ARIZONA REVISED STATUTES
PROFESSIONS AND OCCUPATIONS
ARTICLE 1: GENERAL PROVISIONS
In this chapter, unless the context otherwise requires:
1. "Active license" means a regular or temporary license issued pursuant to this chapter. Active license does not include an inactive license.
2. "Adequate records" means legible medical records containing, at a minimum, sufficient information to identify the patient, support the diagnosis, justify the treatment, accurately document the results, indicate advice and cautionary warnings provided to the patient and provide sufficient information for another practitioner to assume continuity of the patient's care at any point in the course of treatment.
3. "Approved program" means a physician assistant educational program that has been fully or provisionally accredited by the committee on allied health education and accreditation or by the commission on the accreditation for allied health education programs, or successor agencies, on the recommendation of the accreditation review committee on education for physician assistants.
4. "Board" means the joint board on the regulation of physician assistants.
5. "Completed application" means an application for which the applicant has supplied all required fees, information and correspondence requested by the board on forms and in a manner acceptable to the board.
6. "Immediate family" means the spouse, natural or adopted children, father, mother, brothers and sisters of the physician assistant and the natural or adopted children, father, mother, brothers and sisters of the physician assistant's spouse.
7. "Letter of concern" means a nondisciplinary advisory letter to notify a physician assistant that, while there is insufficient evidence to support disciplinary action, the board believes the physician assistant should modify or eliminate certain practices and that continuation of the activities which led to the information being submitted to the board may result in action against the physician assistant's license.
8. "Medically incompetent" means that a physician assistant lacks sufficient medical knowledge or skills, or both, in performing delegated health care tasks to a degree likely to endanger the health or safety of patients.
9. "Minor surgery" means those invasive procedures that may be delegated to a physician assistant by a supervising physician that are consistent with the training and experience of the physician assistant, that are normally taught in courses of training approved by the board and, prior to June 30, 1993, that have been approved by the board as falling within a scope of practice of a physician assistant.
10. "Notification of supervision" means a written notice that is provided to the board by a supervising physician and that notifies the board that the physician intends to supervise a physician assistant. The physician shall provide this notice on a form prescribed by the board before the physician assistant begins work.
11. "Physician" means a physician licensed pursuant to chapter 13 or 17 of this title.
12. "Physician assistant" means a person who is licensed pursuant to this chapter and who performs health care tasks pursuant to a dependent relationship with a physician.
13. "Primary place for meeting patients" includes the supervising physician's office, health care institutions in which the supervising physician's patients are located or homes of patients.
14. "Regular license" means a valid and existing license issued pursuant to section 32-2521 to perform health care tasks. Regular license does not include a temporary license.
15. "Supervising physician" means a physician who holds a current unrestricted license, provides a notification of supervision, assumes legal responsibility for health care tasks performed by the physician assistant and is approved by the board. For purposes of this paragraph, a limited license issued pursuant to section 32-1426, subsection C, before November 2, 1998 is not a restriction.
16. "Supervising physician's agent" means a physician who holds a current unrestricted license, is a cosignatory on the notification of supervision, agrees to act as the supervising physician in the supervising physician's absence and is approved by the board. For purposes of this paragraph, a limited license issued pursuant to section 32-1426, subsection C, before November 2, 1998 is not a restriction.
17. "Supervision" means a physician's opportunity or ability to provide or exercise control over the services of a physician assistant. Supervision does not require a physician's constant physical presence if the supervising physician or the supervising physician's agent is or can be easily in contact with the physician assistant by radio, telephone or telecommunication.
18. "Unprofessional conduct" includes the following acts by a physician assistant that occur in this state or elsewhere:
(a) Violation of any federal or state law or rule which applies to the performance of health care tasks as a physician assistant. Conviction in any court of competent jurisdiction is conclusive evidence of a violation.
(b) Holding himself out as a physician or knowingly permitting another person to represent him as a physician.
(c) Performing health care tasks which have not been delegated by the supervising physician.
(d) Habitual intemperance in the use of alcohol or habitual substance abuse.
(e) Signing a blank, undated or predated prescription form.
(f) Gross malpractice, repeated malpractice or any malpractice resulting in the death of a patient.
(g) Representing that a manifestly incurable disease or infirmity can be permanently cured or that a disease, ailment or infirmity can be cured by a secret method, procedure, treatment, medicine or device, if this is not true.
(h) Refusing to divulge to the board on demand the means, method, procedure, modality of treatment or medicine used in the treatment of a disease, injury, ailment or infirmity.
(i) Prescribing or dispensing controlled substances or prescription-only drugs for which the physician assistant is not approved or in excess of the amount authorized pursuant to this chapter.
(j) Any conduct or practice which is harmful or dangerous to the health of a patient or the public.
(k) Violation of a formal order, probation or stipulation issued by the board.
(l) Failing to clearly identify himself as a physician assistant in the course of his employment.
(m) Failing to use and affix the initials "P.A." or "P.A.C." after the physician assistant's name or signature on charts, prescriptions or professional correspondence.
(n) Procuring or attempting to procure a physician assistant license by fraud, misrepresentation or knowingly taking advantage of the mistake of another.
(o) Having professional connection with or lending the physician assistantís name to an illegal practitioner of any of the healing arts.
(p) Failing or refusing to maintain adequate records on a patient.
