S-3159

   Amend House File 424, as passed by the House, as follows:
   1.  Page 2, line 14, by striking <supervises> and inserting <supervises a physician assistant engaged in independent practice or>
   2.  Page 2, line 16, by striking <supervises> and inserting <supervises a physician assistant engaged in independent practice or>
   3.  Page 4, by striking lines 3 and 4 and inserting: 
   <Sec. ___.  Section 148C.1, subsection 5, Code 2023, is amended by striking the subsection and inserting in lieu thereof the following:
   5.  “Independent practice” means the practice of a physician assistant that is organized as a professional corporation under chapter 469C or a professional limited liability company under chapter 489.
   Sec. ___.  Section 148C.1, subsection 8, Code 2023, is amended by striking the subsection and inserting in lieu thereof the following:
   8.  “Supervising physician” means a physician who supervises the medical services provided by a physician assistant engaged in independent practice consistent with the physician assistant’s education, training, and experience.>
   4.  Page 4, by striking lines 14 and 15 and inserting: 
   <Sec. ___.  Section 148C.3, subsection 2, Code 2023, is amended to read as follows:
   2.  a.  Rules Joint rules shall be adopted by the board and the board of medicine pursuant to this chapter requiring a licensed physician assistant to be supervised by physicians a physician during the first two years of independent practice if the physician assistant has not previously practiced under a supervising physician or in collaboration with the appropriate physician or other health care professional for a period of at least two years. The rules shall provide that not more than five physician assistants shall be supervised by a physician at one time determine the terms of collaboration for a physician assistant engaged in independent practice after the conclusion of two years of practice under a supervising physician. The rules shall also provide that a physician assistant shall notify the board of the identity of the physician assistant’s supervising physician and of any change in the status of the supervisory relationship.
   b.  For purposes of this chapter, “supervision” does not require the personal presence of the physician at the place where medical services are rendered except insofar as the personal presence is expressly required by this chapter or by rules of the board adopted pursuant to chapter 17A.>
   5.  Page 5, by striking lines 7 through 20 and inserting: 
   <3.  The degree of collaboration between a physician assistant and the appropriate member of a health care team shall be determined at the practice level, and may involve decisions made by the medical group, hospital service, supervising physician, or employer of the physician assistant, or the credentialing and privileging system of a licensed health care facility. A physician shall be accessible at all times for consultation with a physician assistant unless the physician assistant is providing emergency medical services pursuant to 
645 IAC 327.1(1)(n)
. The supervising physician shall have ultimate responsibility for determining the medical care provided by the supervising physician-physician assistant team A physician assistant shall be responsible for the services performed by the physician assistant that are not performed under the supervision of a physician.
   Sec. ___.  Section 148C.5, subsection 1, Code 2023, is amended to read as follows:
   1.  If the board commences a contested case hearing against a physician assistant by delivering a statement of charges and notice of hearing to the physician assistant, the board shall deliver a copy of the statement of charges and notice of hearing to the physician assistant’s supervising physician, if applicable.
   Sec. ___.  Section 148C.5, subsection 3, Code 2023, is amended by striking the subsection.
   Sec. ___.  Section 148C.9, Code 2023, is amended to read as follows:
   148C.9  Eye examination restricted.
   A physician assistant shall not be permitted to prescribe lenses, prisms, or contact lenses for the aid, relief, or correction of human vision. A physician assistant engaged in independent practice shall not be permitted to measure the visual power and visual efficiency of the human eye, as distinguished from routine visual screening, except in the personal presence of a supervising physician at the place where such services are rendered.>
   6.  Page 6, line 35, by striking <under the supervision of> and inserting <under the supervision of or>
   7.  Page 7, line 1, after <psychiatrist,> by inserting <a qualified mental health professional physician assistant, a psychiatric advanced registered nurse practitioner as defined in section 125.2,>
   8.  Page 8, line 7, by striking <148.13, 148C.5, 148C.9,> and inserting <148.13>
   9.  Title page, line 2, before <physician> by inserting <certain>
   10.  By renumbering as necessary.

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DAWN DRISCOLL