EVERY PRACTICE IN CALIFORNIA WHICH EMPLOYS PAs
SHOULD HAVE THIS BOOK ON THEIR SHELF

Your knowledge of and adherence to the laws that govern PA practice in California are as important to your career as your knowledge of medicine is to patient care.

You worked hard for your license and it doesn’t make any sense to put yourself in a position to be cited for a violation of the PA Practice Act or charged for Medicare or Medi-Cal fraud and/or abuse. All PA supervisors should also be aware of the laws which regulate PA practice.

Check with you supervising physician and/or practice/clinic administrator to see if they would purchase this book for the practice. It is an invaluable resource to have at your fingertips.

While physician assistants emerge from their academic programs and preceptorships well equipped for the clinical challenges they will face, many are not as knowledgeable regarding the laws and regulations that govern PA practice.  Many supervising physicians also lack information regarding the  rules applicable to the physician-PA relationship. Failure to know and understand these rules can have dangerous, even career ending consequences, particularly as licensing agencies and government reimbursement programs become increasingly vigilant in policing professional misconduct.

The mission of the California Academy of Physician Assistants (CAPA) includes educating PAs and their supervising physicians in legal as well as clinical matters.  CAPA has performed that role over the last thirty years by responding to countless questions from PAs on a wide range of issues, such as:

• What risk do my supervising physician and I face if he/she does not comply with the requirements for delegating services, establishing protocols, reviewing charts, etc.?
• When is “patient-specific authority” required and what does it really mean?
•  Can PAs share ownership of a medical practice?
• What should be included in an employment agreement?
• What are the requirements to bill Medicare for “incident to” services?
• Are PAs exempt employees, or do they have to be paid overtime?
• Does the supervising physician have to be present when I “close” a surgical patient?
• Can PAs give orders to nurses or medical assistants?
• What kind of insurance should I have?
• How do I protect myself from malpractice claims?

In answering these and other questions, for nearly twenty years CAPA and its members have often looked to attorney Mike Scarano, CAPA’s general counsel.  Mike has not only provided CAPA  and its members with guidance on a myriad of issues, he has helped shape the legal face of the PA profession by writing most of the statutes that CAPA has sponsored over the years to enhance PAs’ ability to treat their patients, such as the law permitting PAs to write prescription drug orders.  Mike is recognized as the top expert on physician assistant law in California and one of the leading experts nationwide, having authored issues and position papers for the American Academy of Physician Assistants as well as for CAPA.

As PAs have grown in number, and the laws governing the profession have become increasingly complex, CAPA believes there is a need for a “one stop” authoritative source for legal information regarding the PA profession and other basic health law concepts every PA should know.  Consequently, at CAPA’s request, Mike has authored this first edition of our California Physician Assistant’s and Supervising Physician’s Legal Handbook.   It answers the questions above and many more in a concise, clear fashion, with citations and appendices that will permit practitioners to read the operative statutes and regulations for themselves if they so desire.  We hope it is useful to our members and their supervising physicians and welcome your feedback. 

Gaye Breyman, CAE                                           Robert Miller, PA-C, Chair
CAPA Chief Operating Officer                             CAPA Professional Practice Committee

This publication is intended as a general summary of the law for educational purposes only.  It does not constitute professional advice and should not be relied on as such. 

ABOUT THE AUTHOR

R. Michael Scarano, Jr., has served as General Counsel to the California Academy of Physician Assistants since 1992.  In that capacity, Mike has advised CAPA, its members and their employers on a wide range of legal issues.  He has also played a major role in the evolution of PA law in California by authoring a number of bills successfully sponsored by CAPA which have enhanced the ability of PAs to serve their patients.  Mike is recognized as one of the leading national experts on PA law and has authored issues and position papers for the American Academy of Physician Assistants as well as CAPA.

Mike a partner in the national law firm of Foley & Lardner LLP, where he is Co-chair of the Life Sciences Industry Team and a member of the Health Industry Team.  He is also Co-Chair of the Health Law Committee of the California Bar Association for 2006-2007, and is listed in the 2007 edition of The Best Lawyers in American. Mike is a 1984 graduate of Boalt Hall School of Law at the University of California, Berkeley, where he also received his BA in 1979.