(q) Using controlled substances that have not been prescribed by a physician, physician assistant, dentist or nurse practitioner for use during a prescribed course of treatment.
(r) Prescribing or dispensing controlled substances to members of the physician assistant's immediate family.
(s) Prescribing, dispensing or administering any controlled substance or prescription-only drug for other than accepted therapeutic purposes.
(t) Knowingly making any written or oral false or fraudulent statement in connection with the performance of health care tasks.
(u) Committing of a felony, whether or not involving moral turpitude, or a misdemeanor involving moral turpitude. In either case, conviction by a court of competent jurisdiction or a plea of no contest is conclusive evidence of the commission.
(v) Refusal, revocation, suspension, limitation or restriction of a certification or license by any other licensing jurisdiction for the inability to safely and skillfully perform health care tasks or for unprofessional conduct as defined by that jurisdiction which directly or indirectly corresponds to any act of unprofessional conduct as prescribed by this paragraph.
(w) Sanctions including restriction, suspension or removal from practice imposed by an agency of the federal government.
(x) Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate a provision of this chapter.
(y) Sexual intimacies with a patient.
(z) Using the term "doctor" or the abbreviation "Dr." on a name tag or in a way that leads the public to believe that the physician assistant is licensed to practice as an allopathic or an osteopathic physician in this state.
(aa) Failing to furnish legally requested information to the board or its investigator in a timely manner.
(bb) Failing to allow properly authorized board personnel to examine on demand documents, reports and records of any kind relating to the physician assistant's performance of health care tasks.
(cc) Knowingly making a false or misleading statement on a form required by the board or in written correspondence or attachments furnished to the board.
(dd) Failing to submit to a body fluid examination pursuant to an agreement with the board or an order of the board.
(ee) Violating a formal order, probation agreement or stipulation issued or entered into by the board or its executive director.
(ff) Except as otherwise required by law, intentionally betraying a professional secret or intentionally violating a privileged communication.
(gg) Procuring or attempting to procure a license by fraud, misrepresentation or knowingly taking advantage of the mistake of another person or agency.
(hh) Allowing the use of the licensee's name in any way to enhance or permit the continuance of the activities of, or maintaining a professional connection with, an illegal practitioner of medicine or the performance of health care tasks by a person who is not licensed pursuant to this chapter.
(ii) False, fraudulent, deceptive or misleading advertising by a physician assistant or the physician assistant's staff or representative.
(jj) Knowingly failing to disclose to a patient on a form that is prescribed by the board and that is dated and signed by the patient or guardian acknowledging that the patient or guardian has read and understands that the licensee has a direct financial interest in a separate diagnostic or treatment agency or in nonroutine goods or services that the patient is being prescribed and if the prescribed treatment, goods or services are available on a competitive basis. This subdivision does not apply to a referral by one doctor of medicine to another doctor of medicine within a group of doctors of medicine practicing together.
(kk) Using chelation therapy in the treatment of arteriosclerosis or as any other form of therapy.
(ll) Prescribing, dispensing or administering anabolic or androgenic
steroids for other than therapeutic purposes.
A. The joint board on the regulation of physician assistants is established consisting of the following members:
1. Four physician assistants who hold a current regular license pursuant to this chapter. The governor may appoint these members from a list of qualified candidates submitted by the Arizona state association of physician assistants. The governor may seek additional input and nominations before the governor makes the physician assistant appointments.
2. Two public members appointed by the governor.
3. Two physicians who are actively engaged in the practice of medicine and who are licensed pursuant to chapter 17 of this title, one of whom supervises a physician assistant at the time of appointment, who are appointed by the board of osteopathic examiners in medicine and surgery and who shall report and be responsible to the board of osteopathic examiners in medicine and surgery.
4. Two physicians who are actively engaged in the practice of medicine and who are licensed pursuant to chapter 13 of this title, one of whom supervises a physician assistant at the time of his appointment, who are appointed by the allopathic board of medical examiners and who shall report and be responsible to the allopathic board of medical examiners.
B. The term of office of members of the board is four years to begin and end on July 1.
C. Each board member is eligible for appointment to not more than two full terms. Each board member may continue to hold office until the appointment and qualification of that member's successor. However, the entity that appoints a board member may remove that member, after notice and a hearing before that entity, on a finding of continued neglect of duty, incompetence or unprofessional or dishonorable conduct. That member's term ends when the entity makes this finding.
D. A board member's term automatically ends:
1. On written resignation submitted to the board chairperson or to an appointing entity.
2. If the member is absent from this state for more than six months during a one year period.
3. If the member fails to attend three consecutive regular board meetings.
4. If the member retires from the active practice of medicine or from the active performance of health care tasks.
E. Board members are immune from civil liability for all good faith
actions they take pursuant to this chapter.
41-3008.12. Joint board on the regulation of physician assistants; termination July 1, 2008
A. The joint board on the regulation of physician assistants terminates on July 1, 2008.
B. Title 32, chapter 25 is repealed on January
32-2503. Organization; meetings; compensation
A. The board shall annually elect a chairperson and vice-chairperson from among its members.
B. The board shall hold a regular meeting at least quarterly on a date and at a time and place it designates. In addition, the chairperson may call special meetings the board deems necessary. The board shall hold special meetings on Saturdays as the chairperson may determine necessary to carry out the functions of the board.
C. Members of the board are eligible to receive compensation in the
amount of one hundred dollars for each day of actual service in the business
of the board and for all expenses necessarily and properly incurred in
attending board meetings.
