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| EVERY PRACTICE IN CALIFORNIA WHICH EMPLOYS PAs 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. California Physician Assistant’s and
Supervising Physician’s Legal Handbook Forward to Second Edition In 2007, the California Academy of Physician Assistants ("CAPA") set out to remove several long-standing obstacles to the more effective utilization of PAs in expanding access to care. Through the hard work and dedication of many, and thanks to the support of the California Medical Association, the California Physician Assistant Committee and others, CAPA achieved its goals through the passage of Assembly Bill 3, authored by Assemblywoman (now Speaker of the Assembly) Karen Bass, a former PA. AB 3 expands Medi-Cal coverage for PA services to make it commensurate with the coverage of physician and nurse practitioner services; it eliminates the requirement for patient-specific authority for a PA to write drug orders for controlled substances if the PA has met certain educational requirements; it doubles the number of PAs a supervising physician may supervise from two to four; and it reduces the percentage of charts a supervising physician must review when a PA functions pursuant to protocols from 10% to 5%. This second edition incorporates changes in the law resulting from these stunning legislative accomplishments. The first edition of this book was intended to meet a pressing need among PAs and their supervising physicians. 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:
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, including, most recently, Assembly Bill 3. Mike has authored issues and position papers for the American Academy of Physician Assistants, as well as for CAPA, and is nationally recognized in the area of physician assistant law. 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 in 2006. 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 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. R. Michael Scarano, Jr., has served as General Counsel to the California Academy of Physician Assistants since 1989. 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 has authored issues and position papers for the American Academy of Physician Assistants, as well as for CAPA, and is nationally recognized in the area of physician assistant law. Mike is a partner in the national law firm of Foley & Lardner LLP, where he is Vice Chair of the Health Care Industry Team. He was also Co-Chair of the Health Care Law Committee of the California Bar Association for 2006-2007 and is listed in the 2007 and 2008 editions of the Best Lawyers in America®. 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. In addition to CAPA and numerous individual PAs, Mike represents health facilities, medical groups, emergency medical services providers and other types of health care organizations in a wide range of issues. |
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