S.F. 592 Section 1. Section 147.74, subsection 17, Code 2019, is 1 amended to read as follows: 2 17. A physician assistant licensed under chapter 148C 3 may use the letters “P. A.” as a prefix or may use the words 4 “physician assistant” after the person’s name or signify the 5 same by the use of or the letters “P. A.” after the person’s 6 name. 7 Sec. 2. Section 147.136, subsection 1, Code 2019, is amended 8 to read as follows: 9 1. Except as otherwise provided in subsection 2 , in an 10 action for damages for personal injury against a physician and 11 surgeon, osteopathic physician and surgeon, dentist, podiatric 12 physician, optometrist, pharmacist, chiropractor, physician 13 assistant, or nurse licensed to practice that profession in 14 this state, or against a hospital licensed for operation in 15 this state, based on the alleged negligence of the practitioner 16 in the practice of the profession or occupation, or upon the 17 alleged negligence of the hospital in patient care, in which 18 liability is admitted or established, the damages awarded shall 19 not include actual economic losses incurred or to be incurred 20 in the future by the claimant by reason of the personal 21 injury, including but not limited to the cost of reasonable and 22 necessary medical care, rehabilitation services, and custodial 23 care, and the loss of services and loss of earned income, to 24 the extent that those losses are replaced or are indemnified by 25 insurance, or by governmental, employment, or service benefit 26 programs or from any other source. 27 Sec. 3. Section 147.136A, subsection 1, paragraph a, Code 28 2019, is amended to read as follows: 29 a. “Health care provider” means a hospital as defined in 30 section 135B.1 , a health care facility as defined in section 31 135C.1 , a health facility as defined in section 135P.1 , a 32 physician or an osteopathic physician licensed under chapter 33 148 , a physician assistant licensed and practicing under a 34 supervising physician under chapter 148C , a podiatrist licensed 35 -1- LSB 2768SV (2) 88 pf/rh 1/ 17

S.F. 592 under chapter 149 , a chiropractor licensed under chapter 151 , a 1 licensed practical nurse, a registered nurse, or an advanced 2 registered nurse practitioner licensed under chapter 152 or 3 152E , a dentist licensed under chapter 153 , an optometrist 4 licensed under chapter 154 , a pharmacist licensed under chapter 5 155A , a professional corporation under chapter 496C that is 6 owned by persons licensed to practice a profession listed in 7 this paragraph, or any other person or entity who is licensed, 8 certified, or otherwise authorized or permitted by the law of 9 this state to administer health care in the ordinary course of 10 business or in the practice of a profession. 11 Sec. 4. Section 147.138, Code 2019, is amended to read as 12 follows: 13 147.138 Contingent fee of attorney reviewed by court. 14 In any action for personal injury or wrongful death against 15 any physician and surgeon, osteopathic physician and surgeon, 16 dentist, podiatric physician, optometrist, pharmacist, 17 chiropractor , physician assistant, or nurse licensed under 18 this chapter or against any hospital licensed under chapter 19 135B , based upon the alleged negligence of the licensee in the 20 practice of that profession or occupation, or upon the alleged 21 negligence of the hospital in patient care, the court shall 22 determine the reasonableness of any contingent fee arrangement 23 between the plaintiff and the plaintiff’s attorney. 24 Sec. 5. Section 148C.1, subsection 1, Code 2019, is amended 25 to read as follows: 26 1. “Approved program” means a program for the education 27 of physician assistants which has been accredited by the 28 American medical association’s committee on allied health 29 education and accreditation or its successor, by the commission 30 on accreditation of allied health educational programs or 31 its successor, or by the accreditation review commission on 32 education for the physician assistant or its successor , or, if 33 accredited prior to 2001, either by the committee on allied 34 health education and accreditation, or the commission on 35 -2- LSB 2768SV (2) 88 pf/rh 2/ 17