32-2504. Powers and duties; subcommittees
A. The board shall:
1. As its primary duty, protect the public from unlawful, incompetent, unqualified, impaired or unprofessional physician assistants.
2. License and regulate physician assistants pursuant to this chapter.
3. Order and evaluate physical, psychological, psychiatric and competency testing of licensees and applicants the board determines is necessary to enforce this chapter.
4. Review the credentials and the abilities of applicants for licensure whose professional records or physical or mental capabilities may not meet the requirements of this chapter.
5. Initiate investigations and determine on its own motion if a licensee has engaged in unprofessional conduct or is or may be incompetent or mentally or physically unable to safely perform health care tasks.
6. Establish fees and penalties pursuant to section 32-2526.
7. Develop and recommend standards governing the profession.
8. Engage in the full exchange of information with the licensing and disciplinary boards and professional associations of other states and jurisdictions of the United States and foreign countries and a statewide association for physician assistants.
9. Direct the preparation and circulation of educational material the board determines is helpful and proper for its licensees.
10. Approve notification of supervision including the selection of supervising physicians and supervising agents.
11. Discipline and rehabilitate physician assistants pursuant to this chapter.
B. The board may make and adopt rules which are necessary or proper for the administration of this chapter.
C. The chairperson may establish subcommittees consisting of board members and define their duties as the chairperson deems necessary to carry out the functions of the board.
D. Board employees, includig the executive director, temporary personnel and professional medical investigators, are immune from civil liability for good faith actions they take to enforce this chapter.
E. In performing its duties pursuant to subsection A of this section,
the board may receive and review staff reports on complaints, malpractice
cases and all investigations.
32-2505. Personnel; consultants; compensation; immunity
A. The executive director employed by the board of medical examiners shall be the executive director of the board. The staff of the board of medical examiners shall carry out the administrative responsibilities of the board.
B. The board may employ special medical consultants or other agents
to make investigations, gather information and perform other duties the
board deems necessary or appropriate for the effective enforcement or administration
of this chapter. Compensation for special consultants or agents employed
pursuant to this subsection shall not exceed one hundred dollars per day.
32-2506. Board of medical examiners' fund
A. All monies collected pursuant to this chapter shall be deposited with the state treasurer who shall deposit ten per cent of such monies in the general fund and ninety per cent in the board of medical examiners' fund.
B. Monies deposited in the board of medical examiners' fund pursuant
to this section are subject to section 35-143.01.
ARTICLE 2: LICENSURE
A. An applicant for licensure shall:
1. Have attended and completed a course of training for physician assistants approved by the board.
2. Pass a certifying examination approved by the board.
3. Be physically and mentally able to safely perform health care tasks as a physician assistant.
4. Have a professional record that indicates that the applicant has not committed any act or engaged in any conduct that constitutes grounds for disciplinary action against a licensee pursuant to this chapter.
5. Not have had a physician assistant certification or license refused, suspended, revoked or restricted by any other state or country for reasons that relate to the applicant's ability to safely perform health care tasks as a physician assistant.
B. The board may:
1. Require an applicant to submit written or oral proof of credentials.
2. Make such investigations as it deems necessary to advise itself with respect to the qualifications of the applicant including physical examinations, mental evaluations, written competency examinations or any combination of such examinations and evaluations.
3. Grant an exemption from the licensure requirements of this section to:
(a) A student enrolled in a physician assistant education program approved by the board in order for that student to work within that program. The student shall register with the board on a form prescribed by the board.
(b) A physician assistant who is an employee of the United States government
and who works on land or in facilities owned or operated by the United
States government or a physician assistant who is a member of the reserve
components of the United States and on official orders or performing official
duties as outlined in the appropriate regulation of that branch.
32-2522. Applications; interview; withdrawal
A. Each applicant shall file a verified completed application in the form required and supplied by the board that is accompanied by the prescribed application fee.
B. The application shall be designed to require the submission of evidence, credentials and other proof necessary to satisfy the board that the applicant qualifies for licensure.
C. The application shall contain the oath of the applicant that:
1. All information contained in the application and evidence submitted with it are true and correct.
2. The credentials submitted were not procured by fraud or misrepresentation or any mistake of which the applicant is aware.
3. The applicant is the lawful holder of the credentials.
D. All applications submitted to the board and any attendant evidence, credentials or other proof submitted with an application are the property of the board and part of the permanent record of the board and shall not be returned to an applicant.
E. The board shall promptly notify an applicant, in writing, of the deficiencies, if any, in the application that prevent it from being a completed application.
F. The board or its representatives may interview an applicant to determine whether the application is sufficient.
G. Applications are considered withdrawn on any of the following conditions:
1. Written request of the applicant.
2. Failure of the applicant to appear for an interview with the board unless good cause is shown.
3. Failure to submit a completed application within one year from the
date of the mailing by the board of a statement to the applicant of the
deficiencies in the application pursuant to subsection E.
32-2523. Licensure; renewal; continuing education; expiration
A. Each holder of a regular license shall renew the license on or before June 1 of each year by paying the prescribed renewal fee and supplying the board with information it deems necessary including proof of having completed twenty hours of category I continuing medical education approved by the American academy of physician assistants, the American medical association, the American osteopathic association or other accrediting organization acceptable to the board within the previous renewal year of July 1 through June 30.
