An Act concerning the licensure and scope of practice of physician assistants, amending and supplementing P.L.1991, c.378, amending P.L.1983, c.308 and P.L.1988, c.125, and repealing various parts of the statutory law.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. Section 2 of P.L.1991, c.378 (C.45:9-27.11) is amended to read as follows:

2. As used in this act:

"[Approved] Accredited program" means an education program for physician assistants which is [approved] accredited by the [Committee on Allied Health Education and Accreditation] Accreditation Review Commission on Education for the Physician Assistant or its predecessor or successor agency.

"Board" means the State Board of Medical Examiners created pursuant to R.S.45:9-1.

"Committee" means the Physician Assistant Advisory Committee established pursuant to section 11 of [this act] P.L.1991, c.378 (C.45:9-27.20).

"Director" means the Director of the Division of Consumer Affairs.

"Health care facility" means a health care facility as defined in section 2 of P.L.1971, c.136 (C.26:2H-2).

"Institution" means any of the charitable, hospital, relief and training institutions, noninstitutional agencies, and correctional institutions enumerated in R.S.30:1-7.

"Physician assistant" means a [person] health professional who meets the qualifications under P.L.1991, c.378 (C.45:9-27.10 et seq.) and holds a current, valid license issued pursuant to section 4 of [this act] P.L.1991, c.378 (C.45:9-27.13) ¹[and practices medicine under the supervision of a physician]¹.

"Physician" means a person licensed to practice medicine and surgery pursuant to chapter 9 of Title 45 of the Revised Statutes.

"Veterans' home" means the New Jersey Veterans' Memorial Home - Menlo Park, the New Jersey Veterans' Memorial Home - Vineland, and the New Jersey Veterans' Memorial Home - Paramus.

(cf: P.L.1992, c.102, s.1)

2. Section 4 of P.L.1991, c.378 (C.45:9-27.13) is amended to read as follows:

4. a. The board shall issue a license as a physician assistant to
an applicant who has fulfilled the following requirements:

(1) Is at least 18 years of age;

(2) Is of good moral character;

(3) Has successfully completed an [approved] accredited program; and

(4) Has passed the national certifying examination administered by the National Commission on Certification of Physician Assistants, or its successor.

b. In addition to the requirements of subsection a. of this section, an applicant for renewal of a license as a physician assistant shall:

(1) Execute and submit a sworn statement made on a form provided by the board that neither the license for which renewal is sought nor any similar license or other authority issued by another jurisdiction has been revoked [,] or suspended [or not renewed]; and

(2) Present satisfactory evidence that any continuing education requirements have been completed as required by [this act] P.L.1991, c.378 (C.45:9-27.10 et seq.).

c. The board, in consultation with the committee, may accept, in lieu of the [examination required by paragraph (4)] requirements of subsection a. of this section, proof that an applicant for licensure holds a current license in a state which has standards substantially equivalent to those of this State.

d. [The board shall issue a temporary license to an applicant who meets the requirements of paragraphs (1), (2) and (3) of subsection a. of this section and who is either waiting to take the first scheduled examination following completion of an approved program or is awaiting the results of the examination. The temporary license shall expire upon the applicant's receipt of notification of failure to pass the examination.] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

e. A physician assistant who notifies the board in writing on forms prescribed by the board may elect to place the physician assistant's license on inactive status. A physician assistant with an inactive license shall not be subject to the payment of renewal fees and shall not practice as a physician assistant. A licensee who engages in practice while the physician assistant's license is lapsed or on inactive status shall be deemed to have engaged in professional misconduct in violation of subsection e. of section 8 of P.L.1978, c.73 (C.45:1-21) and shall be subject to disciplinary action by the committee pursuant to P.L.1978, c.73 (C.45:1-14 et seq.). A physician assistant requesting restoration from an inactive status shall be required to pay the current renewal fee and shall be required to meet the criteria for renewal as specified by the board.

