2019 Assembly BILL 575

October 25, 2019 - Introduced by Representatives VanderMeer, Edming, Considine, Anderson, Dittrich, Doyle, Felzkowski, James, Krug, Kulp, Mursau, Oldenburg, Quinn, Ramthun, Rohrkaste, Sortwell, Spiros, Summerfield, Tittl, Vruwink and Tauchen, cosponsored by Senators Bernier, Kooyenga, Hansen, Tiffany, Schachtner and Bewley. Referred to Committee on Regulatory Licensing Reform.

AB575,2,6 An Act to repeal 15.407 (2), 50.01 (4p), 252.01 (5), 448.01 (6), 448.03 (1) (b), 448.03 (3) (e), 448.04 (1) (f), 448.05 (5), 448.20, 448.21, 448.40 (2) (f), 448.695 (4) and 450.01 (15r); to renumber 448.038; to amend 15.08 (1m) (b), 16.417 (1) (e) 3m., 46.03 (44), 48.981 (2m) (b) 1., 49.45 (9r) (a) 7. a., 50.08 (2), 50.39 (3), 50.60 (1), 55.14 (8) (b), 69.01 (6g), 70.47 (8) (intro.), 97.67 (5m) (a) 3., 118.2925 (1) (f), 146.38 (1) (b) 1., 146.81 (1) (d), 146.81 (1) (i), 146.81 (1) (j), 146.82 (3) (a), 146.89 (1) (r) 1., 146.997 (1) (d) 5., 155.01 (7), 252.15 (1) (am), 252.15 (1) (ar) 1., 255.07 (1) (d), 255.07 (7), 257.01 (5) (a), 257.01 (5) (b), 343.16 (5) (a), 440.035 (2m) (b), 440.035 (2m) (c) 1. (intro.), 448.015 (4) (am) 2., 448.02 (1), 448.03 (2) (a), 448.03 (2) (e), 448.03 (2) (k), 448.03 (5) (b), 448.035 (2) to (4), 448.037 (2) (a) (intro.) and (b) and (3), 448.62 (7), 450.01 (16) (hm) 3., 450.10 (3) (a) 5., 450.11 (1), 450.11 (1g) (b), 450.11 (1i) (a) 1., 450.11 (1i) (b) 2. c., 450.11 (1i) (c) 2., 450.11 (8) (b), 462.02 (2) (e), 462.04, 895.48 (1m) (a) (intro.), 961.01 (19) (a) and 971.14 (4) (a); and to create 15.405 (4), 49.45 (9r) (a) 7. am., 69.18 (1) (ck), 146.81 (1) (hr), 146.997 (1) (d) 13m., 180.1901 (1m) (h), 450.10 (3) (a) 12., 450.11 (1i) (b) 2. cm., 450.11 (8) (f), chapter 461 and 990.01 (27s) of the statutes; relating to: regulation of physician assistants, creating a Physician Assistant Examining Board, extending the time limit for emergency rule procedures, providing an exemption from emergency rule procedures, granting rule-making authority, and providing a penalty.

Analysis by the Legislative Reference Bureau

This bill makes changes with respect to the licensure, regulation, and practice of physician assistants (PAs).

Under current law, PAs are defined as individuals who are licensed to provide medical care with physician supervision and direction. The Medical Examining Board licenses and regulates PAs as well as physicians and certain other professions. The Medical Examining Board is composed of ten physicians and three public members and is authorized to promulgate rules establishing licensing and practice standards for PAs.

This bill transfers licensure and regulation of PAs to the newly created Physician Assistant Examining Board. The new board is composed of seven PAs, one member who may be either a physician or a PA, and one public member. In addition, the bill makes various changes to the licensure, regulation, and practice of PAs, including all of the following:

1. Instead of requiring that a PA practice under the supervision and direction of a physician, requires, subject to certain exceptions, that a PA who provides care to patients maintain and provide to the board upon request either 1) evidence that, pursuant to the physician assistant's employment, there is a physician who is primarily responsible for the overall direction and management of the physician assistant's professional activities and for assuring that the services provided by the physician assistant are medically appropriate or 2) a written collaborative agreement with a physician or, if the physician assistant's practice is limited to the practice of podiatry, a podiatrist, which must describe the PA's scope of practice and include other information as required by the board. However, the bill provides that a PA is individually and independently responsible for the quality of the care he or she renders.

2. Defines a PA's practice similarly to the definition of the practice of medicine and surgery. The bill also explicitly provides that a PA may prescribe, dispense, and administer drugs and may serve as a primary or specialty care provider. The bill requires a PA to limit his or her practice to the scope of his or her experience, education, and training, and retains a number of limitations on the practice of PAs.

3. Includes a number of additional provisions with respect to the obligations of PAs. These include a requirement that a PA have in effect malpractice liability insurance coverage when practicing, subject to certain exceptions and other provisions.

4. Establishes licensure requirements for PAs, which differ in a number of respects from the requirements under current law, including that PAs submit additional information, including an employment history, with a licensure application. Under the bill, the board must require continuing education for PAs. Currently, PAs are not required to complete continuing education.

5. Specifies various grounds for professional discipline of a PA by the board and allows the board to impose professional discipline consistent with other professions.

Because this bill creates a new crime or revises a penalty for an existing crime, the Joint Review Committee on Criminal Penalties may be requested to prepare a report.

For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

AB575,1 Section 1. 15.08 (1m) (b) of the statutes is amended to read:

AB575,3,12 15.08 (1m) (b) The public members of the chiropractic examining board, the dentistry examining board, the hearing and speech examining board, the medical examining board, the physical therapy examining board, the perfusionists examining council, the respiratory care practitioners examining council and council on, the physician assistants assistant examining board, the board of nursing, the nursing home administrator examining board, the veterinary examining board, the optometry examining board, the pharmacy examining board, the marriage and family therapy, professional counseling, and social work examining board, the psychology examining board, and the radiography examining board shall not be engaged in any profession or occupation concerned with the delivery of physical or mental health care.

AB575,2 Section 2. 15.405 (4) of the statutes is created to read:

AB575,4,3 15.405 (4) Physician assistant examining board. (a) There is created in the department of safety and professional services a physician assistant examining board consisting of the following members appointed for staggered 4-year terms:

AB575,4,4 1. Seven physician assistants licensed under ch. 461.

AB575,4,6 2. One individual who is either a physician licensed under subch. II of ch. 448 or a physician assistant licensed under ch. 461.

AB575,4,7 3. One public member.

AB575,4,10 (b) The governor may appoint a physician assistant to the physician assistant examining board under par. (a) 2. only if the governor has determined that there is no suitable physician who is willing to serve on the board.

AB575,3 Section 3. 15.407 (2) of the statutes is repealed.

AB575,4 Section 4 . 16.417 (1) (e) 3m. of the statutes is amended to read:

AB575,4,14 16.417 (1) (e) 3m. A physician assistant who is licensed under s. 448.04 (1) (f) 461.07.