B. If a holder of a regular license fails to renew the license on or before July 1 of each year that person shall pay the prescribed penalty fee for a late renewal.
C. If a holder of a regular license fails to renew the license on or before October 1 of each year, the license expires. It is unlawful for a person to perform health care tasks of a physician assistant after the license expires.
D. A person whose license expires may reapply for licensure pursuant to this chapter.
E. If a licensee does not meet the requirements of subsection A because
of that person's illness, military service, religious missionary activity
or residence in a foreign country or of any other extenuating circumstance,
the board may grant an extension of the deadline if it receives a written
request to do so from the licensee that details the reasons for this request.
32-3202. License or certificate suspension
The certificate or license of a health professional
(physician assistant) who does not renew the certificate or license as
prescribed by statute and who has been advised in writing that an investigation
is pending at the time the certificate or license is due to expire or terminate
does not expire or terminate until the investigation is resolved.
The certificate or license is suspended on the date it would otherwise
expire or terminate and the health professional (physician assistant) shall
not practice in this state until the investigation is resolved.
32-2524. Temporary licensure
A. The board may issue a temporary license to an applicant who meets all the qualifications prescribed in section 32-2521, subsection A, paragraphs 1, 3, 4 and 5, submits evidence to the board that the applicant is eligible to take the certifying examination and pays the prescribed application fee. The applicant shall have the national commission on the certification of physician assistants submit to the board a letter that verifies the applicant's registration to sit for the physician assistant national certifying examination.
B. A temporary license is not effective for a term of more than sixteen months and expires on the occurrence of any one of the following:
1. Issuance of a regular license.
2. Failure to pass the certifying examination.
3. Expiration of the term for which the temporary license was issued.
C. The board shall not issue a temporary license to an applicant who has failed the national commission on the certification of physician assistants examination.
D. A physician assistant who holds a temporary license shall have the national commission on the certification of physician assistants submit verification directly to the board of that person's successful passage or failure of the physician assistant national certifying examination.
E. A physician assistant who holds a temporary license shall not prescribe any controlled substance as defined in the federal controlled substances act of 1970 (P.L. 91-513; 84 Stat. 1242; 21 United States code section 801).
F. Before being granted a temporary license, an applicant for a temporary license shall enter into a written agreement with the board to perform health care tasks only at the same geographic work site where the physician assistant's supervising physician sees patients.
32-2525. Cancellation of license
A. A person who holds an active regular license as a physician assistant, who is not presently under investigation by the board as the result of a complaint or information received by it, and against whom the board has not commenced any disciplinary proceedings may request and the board shall grant cancellation of the license.
B. The board may accept the request to cancel the active regular license
of a physician assistant who has been charged with a violation of this
chapter or rules adopted pursuant to this chapter if the physician assistant
admits the charges and stipulates this admission for the record.
A. By a vote at its annual fall meeting, the board shall establish nonrefundable fees and penalties that do not exceed the following:
1. Application for a regular license, one hundred twenty-five dollars.
2. Application for a temporary license, fifty dollars.
3. Conversion from a temporary license to a regular license, seventy-five dollars.
4. Annual renewal of a regular license, a fee of not to exceed one hundred dollars.
5. Penalty fee for late renewal of a regular license, one hundred dollars.
6. Issuance of a duplicate license, twenty-five dollars.
7. Approval of notification of supervision by a supervising physician, one hundred twenty-five dollars.
8. Application to transfer the responsibility of the supervising physician to an approved supervising physician's agent, fifty dollars.
9. For services not required to be provided by this chapter, but which the board deems appropriate to carry out the intent and purpose of this chapter, a fee not to exceed the actual cost of providing the services. Notwithstanding section 32-2506, the state treasurer shall deposit all of the monies collected under this paragraph in the board of medical examiners' fund established pursuant to section 32-1406.
B. Notwithstanding subsection A of this section, or written request
the board may return the license renewal fee, for good cause shown.
32-2527. Change of address; penalty
A. A person holding an active license as a physician assistant in this state shall inform the board in writing within thirty days of that person's current residence address, office address and telephone number and of each change in residence and office address or telephone number that occurs. A residential address is not available to the public unless it is the only address of record.
B. The board may assess its costs incurred in locating a physician assistant
who fails to comply with subsection A of this section within thirty days
after the date of change. The board may also assess a penalty of not to
exceed one hundred dollars against the physician assistant. Notwithstanding
section 32-2506, monies collected pursuant to this subsection shall be
deposited in the board of medical examiners' fund established by section
32-2528. Inactive license; application; prohibited activities
A. A person who holds a regular license pursuant to this chapter may request an inactive license from the board.
B. The board shall grant an inactive license and shall waive the annual renewal fee and requirements for continuing medical education if the person certifies total retirement from the performance of health care tasks in this state, any jurisdiction of the United States and any foreign country and is current on all fees required by this chapter.
C. An inactive licensee shall not perform health care tasks or continue to hold or maintain a drug enforcement administration controlled substance registration license. A licensee who performs health care tasks while holding an inactive license violates this chapter by performing health care tasks without a license.
D. The board may accept a request for inactive status of an active regular license of a physician assistant who has been charged with a violation of this chapter or rules adopted pursuant to this chapter if the physician assistant admits the charges and stipulates this admission for the record.
