CHA News Article

New Law Addresses Supervision, Documentation Requirements for Physician Assistants
Hospitals should update their policies and procedures

Gov. Brown has signed SB 337 (Pavley, D-Agoura Hills), sponsored by the California Academy of Physician Assistants, requiring the medical record of each patient treated by a physician assistant (PA) to identify the physician responsible for supervising that PA for that episode of patient care. Hospitals will need to adopt policies and procedures and train any PAs practicing in their facility to ensure that this requirement is met. The law becomes effective Jan. 1, 2016.

SB 337 also provides new mechanisms for a supervising physician to demonstrate adequate supervision of a PA functioning under protocols. Under existing law, a supervising physician must review, countersign and date a sample of at least five percent of a PA’s cases within 30 days of treatment. Under the new law, the supervising physician and PA will be permitted to meet monthly, at least 10 months per year, to review at least 10 medical records of patients treated by the PA functioning under protocols. These “medical records review meetings” may occur in person or by electronic communication. The physician and PA are required to jointly sign and date documentation of the review meeting.

Alternatively, a supervising physician may conduct a medical records review by reviewing a sample of at least 10 medical records per month, at least 10 months during the year, using a combination of the existing countersignature mechanism and the medical records review meeting mechanism.

Finally, the bill permits a supervising physician to review, countersign and date, within seven days, a sample consisting of the medical records of at least 20 percent of the patients cared for by the PA for whom the PA’s Schedule II drug order has been issued or carried out, if the PA has documentation of the successful completion of an education course that covers controlled substances, and that controlled substance education course meets specified standards.

Whichever supervision mechanism is chosen, the supervising physician must select for review cases that by diagnosis, problem, treatment or procedure represent, in his or her judgment, the most significant risk to the patient.