S.F. 592 accreditation of allied health education programs . 1 Sec. 6. Section 148C.3, Code 2019, is amended to read as 2 follows: 3 148C.3 Licensure. 4 1. The Pursuant to section 147.36, the board shall adopt 5 rules to govern the licensure of physician assistants. An 6 applicant for licensure shall submit the fee prescribed by the 7 board and shall meet the requirements established by the board 8 with respect to each of the following: 9 a. Academic qualifications, including evidence of graduation 10 from an approved program. A physician assistant who is not a 11 graduate of an approved program, but who passed the national 12 commission on certification of physician assistants’ physician 13 assistant national certifying examination prior to 1986, is 14 exempt from this graduation requirement. 15 b. Evidence of passing the national commission on the 16 certification of physician assistants’ physician assistant 17 national certifying examination or an equivalent examination 18 approved by the board. 19 c. Hours of continuing medical education necessary to become 20 or remain licensed. 21 2. Rules shall be adopted by the board pursuant to this 22 chapter requiring a licensed physician assistant to be 23 supervised by physicians. The rules shall provide that not 24 more than five physician assistants shall be supervised by a 25 physician at one time. The rules shall also provide that a 26 physician assistant shall notify the board of the identity of 27 the physician assistant’s supervising physician and of any 28 change in the status of the supervisory relationship. 29 3. The board may grant a license to an applicant under this 30 chapter who meets all of the following requirements: 31 a. Submits an application on forms approved by the board. 32 b. Pays the appropriate fee prescribed by the board pursuant 33 to section 147.80. 34 c. Has successfully completed an educational program for 35 -3- LSB 2768SV (2) 88 pf/rh 3/ 17

S.F. 592 physician assistants from an approved program. The board 1 may grant a license to an applicant who does not meet the 2 educational requirement under this paragraph “c” if the 3 applicant passed the physician assistant national certifying 4 examination administered by the national commission on 5 certification of physician assistants prior to 1986. 6 d. Has passed an examination prescribed by the board 7 pursuant to section 147.34. 8 e. Is mentally and physically able to engage safely in 9 practice as a physician assistant. 10 f. Is not subject to current discipline, revocation, 11 suspension, or probation for cause resulting from the 12 applicant’s practice as a physician assistant, unless the 13 board, following consideration of the condition agrees to 14 licensure. 15 g. Is of good moral character. 16 h. Submits to the board any other information the board 17 deems necessary to evaluate the applicant’s qualifications. 18 4. Pursuant to section 147.4, the board may refuse to grant 19 a license to any person otherwise qualified upon the grounds 20 for which a license may be revoked or suspended. 21 5. The form of the license shall comply with section 147.5. 22 3. 6. A licensed physician assistant shall perform only 23 those services for which the licensed physician assistant is 24 qualified by training or education or not prohibited by the 25 board. 26 4. 7. The board may issue a temporary license under special 27 circumstances and upon conditions prescribed by the board as 28 specified in section 148C.24 . A temporary license shall not 29 be valid for more than one year and shall not be renewed more 30 than once. 31 5. 8. The board may issue an inactive license under 32 conditions prescribed by rules adopted by the board. 33 6. 9. The board shall adopt rules pursuant to this section 34 after consultation with the board of medicine. 35 -4- LSB 2768SV (2) 88 pf/rh 4/ 17

S.F. 592 10. The board shall comply with section 147.3 in determining 1 an applicant’s qualifications. 2 11. The board shall maintain records of licenses pursuant 3 to section 147.8. 4 Sec. 7. NEW SECTION . 148C.4A Blood specimen —— peace 5 officer. 6 A physician assistant may, at the request of a peace officer, 7 withdraw a specimen of blood from a patient for the purpose of 8 determining the alcohol concentration or the presence of drugs 9 in the patient’s body. 10 Sec. 8. NEW SECTION . 148C.4B Staff of ambulance or rescue 11 squad. 12 A physician assistant may be a member of the staff of 13 an ambulance or rescue squad pursuant to chapter 147A. A 14 physician assistant who is a member of such staff shall possess 15 skills, training, and education equivalent to that required 16 of a certified advanced emergency medical technician or a 17 paramedic. 18 Sec. 9. NEW SECTION . 148C.14 Physician assistant title. 19 1. In accordance with section 147.74, a person who meets 20 the qualifications for licensure under this chapter may use 21 the letters “P. A.” as a prefix or may use the words “physician 22 assistant” or the letters “P. A.” after the person’s name. 23 2. A person who meets the qualifications for licensure under 24 this chapter but does not possess a current license may use 25 the title “P. A.” or “physician assistant” but may not act or 26 practice as a physician assistant unless licensed under this 27 chapter. 28 Sec. 10. NEW SECTION . 148C.15 Licensure by endorsement. 29 1. An applicant who has been licensed under the laws of 30 another jurisdiction may file an application for licensure by 31 endorsement. 32 2. An applicant for licensure by endorsement shall do all 33 of the following: 34 a. Submit to the board a completed application according to 35 -5- LSB 2768SV (2) 88 pf/rh 5/ 17