E. The board may convert an inactive license to a regular license on
payment of the annual renewal fee and presentation of evidence to the board
that the holder possesses the medical knowledge and the physical and mental
ability to safely engage in the performance of health care tasks.
The board may require any combination of physical examination, psychiatic
or psychological evaluation, oral competency examination or a board qualified
written examination or interview it believes necessary to assist it in
determining the ability of a physician assistant who holds an inactive
license to return to regular licensure.
ARTICLE 3: SCOPE OF PRACTICE AND APPROVAL OF EMPLOYMENT
32-2531. Health care tasks; scope of practice; restrictions; civil penalty
A. After a supervising physician receives board approval of a notice of supervision, that physician may delegate health care tasks to the physician assistant. The physician assistant may perform these tasks in any setting authorized by the approved supervising physician and the board, pursuant to subsections E and F of this section, including clinics, hospitals, ambulatory surgical centers, patient homes, nursing homes and other health care institutions. These tasks may include:
1. Obtaining patient histories.
2. Performing physical examinations.
3. Ordering and performing diagnostic and therapeutic procedures.
4. Formulating a diagnostic impression.
5. Developing and implementing a treatment plan.
6. Monitoring the effectiveness of therapeutic interventions.
7. Assisting in surgery.
8. Offering counseling and education to meet patient needs.
9. Making appropriate referrals.
10. Prescribing schedule IV or V controlled substances as defined in the federal controlled substances act of 1970 (P.L. 91-513; 84 Stat. 1242; 21 United States code section 801) and prescription-only medications.
11. Prescribing schedule II and III controlled substances as defined in the federal controlled substances act of 1970.
12. Performing minor surgery as defined in section 32-2501.
13. Performing other nonsurgical health care tasks that are normally taught in courses of training approved by the board, that are consistent with the training and experience of the physician assistant and that have been properly delegated by the approved supervising physician.
B. The approved supervising physician shall:
1. Meet the requirements established by the board for supervising a physician assistant and receive written board notification of this compliance.
2. Accept responsibility for all tasks and duties the physician delegates to a physician assistant.
3. Notify the board and the physician assistant in writing if the physician assistant exceeds the scope of the delegated health care tasks.
4. Notify the board if the physician has delegated authority to the physician assistant to prescribe medication. The physician shall also notify the board if the physician makes any changes to this authority.
C. Supervision does not require the personal presence of the physician at the place where health care tasks are performed. The board by order may require the personal presence of a physician when designated health care tasks are performed.
D. A physician assistant shall meet in person with the supervising physician at least once each week to discuss patient management. If the supervising physician is unavailable due to vacation, illness or continuing education programs, a physician assistant may meet with the supervising physician's agent. If the supervising physician is unavailable for any other reason, the fulfillment of this responsibility by the supervising physician's agent is subject to board approval.
E. A physician assistant shall not perform health care tasks in a place which is geographically separated from the supervising physician's primary place for meeting patients without the authorization of the supervising physician and the board.
F. The board may approve the performance of health care tasks by a physician assistant in a place which is geographically separated from the supervising physician's primary place for meeting patients if:
1. Adequate provision for immediate communication between the supervising physician or supervising physician's agent and the physician assistant exists.
2. The physician assistant's performance of health care tasks is adequately supervised and reviewed.
3. A printed announcement which contains the names of the physician assistant and supervising physician and states that the facility employs a physician assistant who is performing health care tasks under the supervision of a licensed physician is posted in the waiting room of the geographically separated site.
G. At all times while a physician assistant is on duty, he shall wear a name tag with the designation "physician assistant" on it.
H. The board by rule may prescribe a civil penalty for a violation of
this article relating to charting, wearing tags, identifying prescriptions
and posting signs in geographically separated locations. The penalty shall
not exceed fifty dollars for each violation. The board shall transmit monies
it receives from this penalty to the state treasurer for deposit in the
state general fund pursuant to section 35-141. A physician assistant and
the supervising physician may contest the imposition of this penalty pursuant
to board rule. The imposition of a civil penalty is public information,
and the board may use this information in any future disciplinary actions.
32-2532. Prescribing, administering and dispensing drugs; limits and requirements; notice
A. Except as provided in subsection F of this section, a physician assistant shall not prescribe, dispense or administer:
1. A schedule II or schedule III controlled substance as defined in the federal controlled substances act of 1970 (P.L. 91-513; 84 Stat. 1242; 21 United States Code section 801) without delegation by the supervising physician, board approval and drug enforcement administration registration.
2. A schedule IV or schedule V controlled substance as defined in the federal controlled substances act of 1970 without drug enforcement administration registration and delegation by the supervising physician.
3. Prescription-only medication without delegation by the supervising physician.
B. All prescription orders issued by a physician assistant shall contain the name, address and telephone number of the supervising physician. A physician assistant shall issue prescription orders for controlled substances under the physician assistant's own drug enforcement administration registration number.
C. A physician assistant shall not prescribe a schedule II or III controlled substance for a period exceeding seventy-two hours or a schedule IV or V controlled substance for a period exceeding thirty-four days.
D. A prescription for controlled substances is not refillable without the written consent of the supervising physician.
E. Prescription-only drugs shall not be dispensed, prescribed or refillable for a period exceeding one year.
F. Except in an emergency, a physician assistant may dispense schedule II or schedule III controlled substances for a period of use of not to exceed seventy-two hours with board approval or any other controlled substance for a period of use of not to exceed thirty-four days and may administer controlled substances without board approval if it is medically indicated in an emergency dealing with potential loss of life or limb or major acute traumatic pain.
