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<section article="gho" article_name="Health Occupations" number="15-302.1" title_number="15" title_name="Physician Assistants" subtitle_number="3" subtitle_name="Certification">
  <level label="a">
    <text>In this section, “exempt facility” means:</text>
    <level label="1">
      <text>A hospital;</text>
    </level>
    <level label="2">
      <text>An ambulatory surgical facility;</text>
    </level>
    <level label="3">
      <text>A federally qualified health center; or</text>
    </level>
    <level label="4">
      <text>Another practice setting listed on a hospital delineation of privileges document.</text>
    </level>
  </level>
  <level label="b">
    <text>Except as provided in subsection (e) of this section, a physician assistant may perform advanced duties without Board approval if the advanced duty will be performed in an exempt facility and:</text>
    <level label="1">
      <text>The physician assistant is supervised by a physician with credentials that have been reviewed by the exempt facility as a condition of employment as an independent contractor or as a member of the medical staff;</text>
    </level>
    <level label="2">
      <text>The physician assistant has credentials that have been reviewed by the exempt facility as a condition of employment as an independent contractor or as a member of the medical staff; and</text>
    </level>
    <level label="3">
      <text>The advanced duty to be delegated to the physician assistant is reviewed and approved in a process approved by the exempt facility before the physician assistant performs the advanced duty.</text>
    </level>
  </level>
  <level label="c">
    <level label="1">
      <text>Subject to paragraph (2) of this subsection and subsection (d) of this section and except as provided in subsection (e) of this section, a physician assistant may perform advanced duties in a practice setting that is not an exempt facility only after the physician assistant obtains Board approval of the advanced duty under the collaboration agreement.</text>
    </level>
    <level label="2">
      <text>A physician assistant may perform X–ray duties in the medical office of a patient care team physician if:</text>
      <level label="i">
        <text>The physician assistant has completed a course that includes radiographic studies of the extremities of at least 20 separate patients;</text>
      </level>
      <level label="ii">
        <text>The X–rays are limited to the extremities;</text>
      </level>
      <level label="iii">
        <text>The X–rays are performed under the direct supervision of a collaborating physician or radiologist;</text>
      </level>
      <level label="iv">
        <text>The X–rays are performed using a mini C–arm or a similar low–level radiation machine to perform nonfluoroscopic X–ray procedures; and</text>
      </level>
      <level label="v">
        <text>The physician assistant obtains Board approval of the X–ray duty as an advanced duty under the collaboration agreement.</text>
      </level>
    </level>
  </level>
  <level label="d">
    <text>A physician assistant may not perform the medical acts of administering general anesthesia or neuroaxial anesthesia, including spinal, epidural, and image guided interventional spine procedures.</text>
  </level>
  <level label="e">
    <text>A physician assistant may perform an advanced duty in collaboration with a patient care team physician without prior approval of the Board if:</text>
    <level label="1">
      <text>The Board has previously approved the physician assistant to perform the advanced duty in collaboration with a patient care team physician; or</text>
    </level>
    <level label="2">
      <text>The physician assistant has at least 7,000 hours of clinical practice experience.</text>
    </level>
  </level>
  <level label="f">
    <text>If an advanced duty requires Board approval, the Committee:</text>
    <level label="1">
      <text>Shall review the collaboration agreement;</text>
    </level>
    <level label="2">
      <text>May conduct a personal interview of the physician assistant and patient care team physicians; and</text>
    </level>
    <level label="3">
      <text>May recommend to the Board that the collaboration agreement be modified to ensure conformance with the requirements of this title.</text>
    </level>
  </level>
  <level label="g">
    <level label="1">
      <text>On review of the Committee’s recommendations regarding the request of a patient care team physician to delegate advanced duties as described in a collaboration agreement, the Board may modify the performance of advanced duties under a collaboration agreement if the physician assistant does not meet the applicable education, training, and experience requirements to perform the specified advanced duties.</text>
    </level>
    <level label="2">
      <text>If the Board makes a modification under paragraph (1) of this subsection, the Board:</text>
      <level label="i">
        <text>Shall notify the delegating patient care team physician listed in the collaboration agreement and the physician assistant in writing of the particular elements of the advanced duty approval request that were the cause for the modification; and</text>
      </level>
      <level label="ii">
        <text>May not restrict the submission of an amendment to the advanced duty.</text>
      </level>
    </level>
  </level>
  <level label="h">
    <text>Documentation demonstrating a physician assistant’s authority to perform an advanced duty under this section shall be maintained at the facility in which the physician assistant is performing the advanced duty.</text>
  </level>
  <level label="i">
    <text>Individual members of the Board are not civilly liable for actions regarding the approval, modification, or disapproval of an advanced duty under the collaboration agreement described in this section.</text>
  </level>
</section>