S.F. 592 the instructions on the application. 1 b. Pay the nonrefundable licensure fee. 2 c. Provide an official copy of the transcript sent directly 3 to the board from an approved program for the education of 4 physician assistants or qualify for the exception determined 5 by the board. 6 d. Provide a copy of the initial certification from the 7 national commission on certification of physician assistants 8 or its successor agency sent directly to the board from the 9 national commission on certification of physician assistants, 10 or its successor agency. 11 e. Provide one of the following documents: 12 (1) A copy of current certification from the national 13 commission on certification of physician assistants or its 14 successor agency sent directly to the board from the national 15 commission on certification of physician assistants or its 16 successor agency. 17 (2) Proof of completion of one hundred continuing medical 18 education hours for each biennium since initial certification. 19 f. Provide verification of a license from every jurisdiction 20 in which the applicant has been licensed, sent directly from 21 the jurisdiction to the board office. Web-based verification 22 may be substituted for verification sent directly from the 23 jurisdiction’s board office if the verification provides all 24 of the following: 25 (1) The licensee’s name. 26 (2) The date of initial licensure. 27 (3) The applicant’s current licensure status. 28 (4) Any disciplinary action taken against the license. 29 Sec. 11. NEW SECTION . 148C.16 License renewal. 30 1. The biennial license renewal period for a license to 31 practice as a physician assistant shall begin on October 32 1 and end on September 30 two years later. The licensee 33 shall be responsible for renewing the license prior to its 34 expiration. Failure of the licensee to receive notice from the 35 -6- LSB 2768SV (2) 88 pf/rh 6/ 17

S.F. 592 board regarding renewal shall not relieve the licensee of the 1 responsibility for renewing the license. 2 2. An individual who was issued a license within six months 3 of the license renewal date shall not be required to renew the 4 license until the subsequent renewal date two years later. 5 3. A licensee seeking renewal shall comply with all of the 6 following: 7 a. Meet the continuing education requirements specified by 8 the board. A licensee whose license was reactivated during the 9 current renewal compliance period may use continuing education 10 credit earned during the compliance period for the first 11 renewal following reactivation. 12 b. Submit the completed renewal application and renewal fee 13 before the license expiration date. 14 c. (1) Complete mandatory reporter child abuse training 15 requirements as established in section 232.69. A licensee who, 16 in the scope of professional practice or in the licensee’s 17 employment responsibilities, examines, attends, counsels, or 18 treats children in this state shall indicate on the renewal 19 application completion of two hours of training in child abuse 20 identification and reporting in the previous five years or 21 conditions for waiver of this requirement as identified in 22 subparagraph (5). 23 (2) Complete mandatory reporter dependent adult abuse 24 training requirements as established in sections 235B.3 25 and 235E.2. A licensee who, in the course of employment 26 responsibilities, examines, attends, counsels, or treats 27 adults in this state shall indicate on the renewal application 28 completion of two hours of training in dependent adult abuse 29 identification and reporting in the previous five years or 30 conditions for waiver of this requirement as identified in 31 subparagraph (5). 32 (3) A licensee who, in the scope of professional practice or 33 in the course of employment, examines, attends, counsels, or 34 treats both children and adults in this state shall indicate 35 -7- LSB 2768SV (2) 88 pf/rh 7/ 17