G. Except for samples provided by manufacturers, all drugs dispensed by a physician assistant shall be:
1. Prepackaged in a unit-of-use package by the supervising physician or a pharmacist acting on a written order of the supervising physician.
2. Labeled to show the name of the supervising physician and physician assistant.
H. A physician assistant shall not obtain a drug from any source other than the supervising physician or a pharmacist acting on a written order of the supervising physician. A physician assistant may receive manufacturers' samples if allowed to do so by the supervising physician.
I. If a physician assistant is approved by the board to prescribe, administer or dispense schedule II and III controlled substances, the physician assistant shall maintain an up-to-date and complete log of all schedule II and III controlled substances he administers or dispenses.
J. The board shall advise the state board of pharmacy and the federal drug enforcement administration of all physician assistants who are authorized to prescribe or dispense drugs and any modification of their authority.
K. The state board of pharmacy shall notify all pharmacies at least
quarterly of physician assistants who are authorized to prescribe or dispense
32-2533. Supervising physician; supervising physician's agent; responsibilities
A. The supervising physician is responsible for all aspects of the performance of a physician assistant, whether or not the supervising physician actually pays the physician assistant a salary. The supervising physician is responsible for supervising the physician assistant and ensuring that the health care tasks performed by a physician assistant are within the physician assistant's scope of training and experience and have been properly delegated by the supervising physician.
B. A supervising physician shall not supervise more than two physician assistants who work the same hours at the same employment location.
C. A supervising physician may designate a supervising physician's agent to provide consultation and supervise a physician assistant when the supervising physician is not immediately available. The supervising physician remains responsible for the acts of a physician assistant when he is supervised by a supervising physician's agent.
D. In order to act as a supervising physician or a supervising physician's agent, a physician shall:
1. Complete an application as prescribed by the board.
2. Hold a license pursuant to chapter 13 or 17 of this title and not hold a license under probation, restriction or suspension unrelated to rehabilitation.
3. Submit a statement that the supervising physician or supervising physician's agent is familiar with the statutes and rules regarding the performance of health care tasks of physician assistants and accepts responsibility for supervising the physician assistant.
E. A physician who violates the provisions of this chapter shall not serve as a supervising physician or supervising physician's agent.
F. The supervising physician's agent is responsible for the acts of a physician assistant in the absence of the supervising physician if the board approves. The board considers the supervising physician's agent's signature on a physician assistant's current notification of supervision to be acknowledgement by the supervising physician's agent that he understands and is familiar with the physician assistant's approved health care tasks.
G. A supervising physician or supervising physician's agent shall not
delegate to the physician assistant any health care task that the supervising
physician or supervising physician's agent does not have training or experience
in and does not perform.
32-2534. Employment of physician assistant; application
A. A physician assistant shall not perform health care tasks until the supervising physician receives approval of the notification of supervision from the board.
B. A supervising physician shall file a notification of supervision in the form required and supplied by the board which is accompanied by the prescribed application fee. The notification shall include the following:
1. The supervising physician's field and type of practice, license number, address and telephone number.
2. Locations of the physician assistant's employment, including health care institutions.
3. The identity of all intended supervising physician's agents and their professional relationship to the supervising physician.
4. Guidelines the supervising physician or supervising physician's agents will follow to ensure timely supervision of the physician assistant's approved health care tasks.
5. A statement to the board indicating whether the physician has been approved by the board for supervision pursuant to section 32-2533.
6. A statement signed by the supervising physician, the supervising physician's agent and the physician assistant that indicates that they have read, are familiar with and shall abide by this chapter and rules adopted under this chapter.
C. The board shall promptly review each notification of supervision submitted for approval by a supervising physician.
D. If the notification of supervision includes a request for authority to prescribe, administer or dispense schedule II or III controlled substances, the board shall review and may approve, modify or deny the request based on the following criteria:
1. The physician assistant's previous training and experience.
2. The physician assistant's previous performance.
3. The employment situation.
4. The availability of the supervising physician and supervising physician's agents.
5. A complete list of the United States drug enforcement agency's schedule of drugs that the supervising physician has delegated to the physician assistant for dispensing.
E. If there are any deficiencies in the notification of supervision which prevent it from being complete, the board, promptly and in writing, shall notify the supervising physician of the deficiencies.
F. If the notification of supervision satisfies the requirements in subsection B of this section, the board may approve, modify or deny the supervision of a physician assistant by the supervising physician.
G. The board may approve the transfer of supervision of a physician assistant from one supervising physician to another supervising physician if the board approves that physician pursuant to section 32-2533. If the request for transfer is made before a physician assistant begins employment, the new supervising physician shall comply with subsection B of this section. If the request is for a transfer of employment of a physician assistant from a supervising physician to a supervising physician's agent and there is no change in the physician assistant's notification of supervision, the supervising physician's agent shall sign the physician assistant's current notification of supervision and pay the prescribed transfer fee. The transfer from a supervising physician to a supervising physician's agent is subject to board approval.
