this chapter requiring a licensed physician assistant to 4 be supervised by physicians during the first two years of 5 licensure . The rules shall provide that not more than five 6 physician assistants shall be supervised by a physician at one 7 time. The rules shall also provide that a physician assistant 8 shall notify the board of the identity of the physician 9 assistant’s supervising physician and of any change in the 10 status of the supervisory relationship. 11 Sec. ___. Section 148C.4, subsection 3, Code 2023, is 12 amended to read as follows: 13 3. The degree of collaboration between a physician 14 assistant and the appropriate member of a health care team 15 shall be determined at the practice level, and may involve 16 decisions made by the medical group, hospital service, 17 supervising physician, or employer of the physician assistant, 18 or the credentialing and privileging system of a licensed 19 health care facility. A physician shall be accessible at all 20 times for consultation with a physician assistant unless the 21 physician assistant is providing emergency medical services 22 pursuant to 645 IAC 327.1(1)(n) . The supervising physician 23 shall have ultimate responsibility for determining the medical 24 care provided by the supervising physician-physician assistant 25 team. A physician assistant shall be responsible for the 26 services performed by the physician assistant that are not 27 performed under the supervision of a physician. 28 Sec. ___. Section 148C.9, Code 2023, is amended to read as 29 follows: 30 148C.9 Eye examination restricted. 31 A physician assistant shall not be permitted to prescribe 32 lenses, prisms, or contact lenses for the aid, relief, or 33 correction of human vision during the first two years of 34 licensure . A physician assistant shall not be permitted to 35 -2- HF 424.555 (3) 90 ss/rh 2/ 4

measure the visual power and visual efficiency of the human 1 eye, as distinguished from routine visual screening, except 2 in the personal presence of a supervising physician at the 3 place where such services are rendered , unless the physician 4 assistant has been licensed for two or more years . > 5 8. Page 5, by striking lines 29 through 31 and inserting 6 < assistant who has been delegated the authority to order the 7 services of an orthotist, prosthetist, or pedorthist by the 8 assistant’s supervising physician or who has been licensed as a 9 physician assistant for two or more years . > 10 9. Page 5, line 35, by striking < and licensed physician 11 assistants , > and inserting < licensed physician assistants 12 during the first two years of licensure > 13 10. Page 6, line 1, by striking < and > and inserting < and > 14 11. Page 6, line 2, after < physician, > by inserting 15 < licensed physician assistants who have been licensed for two 16 or more years, > 17 12. Page 6, line 25, by striking < to practice under the > and 18 inserting < to practice under the > 19 13. Page 6, by striking lines 26 and 27 and inserting 20 < supervision of a physician as authorized in chapters 147 and 21 148C or who has been licensed as a physician assistant for two 22 or more years . > 23 14. Page 6, line 35, by striking < under the supervision of > 24 and inserting < under the supervision of or > 25 15. Page 7, line 11, by striking < to > and inserting < to > 26 16. Page 7, by striking lines 12 and 13 and inserting 27 < practice under the supervision of a physician as authorized in 28 chapters 147 and 148C or who has been licensed as a physician 29 assistant for two or more years > 30 17. Page 7, line 17, by striking < or modify the > and 31 inserting < or modify the > 32 18. Page 7, by striking lines 18 through 20 and inserting 33 < requirement in section 148C.4 that a physician assistant 34 perform medical services under the supervision of a licensed 35 -3- HF 424.555 (3) 90 ss/rh 3/ 4 #8. #9. #10. #11. #12. #13. #14. #15. #16. #17.

physician during the first two years of licensure as a 1 physician assistant . > 2 19. Page 7, line 24, by striking < or modify the > and 3 inserting < or modify the > 4 20. Page 7, by striking lines 25 through 27 and inserting 5 < requirement in section 148C.4 that a physician assistant 6 perform medical services under the supervision of a licensed 7 physician during the first two years of licensure as a 8 physician assistant . > 9 21. Page 7, line 31, by striking < or modify the > and 10 inserting < or modify the > 11 22. Page 7, by striking lines 32 through 34 and inserting 12 < requirement in section 148C.4 that a physician assistant 13 perform medical services under the supervision of a licensed 14 physician during the first two years of licensure as a 15 physician assistant . > 16 23. Page 8, line 3, by striking < or modify the > and 17 inserting < or modify the > 18 24. Page 8, by striking lines 4 through 6 and inserting 19 < requirement in section 148C.4 that a physician assistant 20 perform medical services under the supervision of a licensed 21 physician during the first two years of licensure as a 22 physician assistant . > 23 25. Page 8, by striking lines 7 and 8. 24 26. Title page, line 2, after < practice of > by inserting 25 < certain > 26 27. By renumbering as necessary. 27 ______________________________ TUREK of Pottawattamie -4- HF 424.555 (3) 90 ss/rh 4/ 4 #19. #20. #21. #22. #23. #24. #25. #26. #27.