(cf: P.L.1993, c.337, s.1)

3. Section 6 of P.L.1991, c.378 (C.45:9-27.15) is amended to read as follows:

6. a. A physician assistant may practice in all medical care settings, including, but not limited to, a physician's office, a health care facility, an institution, a veterans' home, or a private home, provided that:

(1) the physician assistant [is] ¹[practices medicine] performs medical services within the physician assistant's education, training, and experience¹ under the [direct] supervision of a physician pursuant to section 9 of [this act] P.L.1991, c.378 (C.45:9-27.18);

(2) the practice of the physician assistant is limited to those procedures ¹enumerated under section 7 of P.L.1991, c.378 (C.45:9-27.16), and any other procedures¹ that are delegated to the physician assistant by the supervising physician, as authorized under ¹subsection d. of¹ section 7 of [this act] P.L.1991, c.378 (C.45:9-27.16);

(3) [an appropriate notice of employment has been filed with the board pursuant to subsection b. of section 5 of this act;] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

(4) the supervising physician or physician assistant advises the patient at the time that services are rendered that they are to be performed by the physician assistant;

(5) the physician assistant conspicuously wears an identification tag using the term "physician assistant" ¹or the designation, "PA-C" or "PA"¹ whenever acting in that capacity; and

(6) any entry by a physician assistant in a clinical record is appropriately signed and followed by the designation, ["PA-C."] "PA-C" or "PA."

b. Any physician assistant who practices in violation of any of the conditions specified in subsection a. of this section shall be deemed to have engaged in professional misconduct in violation of subsection ¹[f.] e.¹ of section 8 of P.L.1978, c.73 (C.45:1-21).

(cf: P.L.1992, c.102, s.4)

4. Section 7 of P.L.1991, c.378 (C.45:9-27.16) is amended to read as follows:

7. a. A physician assistant may perform [the following procedures:] ¹[those duties and responsibilities, including the ordering, prescribing, dispensing, and administering of drugs and medical devices, that are delegated by the supervising physician. A physician assistant may provide any medical service that is delegated by the supervising physician when the service is within the physician assistant's skills, forms a component of the supervising physician's scope of practice, and is provided under the physician's supervision. A physician assistant may perform a task that is not within the supervising physician's scope of practice, provided that the supervising physician has adequate training, oversight skills, and supervisory and referral arrangements to ensure competent provision of the service by the physician assistant.] the following procedures:¹

(1) [Approaching a patient to elicit a detailed and accurate history, perform an appropriate physical examination, identify problems, record information and interpret and present information to the supervising physician;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Approaching a patient to elicit a detailed and accurate history, perform an appropriate physical examination, identify problems, record information, and interpret and present information to the supervising physician;¹

(2) [Suturing and caring for wounds including removing sutures and clips and changing dressings, except for facial wounds, traumatic wounds requiring suturing in layers and infected wounds;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Suturing and caring for wounds including removing sutures and clips and changing dressings, except for facial wounds, traumatic wounds requiring suturing in layers, and infected wounds;¹

(3) [Providing patient counseling services and patient education consistent with directions of the supervising physician;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Providing patient counseling services and patient education consistent with directions of the supervising physician;¹

(4) [Assisting a physician in an inpatient setting by conducting patient rounds, recording patient progress notes, determining and implementing therapeutic plans jointly with the supervising physician and compiling and recording pertinent narrative case summaries;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Assisting a physician in an inpatient setting by conducting patient rounds, recording patient progress notes, determining and implementing therapeutic plans jointly with the supervising physician, and compiling and recording pertinent narrative case summaries;¹

(5) [Assisting a physician in the delivery of services to patients requiring continuing care in a private home, nursing home, extended care facility or other setting, including the review and monitoring of treatment and therapy plans;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Assisting a physician in the delivery of services to patients requiring continuing care in a private home, nursing home, extended care facility, or other setting, including the review and monitoring of treatment and therapy plans;¹

(6) [Facilitating the referral of patients to, and promoting their awareness of, health care facilities and other appropriate agencies and resources in the community; and] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Referring patients to, and promoting their awareness of, health care facilities and other appropriate agencies and resources in the community; and¹

(7) [Such other procedures suitable for discretionary and routine performance by physician assistants as designated by the board pursuant to subsection a. of section 15 of this act.] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Such other procedures suitable for discretionary and routine performance by physician assistants as designated by the board pursuant to subsection a. of section 15 of P.L.1991, c.378 (C.45:9-27.24).¹

b. [A physician assistant may perform the following procedures only when directed, ordered or prescribed by the supervising physician or specified in accordance with protocols promulgated pursuant to subsection c. of section 15 of this act:] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] A physician assistant may perform the following procedures only when directed, ordered, or prescribed by the supervising physician or specified in accordance with protocols promulgated pursuant to subsection c. of section 15 of P.L.1991, c.378 (C.45:9-27.24):¹

(1) [Performing non-invasive laboratory procedures and related studies or assisting duly licensed personnel in the performance of invasive laboratory procedures and related studies;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Performing non-invasive laboratory procedures and related studies or assisting duly licensed personnel in the performance of invasive laboratory procedures and related studies;¹