S.F. 592 on the renewal application completion of training in abuse 1 identification and reporting for children and dependent adults 2 in the previous five years or conditions for waiver of this 3 requirement as identified in subparagraph (5). Training 4 may be completed through separate courses as identified in 5 subparagraphs (1) and (2) or in one combined two-hour course 6 that includes curricula for identifying and reporting child 7 abuse and dependent adult abuse. The course shall be a 8 curriculum reviewed and approved by the department. 9 (4) The licensee shall maintain written documentation 10 for five years after mandatory training as identified in 11 subparagraphs (1), (2), and (3), including program date, 12 content, duration, and proof of participation. 13 (5) The requirement for mandatory training for identifying 14 and reporting child abuse and dependent adult abuse shall be 15 suspended if the board determines that suspension is in the 16 public interest or that a person at the time of license renewal 17 meets one of the following conditions: 18 (a) Is engaged in active duty in the military service of 19 this state or the United States. 20 (b) Holds a current waiver by the board based on evidence of 21 significant hardship in complying with training requirements, 22 including an exemption of continuing education requirements or 23 extension of time in which to fulfill requirements due to a 24 physical or mental disability or illness as identified in 645 25 IAC 328. 26 4. The board may select licensees for audit of compliance 27 with the requirements in subsection 3, paragraph “c” . 28 5. Upon receiving the information required by this section 29 and the required fee, board staff shall administratively issue 30 a two-year license and shall send the licensee a wallet card 31 by regular mail. In the event the board receives adverse 32 information on the renewal application, the board shall issue 33 the renewal license but may refer the adverse information for 34 further consideration or disciplinary investigation. 35 -8- LSB 2768SV (2) 88 pf/rh 8/ 17

S.F. 592 6. A person licensed to practice as a physician assistant 1 shall keep the physician assistant’s license certificate and 2 wallet card displayed in a conspicuous public place at the 3 primary site of practice. 4 7. A license shall be deemed late when the license has 5 not been renewed by the expiration date on the wallet card, 6 and the licensee shall be assessed a late fee as specified 7 by the board. To renew a license deemed late, the licensee 8 shall complete the renewal requirements and submit the late fee 9 within the grace period. 10 8. If a licensee fails to renew a license by the end of 11 the grace period, the license shall be deemed inactive. A 12 licensee whose license is inactive shall continue to hold the 13 privilege of licensure in the state, but shall not practice 14 as a physician assistant in the state until the license is 15 reactivated. A licensee who practices as a physician assistant 16 in this state with an inactive license may be subject to 17 disciplinary action by the board, injunctive action pursuant to 18 section 147.83, criminal penalties pursuant to section 147.86, 19 and other available legal remedies. 20 Sec. 12. NEW SECTION . 148C.17 Grounds for discipline. 21 The board may impose any of the following disciplinary 22 sanctions when the board determines that the licensee is guilty 23 of any of the following acts or offenses: 24 1. Fraud in procuring a license. Fraud in procuring 25 a license includes but is not limited to an intentional 26 perversion of the truth in making application for a license to 27 practice in this state which includes the following: 28 a. False representations of a material fact, whether by 29 word or by conduct, by false or misleading allegations, or by 30 concealment of information which should have been disclosed 31 when making application for a license in this state. 32 b. Attempting to file or filing with the board or the 33 department any false or forged diploma or certificate or 34 affidavit or identification or qualification in making an 35 -9- LSB 2768SV (2) 88 pf/rh 9/ 17

