Senate Amendment to House File 424 H-1280 Amend House File 424, as passed by the House, as follows: 1 1. Page 2, line 14, by striking < supervises > and inserting 2 < supervises a physician assistant engaged in independent 3 practice or > 4 2. Page 2, line 16, by striking < supervises > and inserting 5 < supervises a physician assistant engaged in independent 6 practice or > 7 3. Page 4, by striking lines 3 and 4 and inserting: 8 < Sec. ___. Section 148C.1, subsection 5, Code 2023, is 9 amended by striking the subsection and inserting in lieu 10 thereof the following: 11 5. “Independent practice” means the practice of a physician 12 assistant that is organized as a professional corporation under 13 chapter 496C or a professional limited liability company under 14 chapter 489. 15 Sec. ___. Section 148C.1, subsection 8, Code 2023, is 16 amended by striking the subsection and inserting in lieu 17 thereof the following: 18 8. “Supervising physician” means a physician who supervises 19 the medical services provided by a physician assistant 20 engaged in independent practice consistent with the physician 21 assistant’s education, training, and experience. > 22 4. Page 4, by striking lines 14 and 15 and inserting: 23 < Sec. ___. Section 148C.3, subsection 2, Code 2023, is 24 amended to read as follows: 25 2. a. Rules Joint rules shall be adopted by the board and 26 the board of medicine pursuant to this chapter requiring a 27 licensed physician assistant to be supervised by physicians a 28 physician during the first two years of independent practice if 29 the physician assistant has not previously practiced under a 30 supervising physician or in collaboration with the appropriate 31 physician or other health care professional for a period of at 32 least two years . The rules shall provide that not more than 33 five physician assistants shall be supervised by a physician at 34 one time determine the terms of collaboration for a physician 35 -1- HF 424.1915.S (2) 90 mb 1/ 3 #1. #2. #3. #4.

assistant engaged in independent practice after the conclusion 1 of two years of practice under a supervising physician . The 2 rules shall also provide that a physician assistant shall 3 notify the board of the identity of the physician assistant’s 4 supervising physician and of any change in the status of the 5 supervisory relationship. 6 b. For purposes of this chapter, “supervision” does not 7 require the personal presence of the physician at the place 8 where medical services are rendered except insofar as the 9 personal presence is expressly required by this chapter or by 10 rules of the board adopted pursuant to chapter 17A. > 11 5. Page 5, by striking lines 7 through 20 and inserting: 12 < 3. The degree of collaboration between a physician 13 assistant and the appropriate member of a health care team 14 shall be determined at the practice level, and may involve 15 decisions made by the medical group, hospital service, 16 supervising physician, or employer of the physician assistant, 17 or the credentialing and privileging system of a licensed 18 health care facility. A physician shall be accessible at all 19 times for consultation with a physician assistant unless the 20 physician assistant is providing emergency medical services 21 pursuant to 645 IAC 327.1(1)(n) . The supervising physician 22 shall have ultimate responsibility for determining the medical 23 care provided by the supervising physician-physician assistant 24 team A physician assistant shall be responsible for the 25 services performed by the physician assistant that are not 26 performed under the supervision of a physician . 27 Sec. ___. Section 148C.5, subsection 1, Code 2023, is 28 amended to read as follows: 29 1. If the board commences a contested case hearing against 30 a physician assistant by delivering a statement of charges 31 and notice of hearing to the physician assistant, the board 32 shall deliver a copy of the statement of charges and notice of 33 hearing to the physician assistant’s supervising physician , if 34 applicable . 35 -2- HF 424.1915.S (2) 90 mb 2/ 3 #5.

Sec. ___. Section 148C.5, subsection 3, Code 2023, is 1 amended by striking the subsection. 2 Sec. ___. Section 148C.9, Code 2023, is amended to read as 3 follows: 4 148C.9 Eye examination restricted. 5 A physician assistant shall not be permitted to prescribe 6 lenses, prisms, or contact lenses for the aid, relief, or 7 correction of human vision. A physician assistant engaged 8 in independent practice shall not be permitted to measure 9 the visual power and visual efficiency of the human eye, as 10 distinguished from routine visual screening, except in the 11 personal presence of a supervising physician at the place where 12 such services are rendered. > 13 6. Page 6, line 35, by striking < under the supervision of > 14 and inserting < under the supervision of or > 15 7. Page 7, line 1, after < psychiatrist, > by inserting < a 16 qualified mental health professional physician assistant, a 17 psychiatric advanced registered nurse practitioner as defined 18 in section 125.2, > 19 8. Page 8, line 7, by striking < 148.13, 148C.5, 148C.9, > and 20 inserting < 148.13 > 21 9. Title page, line 2, before < physician > by inserting 22 < certain > 23 10. By renumbering as necessary. 24 -3- HF 424.1915.S (2) 90 mb 3/ 3 #6. #7. #8. #9.