(2) [Giving injections, administering medications and requesting diagnostic studies;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Giving injections, administering medications, and requesting diagnostic studies;¹

(3) [Suturing and caring for facial wounds, traumatic wounds requiring suturing in layers and infected wounds;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Suturing and caring for facial wounds, traumatic wounds requiring suturing in layers, and infected wounds;¹

(4) [Writing prescriptions or ordering medications in an inpatient or outpatient setting in accordance with section 10 of this act; and] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Writing prescriptions or ordering medications in an inpatient or outpatient setting in accordance with section 10 of P.L.1991, c.378 (C.45:9-27.19);¹

(5) [Such other procedures as may be specified in accordance with protocols promulgated in accordance with subsection b. of section 15 of this act.] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] Prescribing the use of patient restraints; and

(6) Such other procedures as may be specified in accordance with protocols promulgated in accordance with subsection b. of section 15 of P.L.1991, c.378 (C.45:9-27.24).¹

c. [A physician assistant may assist a supervising surgeon in the operating room when a qualified assistant physician is not required by the board and a second assistant is deemed necessary by the supervising surgeon.] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] A physician assistant may assist a supervising surgeon in the operating room when a qualified assistant physician is not required by the board and a second assistant is deemed necessary by the supervising surgeon.

d. A physician assistant may perform medical services beyond those explicitly authorized in this section, when such services are delegated by a supervising physician with whom the physician assistant has signed a delegation agreement pursuant to section 8 of P.L.1991, c.378 (C.45:9-27.17). The procedures delegated to a physician assistant shall be limited to those customary to the supervising physician's specialty and within the supervising physician's competence and training.¹

(cf: P.L.1998, c.125, s.1)

5. Section 8 of P.L.1991, c.378 (C.45:9-27.17) is amended to read as follows:

8. a. [A physician may delegate to a physician assistant under his supervision only those procedures identified in section 7 of this act.] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

b. Any physician who permits a physician assistant under [his] the physician's supervision to practice contrary to the provisions of ¹[this act] P.L.1991, c.378 (C.45:9-27.10 et seq.)¹ shall be deemed to have engaged in professional misconduct in violation of subsection e. of section 8 of P.L.1978, c.73 (C.45:1-21) and shall be subject to disciplinary action by the board pursuant to P.L.1978, c.73 (C.45:1-14 et seq.);

c. In the performance of [a medical procedure] all practice-related activities, including, but not limited to, the ordering of diagnostic, therapeutic, and other medical services, a physician assistant shall be conclusively presumed to be the agent of the physician under whose supervision the physician assistant is [performing] practicing ¹[medicine]¹.

d. A physician who supervises a physician assistant ¹[shall] may¹ maintain a written ¹delegation¹ agreement with the physician assistant. ¹A physician assistant shall sign a separate written agreement with each physician who delegates medical services in accordance with the provisions of subsection d. of section 7 of P.L.1991, c.378 (C.45:9-27.16). However, a written delegation agreement may be executed by a single-specialty physician practice, provided it is signed by all of the delegating physicians supervising the physician assistant. In the case of a multi-specialty physician practice, a written delegation agreement may be executed for each physician specialty within the practice, provided it is signed by all of the delegating physicians supervising the physician assistant in that specialty area. Nothing in this section shall authorize the execution of a global written delegation agreement between a physician assistant and a multi-specialty physician practice.¹ The agreement shall ¹:

(1)¹ state that the physician will exercise supervision over the physician assistant in accordance with the provisions of P.L.1991, c.378 (C.45:9-27.10 et seq.) and any rules adopted by the board ¹[and will retain professional and legal responsibility for the care rendered by the physician assistant. The agreement shall] ;

(2)¹ be signed ¹and dated annually¹ by the physician and the physician assistant ¹[. The agreement shall] , and updated as necessary to reflect any changes in the practice or the physician assistant's role in the practice; and

(3)¹ be kept on file at the practice site ¹[and made available to the board upon request] , be provided to the Physician Assistant Advisory Committee, and be kept on file by the committee.

e. The delegation agreement shall include, but need not be limited to, the following provisions:

(1) The physician assistant's role in the practice, including any specific aspects of care that require prior consultation with the supervising physician;

(2) A determination of whether the supervising physician requires personal review of all charts and records of patients and countersignature by the supervising physician of all medical services performed under the delegation agreement, including prescribing and administering medication as authorized under section 10 of P.L.1991, c.378 (C.45:9-27.19). This provision shall state the specified time period in which a review and countersignature shall be completed by the supervising physician. If no review and countersignature is necessary, the agreement must specifically state such provision; and

(3) The locations of practice where the physician assistant may practice under the delegation agreement, including licensed facilities in which the physician authorizes the physician assistant to provide medical services¹ .