S.F. 592 application for a license in this state. 1 2. Professional incompetency. Professional incompetency 2 includes, but is not limited to: 3 a. A substantial lack of knowledge or ability to discharge 4 professional obligations within the scope of practice. 5 b. A substantial deviation from the standards of learning 6 or skill ordinarily possessed and applied by other physician 7 assistants in this state acting in the same or similar 8 circumstances. 9 c. Failure to exercise the degree of care which is 10 ordinarily exercised by the average physician assistant acting 11 in the same or similar circumstances. 12 d. Failure to conform to the minimal standard of acceptable 13 and prevailing practice of a physician assistant in this state. 14 e. Inability to practice with reasonable skill and safety 15 by reason of illness, drunkenness, excessive use of drugs, 16 narcotics, chemicals, or any other type of material or as a 17 result of a mental or physical condition. 18 f. Being adjudged mentally incompetent by a court of 19 competent jurisdiction. 20 3. Knowingly making misleading, deceptive, untrue, or 21 fraudulent representations in the practice of the profession 22 or engaging in unethical conduct or practice harmful or 23 detrimental to the public. Proof of actual injury need not be 24 established to constitute an offense under this subsection. 25 4. Practice outside the scope of the profession. 26 5. Use of untruthful or improbable statements in 27 advertisements. Use of untruthful or improbable statements in 28 advertisements includes but is not limited to an action by a 29 licensee in making information or intention known to the public 30 which is false, deceptive, misleading, or promoted through 31 fraud or misrepresentation. 32 6. Habitual intoxication or addiction to the use of drugs. 33 7. Obtaining, possessing, attempting to obtain or possess, 34 or administering controlled substances without lawful 35 -10- LSB 2768SV (2) 88 pf/rh 10/ 17

S.F. 592 authority. 1 8. Falsification of client records. 2 9. Acceptance of any fee by fraud or misrepresentation. 3 10. Negligence by the licensee in the practice of the 4 profession. Negligence by the licensee in the practice of the 5 profession includes a failure to exercise due care including 6 negligent delegation of duties or supervision of employees 7 or other individuals, whether or not injury results, or any 8 conduct, practice, or conditions which impair the ability to 9 safely and skillfully practice the profession. 10 11. Conviction of a crime related to the profession or 11 occupation of the licensee or the conviction of any crime that 12 would affect the licensee’s ability to practice within the 13 profession, regardless of whether the judgment of conviction 14 or sentence was deferred. A copy of the record of conviction 15 or plea of guilty shall be conclusive evidence of the offense 16 under this subsection. 17 12. Violation of a regulation or law of this state, another 18 state, or the United States, which relates to the practice of 19 the profession. 20 13. Revocation, suspension, or other disciplinary action 21 taken by a licensing authority of this state, another state, 22 territory, or country, or failure by the licensee to report 23 in writing to the board revocation, suspension, or other 24 disciplinary action taken by a licensing authority within 25 thirty days of the final action. A stay by an appellate 26 court shall not negate this requirement; however, if such 27 disciplinary action is overturned or reversed by a court of 28 last resort, the report shall be expunged from the records of 29 the board. 30 14. Failure of a licensee or an applicant for licensure 31 in this state to report any voluntary agreements restricting 32 the practice of the profession in another state, territory, or 33 country. 34 15. Failure to notify the board of a criminal conviction 35 -11- LSB 2768SV (2) 88 pf/rh 11/ 17

S.F. 592 within thirty days of the action, regardless of the 1 jurisdiction where the criminal conviction occurred. 2 16. Failure to notify the board within thirty days after any 3 judgment or settlement of a malpractice claim or action. 4 17. Engaging in any conduct that subverts or attempts to 5 subvert a board investigation. 6 18. Failure to comply with a subpoena issued by the board 7 or to otherwise fail to cooperate with an investigation of the 8 board. 9 19. Failure to comply with the terms of a board order or the 10 terms of a settlement agreement or consent order. 11 20. Failure to pay costs assessed in any disciplinary 12 action. 13 21. Submission of a false report of continuing education or 14 failure to submit the biennial report of continuing education. 15 22. Failure to report another licensee to the board for any 16 violations pursuant to section 272C.9. 17 23. Knowingly aiding, assisting, procuring, or advising a 18 person to unlawfully practice as a physician assistant. 19 24. Failure to report a change of name or address within 20 thirty days after it occurs. 21 25. Permitting another person to use the licensee’s license 22 for any purpose. 23 26. Permitting an unlicensed employee or person under the 24 licensee’s control to perform activities requiring a license. 25 27. Unethical conduct. In accordance with section 147.55, 26 behavior, including acts, knowledge, and practices, which 27 constitutes unethical conduct including but not limited to the 28 following: 29 a. Verbally or physically abusing a patient, client, or 30 coworker. 31 b. Improper sexual contact with, or making suggestive, 32 lewd, lascivious, or improper remarks or advances to a patient, 33 client, or coworker. 34 c. Betrayal of a professional confidence. 35 -12- LSB 2768SV (2) 88 pf/rh 12/ 17