H. Within thirty days after an employer terminates the employment of
a physician assistant, the supervising physician and the physician assistant
shall submit a written report to the board that provides the date of termination
and the reasons for the termination. The physician assistant shall
not work as a physician assistant until the board approves another supervising
ARTICLE 4: REGULATION
32-2551. Grounds for disciplinary action; duty to report; immunity; proceedings; board action; notice
A. The board on its own motion may investigate any evidence which appears to show that a physician assistant is or may be medically incompetent, is or may be guilty of unprofessional conduct or is or may be mentally or physically unable to carry out approved health care tasks. Any physician, physician assistant or health care institution as defined in section 36-401 shall, and any other person may, report to the board any information the physician, physician assistant, health care institution or other person has which appears to show that a physician assistant is or may be medically incompetent, is or may be guilty of unprofessional conduct or is or may be mentally or physically unable to carry out approved health care tasks. The board shall notify the physician assistant and the approved supervising physician of the content of the reported information in writing within one hundred twenty days of its receipt of the information. Any physician, physician assistant, health care institution or other person that reports or provides information to the board in good faith is not subject to an action for civil damages as a result of reporting or providing information, and, if requested, the name of the reporter shall not be disclosed unless the information is essential to proceedings conducted pursuant to this section.
B. The board may require a mental, physical or medical competency examination or any combination of those examinations or may make investigations including investigational interviews between representatives of the board and the physician assistant and the supervising physician as it deems necessary to fully inform itself with respect to any information reported pursuant to subsection A of this section.
C. If the board finds, based on the information it receives under subsections A and B of this section, that the public safety imperatively requires emergency action, and incorporates a finding to that effect in its order, the board may order a summary suspension of a license pending proceedings for revocation or other action. If an order of summary suspension is issued, the physician assistant shall also be served with a written notice of complaint and formal hearing, setting forth the charges, and is entitled to a formal hearing before the board or a hearing officer on the charges within sixty days.
D. If, after completing its investigation, the board finds that the information provided pursuant to subsection A of this section is not of sufficient seriousness to merit direct action against the physician assistant's license, it may take the following actions:
1. Dismiss if, in the opinion of the board, the information is without merit.
2. File a letter of concern.
E. If, after completing its investigation, the board holds the opinion that the information is or may be true and that the information may be of sufficient seriousness to merit direct action against the physician assistant's license, it may request an informal interview with the physician assistant and the supervising physician. The board shall notify the physician assistant in writing of the time, date and place of the informal interview at least twenty days before the interview. The notice shall include the right to be represented by counsel and shall fully set forth the conduct or matters to be discussed.
F. After an informal interview, the board may take the following actions:
1. Dismiss if, in the opinion of the board, the information is without merit.
2. File a letter of concern.
3. Issue a decree of censure which constitutes an official action against the physician assistant's license.
4. Enter into a stipulation with the physician assistant to restrict or limit the physician assistant's practice or medical activities in order to rehabilitate the physician assistant, protect the public and ensure the physician assistant's ability to safely perform health care tasks.
5. Fix a period and terms of probation best adapted to protect the public health and safety and rehabilitate or educate the physician assistant. Probation may include restrictions on the health care tasks the physician assistant may perform or temporary suspension for not to exceed twelve months. Failure to comply with any terms of probation is cause for initiating formal proceedings pursuant to subsection G of this section.
G. If the board finds that the information provided pursuant to subsection A of this section warrants suspension or revocation of a physician assistant's license, it shall immediately initiate formal proceedings for the suspension or revocation of the license as provided in title 41, chapter 6, article 6. The notice of complaint and hearing is fully effective by mailing a true copy of the notice of complaint and hearing by certified mail addressed to the physician assistant's last known address of record in the board's files. The notice of complaint and hearing is complete at the time of its deposit in the mail. An administrative law judge may conduct a hearing pursuant to this subsection and shall submit a record of the findings of fact and conclusions of law to the board, together with any additional information the board requests, within thirty days after the hearing. The board may affirm, reverse, adopt, modify, supplement, amend or reject the administrative law judge's findings of fact and conclusions of law in whole or in part.
H. A physician assistant who after a formal hearing as provided in this section is found to be medically incompetent, guilty of unprofessional conduct or mentally or physically unable to safely carry out the physician assistant's approved health care tasks, or any combination thereof, is subject to censure, probation, suspension or revocation, or any combination of these, for a period of time or permanently and under conditions the board deems appropriate for the protection of the public health and safety.
I. A letter of concern is a public document and may be used in future disciplinary actions against a physician assistant.
J. The board may charge the costs of a formal hearing held pursuant to this section to the licensee if it finds the licensee in violation of this chapter.
K. If the board acts to modify a physician assistant's precription writing privileges, the board shall immediately notify the state board of pharmacy and the federal drug enforcement administration of this modification.
L. If during the course of an investigation the board determines that
a criminal violation may have occurred involving the performance of health
care tasks, it shall provide evidence of the violation to the appropriate
criminal justice agency.
32-2552. Right to examine and copy evidence; subpoena authority; right to counsel; confidentiality of records
A. In connection with an investigation conducted by the board on its own motion or as the result of information received pursuant to section 32-2551, subsection A, the board or its duly authorized agent or employee shall at all reasonable times have access to, for the purpose of examination, and the right to copy any documents, reports, records or other physical evidence of any person being investigated or the reports, the records and any other documents maintained by and in the possession of any hospital, clinic, physician's office, physician assistant's office, laboratory, pharmacy, health care institution as defined in section 36-401 or other public or private agency if the documents, reports, records or evidence relate to a physician assistant's medical competence, unprofessional conduct or mental or physical ability to safely engage in the physician assistant's approved health care tasks.