S.F. 592 d. Engaging in a professional conflict of interest. 1 28. Failure to comply with universal precautions for 2 preventing transmission of infectious diseases as issued by the 3 centers for disease control and prevention of the United States 4 department of health and human services. 5 29. Violation of the terms of an initial agreement with 6 the impaired practitioner review committee or violation of the 7 terms of an impaired practitioner recovery contract with the 8 impaired practitioner review committee. 9 Sec. 13. NEW SECTION . 148C.18 Method of discipline. 10 The board has the authority to impose the following 11 disciplinary sanctions: 12 1. Revocation of license. 13 2. Suspension of a license until further order of the board 14 or for a specific period. 15 3. Prohibition permanently, until further order of the 16 board, or for a specific period, against engaging in specified 17 procedures, methods, or acts. 18 4. Probation. 19 5. Required additional education or training. 20 6. Required reexamination. 21 7. Ordering a mental, physical, or clinical competency 22 examination or an alcohol and drug screening within a time 23 specified by the board. 24 8. Imposing civil penalties not to exceed one thousand 25 dollars. 26 9. Issuing a citation and warning. 27 10. Such other sanctions allowed by law as may be 28 appropriate. 29 Sec. 14. NEW SECTION . 148C.19 Discretion of board. 30 The following factors may be considered by the board in 31 determining the nature and severity of the disciplinary 32 sanction to be imposed: 33 1. The relative serious nature of the violation as it 34 relates to ensuring a high standard of professional care to the 35 -13- LSB 2768SV (2) 88 pf/rh 13/ 17

S.F. 592 citizens of this state. 1 2. The facts of the particular violation. 2 3. Any extenuating facts or other countervailing 3 considerations. 4 4. The number of prior violations or complaints. 5 5. The seriousness of prior violations or complaints. 6 6. Whether remedial action has been taken. 7 7. Such other factors as may reflect upon the competency, 8 ethical standards, and professional conduct of the licensee. 9 Sec. 15. NEW SECTION . 148C.20 Lyme disease. 10 A licensee shall not be disciplined based solely on the 11 licensee’s recommendation of a treatment method for Lyme 12 disease or other tick-borne disease if the recommendation meets 13 the criteria specified in section 147.56. 14 Sec. 16. NEW SECTION . 148C.21 Student physician assistant. 15 1. Any person who is enrolled as a student in an approved 16 program shall comply with this chapter. However, a student is 17 exempt from the licensure requirements under this chapter. 18 2. Notwithstanding any other provision of this chapter to 19 the contrary, a student may perform medical services when the 20 medical services are rendered within the scope of an approved 21 program. 22 Sec. 17. NEW SECTION . 148C.22 License reactivation. 23 In accordance with section 147.11, a licensee may apply for 24 reactivation of an inactive license. To apply for reactivation 25 of an inactive license, a licensee shall do all of the 26 following: 27 1. Submit a reactivation application on a form provided by 28 the board. 29 2. Pay the reactivation fee determined by the board. 30 3. Provide verification of current competence to practice 31 as a physician assistant by satisfying one of the following 32 criteria: 33 a. If the license has been on inactive status for five 34 years or less, an applicant must provide verification of the 35 -14- LSB 2768SV (2) 88 pf/rh 14/ 17

S.F. 592 license from every jurisdiction in which the applicant is or 1 has been licensed and is or has been practicing during the time 2 period the Iowa license was inactive, sent directly from the 3 jurisdiction to the board office. Web-based verification may 4 be substituted for verification from a jurisdiction’s board 5 office if the verification includes: 6 (1) The licensee’s name. 7 (2) The date of initial licensure. 8 (3) The applicant’s current licensure status. 9 (4) Any disciplinary action taken against the licensee. 10 (5) Verification of completion of one hundred hours of 11 continuing education within two years of an application for 12 reactivation or certification from the national commission on 13 certification of physician assistants or its successor agency. 14 b. If the license has been on inactive status for more 15 than five years, an applicant must provide verification of the 16 license from every jurisdiction in which the applicant is or 17 has been licensed and is or has been practicing during the time 18 period the Iowa license was inactive, sent directly from the 19 jurisdiction to the board office. Web-based verification may 20 be substituted for verification from a jurisdiction’s board 21 office if the verification includes: 22 (1) The licensee’s name. 23 (2) The date of initial licensure. 24 (3) The licensee’s current licensure status. 25 (4) Any disciplinary action taken against the licensee. 26 (5) Verification of completion of two hundred hours of 27 continuing education within two years of an application for 28 reactivation, of which at least forty percent of the hours 29 completed shall be in category I or certification from the 30 national commission on certification of physician assistants 31 or its successor agency. 32 Sec. 18. NEW SECTION . 148C.23 License reinstatement. 33 In accordance with section 147.11, a licensee whose license 34 has been revoked, suspended, or voluntarily surrendered 35 -15- LSB 2768SV (2) 88 pf/rh 15/ 17

S.F. 592 must apply for and receive reinstatement of the license and 1 must apply for and be granted reactivation of the license 2 in accordance with section 148C.22 prior to practicing as a 3 physician assistant in this state. 4 Sec. 19. NEW SECTION . 148C.24 Temporary licensure. 5 1. A temporary license may be issued for an applicant 6 who has not taken the national commission on certification 7 of physician assistants initial certification examination or 8 successor agency examination or is waiting for the results of 9 the examination. 10 2. The applicant must complete an application and pay the 11 appropriate fee established by the board. 12 3. A temporary license shall be valid for one year from the 13 date of issuance. 14 4. The temporary license shall be renewed only once upon 15 the applicant showing proof that, through no fault of the 16 applicant, the applicant was unable to take the certification 17 examination recognized by the board. Proof of inability to 18 take the certification examination shall be submitted to the 19 board office with a written request for renewal of a temporary 20 license, accompanied by the temporary license renewal fee. 21 5. If the temporary licensee fails the certification 22 examination, the temporary licensee must cease practice 23 immediately and surrender the temporary license by the next 24 business day. 25 6. There shall be no additional fee for an applicant 26 converting temporary licensure to permanent licensure. 27 7. The applicant shall ensure that certification of 28 completion is sent to the board directly from an approved 29 program for the education of physician assistants. The 30 certification of completion must be signed by a designee from 31 the approved program. 32 Sec. 20. Section 249A.4, subsection 7, paragraph b, Code 33 2019, is amended to read as follows: 34 b. Advanced registered nurse practitioners licensed pursuant 35 -16- LSB 2768SV (2) 88 pf/rh 16/ 17

S.F. 592 to chapter 152 and physician assistants licensed pursuant to 1 chapter 148C shall be regarded as approved providers of health 2 care services, including primary care, for purposes of managed 3 care or prepaid services contracts under the medical assistance 4 program. This paragraph shall not be construed to expand the 5 scope of practice of an advanced registered nurse practitioner 6 pursuant to chapter 152 or physician assistants pursuant to 7 chapter 148C . 8 EXPLANATION 9 The inclusion of this explanation does not constitute agreement with 10 the explanation’s substance by the members of the general assembly. 11 This bill relates to the practice and licensure of physician 12 assistants in the state. The bill codifies several provisions 13 currently in administrative rules including those relating 14 to services which may be performed by a physician assistant, 15 a physician assistant’s title, licensure by endorsement, 16 license renewal, grounds for discipline, methods of discipline, 17 the discretionary factors to be considered by the board of 18 physician assistants in a disciplinary action, discipline 19 relative to treatment for Lyme disease, student physician 20 assistants, license reactivation, license reinstatement, and 21 temporary licensure. The bill also makes conforming changes in 22 the Code to reflect the other changes in the bill. 23 -17- LSB 2768SV (2) 88 pf/rh 17/ 17