B. For the purpose of all investigations and proceedings conducted by the board:
1. On its own motion or on application of a person involved in an investigation, the board may issue subpoenas compelling the attendance and testimony of witnesses or demanding the production of documents or any other physical evidence for examination or copying if the evidence relates to the medical incompetence, unprofessional conduct or mental or physical ability of a physician assistant to safely perform health care tasks. Within five days after service of a subpoena requiring the production of evidence in the person's possession or under the person's control, the person may petition the board to revoke, limit or modify the subpoena. The board shall do so if it believes that the evidence required does not relate to violations of this chapter, is not relevant to the subject matter of the hearing or investigation or does not describe with sufficient particularity the physical evidence requested.
2. A person appearing before the board may be represented by counsel.
3. A board member or agent designated by the board may administer oaths or affirmations, examine witnesses and receive evidence.
4. On application by the board or by the person subpoenaed, the superior court has jurisdiction to issue an order to do either of the following:
(a) Require a person to appear before the board or its authorized agent to produce evidence relating to the investigation.
(b) Revoke, limit or modify a subpoena if the court determines that the evidence does not relate to a violation of this chapter, is not relevant to the hearing or investigation or does not describe with sufficient particularity the physical evidence requested.
C. The following items are not available to the public:
1. Patient records, including clinical records, medical reports and laboratory statements and reports.
2. Files, films, reports or oral statements relating to diagnostic findings or treatment of patients.
3. Any information from which a patient or the patient's family might be identified.
4. Information received and records kept by the board in its investigations.
D. This section and any other provision of law that makes communications between a physician or a physician assistant and the physician assistant's patient a privileged communication does not apply to investigations or proceedings conducted pursuant to this chapter. The board and its employees, agents and representatives shall keep in confidence the names of any patients whose records are reviewed during the course of investigations and proceedings pursuant to this chapter.
E. Hospital records, medical staff records, medical staff review committee
records, testimony concerning those records and proceedings related to
the creation of those records are not available to the public, shall be
kept confidential by the board and are subject to the same provisions of
law concerning discovery and use in legal actions as are the original records
in the possession and control of hospitals, medical staffs and medical
staff review committees.
32-2553. Judicial review
Decisions of the board are subject to judicial review pursuant to title
12, chapter 7, article 6.
32-2554. Violations; classification
A. A person who does any of the following is guilty of a class 6 felony:
1. Performs a health care task if that person is not licensed pursuant to this chapter or is not exempt from licensure pursuant to this chapter.
2. Secures a license to perform health care tasks by fraud or deceit.
3. Impersonates a member of the board.
B. A person who is not licensed pursuant to this chapter shall not use
the designation "P.A.", "P.A.-C." or "physician assistant" or use of any
other words, initials or symbols in a way that leads the public to believe
that the person is licensed pursuant to this chapter. A person who
violates this subsection is guilty of a class 2 misdemeanor.
A. The superior court may issue an injunction to enjoin:
1. A person who is not licensed pursuant to this chapter or who is not exempt from licensure pursuant to this chapter from performing health care tasks.
2. A physician assistant from performing health care tasks if the court determines that the licensee will or may cause irreparable damage to the public health and safety before the board has an opportunity to act pursuant to section 32-3551.
3. An act proscribed in section 32-2554, subsection B.
B. In a petition for an injunction pursuant to subsection A, paragraph 1 of this section, it is sufficient for the petitioner to charge that the respondent on a day certain in a named county engaged in the performance of health care tasks without being licensed or exempt from licensure pursuant to this chapter. It is not necessary for the petitioner to show damage or injury.
C. In a petition for an injunctin pursuant to subsection A, paragraph 2 of this section, the petitioner shall specify the facts regarding the licensee's threat to the public health and safety.
D. The board shall file the petition in the superior court in Maricopa
county or in the county where the respondent resides or is found.
32-2556. Human immunodeficiency virus; disclosure; immunity; definition
A. It is not an act of unprofessional conduct for a licensee to report to the department of health services the name of a patient's spouse, sex partner or person with whom the patient has shared hypodermic needles or syringes if the licensee knows that the patient tests positive for the human immunodeficiency virus and that the patient has not or will not notify these people and refer them to testing. Before reporting this information to the department of health services the licensee shall ask the patient to release this information voluntarily.
B. It is not an act of unprofessional conduct for a licensee who knows or who has reason to believe that a significant exposure has occurred between a patient who tests positive for the human immunodeficiency virus and a health care worker or a public safety employee to inform the worker or employee of the exposure. Before disclosing this information the licensee shall ask the patient to disclose this information voluntarily. If the patient does not agree to do this the licensee may disclose the information in a manner that does not identify the patient.
C. This section does not impose a duty to disclose information. A licensee is not subject to civil or criminal liability for either disclosing or not disclosing information.
D. If a licensee decides to make a disclosure pursuant to this section the licensee may request the department of health services to make the disclosure on the licensee's behalf.
E. For the purposes of this section, "significant exposure" means contact
of a person's ruptured or broken skin or mucous membranes with another
person's blood or body fluid, other than tears, saliva or perspiration,
of a magnitude that the centers for disease control of the United States
public health service have epidemiologically demonstrated can result in
the transmission of the human immunodeficiency virus.