(cf: P.L.1991, c.378, s.8)

6. Section 9 of P.L.1991, c.378 (C.45:9-27.18) is amended to read as follows:

9. a. A physician assistant [and a temporary licensed physician assistant] shall be under the [direct] supervision of a physician at all times during which the physician assistant [or temporary licensed physician assistant] is working in [his] an official capacity.

b. [In an inpatient setting, direct supervision] Supervision of a physician assistant shall [include, but not be limited to:] be continuous but shall not be construed as necessarily requiring the physical presence of the supervising physician, provided that the supervising physician and physician assistant ¹[are or can be easily in contact with each other by] maintain contact through¹ electronic ¹, or other means of,¹ communication.

(1) [continuing or intermittent presence with constant availability through electronic communications;] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

(2) [regularly scheduled review of the practice of the physician assistant; and] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

(3) [personal review by a physician of all charts and records of patients and countersignature by a physician of all medical orders, including prescribing and administering medication, within 24 hours of their entry by the physician assistant.] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

c. [In an outpatient setting, direct supervision of a physician assistant shall include, but not be limited to:] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

(1) [constant availability through electronic communications;] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

(2) [regularly scheduled review of the practice of the physician assistant; and] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

(3) [personal review by a physician of the charts and records of patients and countersignature by a physician of all medical orders, within seven days of their entry by the physician assistant, except that in the case of any medical order prescribing or administering medication, a physician shall review and countersign the order within 48 hours of its entry by the physician assistant.] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

d. [In any setting, direct supervision of a temporary licensed physician assistant shall include, but not be limited to:] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

(1) [continuing physical presence of a physician or a licensed physician assistant;] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

(2) [regularly scheduled review by a physician of the practice of the temporary licensed physician assistant; and] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

(3) [personal review by a physician of all charts and records of patients within 24 hours of an entry by the temporary licensed physician assistant.] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

e. It is the obligation of each supervising physician and physician assistant to ensure that: (1) the physician assistant's scope of practice is identified; (2) delegation of medical tasks is appropriate to the physician assistant's level of competence; (3) the relationship of, and access to, the supervising physician is defined; and (4) a process for evaluation of the physician assistant's performance is established.

(cf: P.L.1998, c.125, s.2)

7. Section 10 of P.L.1991, c.378 (C.45:9-27.19) is amended to read as follows:

10. A physician assistant [treating a patient in an inpatient or outpatient setting] may order [or] , prescribe, dispense, and administer medications [, subject to the following conditions:] and medical devices to the extent delegated by a supervising physician.

a. [controlled] Controlled dangerous substances may only be ordered or prescribed if:

(1) a supervising physician has authorized a physician assistant to order or prescribe Schedule II, III, IV or V controlled dangerous substances [in order to:] ¹in order to¹ ;

(a) [continue or reissue an order or prescription for a controlled dangerous substance issued by the supervising physician;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] continue or reissue an order or prescription for a controlled dangerous substance issued by the supervising physician;¹

(b) [otherwise adjust the dosage of an order or prescription for a controlled dangerous substance originally ordered or prescribed by the supervising physician, provided there is prior consultation with the supervising physician;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] otherwise adjust the dosage of an order or prescription for a controlled dangerous substance originally ordered or prescribed by the supervising physician, provided there is prior consultation with the supervising physician;¹

(c) [initiate an order or prescription for a controlled dangerous substance for a patient, provided there is prior consultation with the supervising physician if the order or prescription is not pursuant to subparagraph (d) of this paragraph; or] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] initiate an order or prescription for a controlled dangerous substance for a patient, provided there is prior consultation with the supervising physician if the order or prescription is not pursuant to subparagraph (d) of this paragraph; or¹

(d) [initiate an order or prescription for a controlled dangerous substance as part of a treatment plan for a patient with a terminal illness, which for the purposes of this subparagraph means a medical condition that results in a patient's life expectancy being 12 months or less as determined by the supervising physician;] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] initiate an order or prescription for a controlled dangerous substance as part of a treatment plan for a patient with a terminal illness, which for the purposes of this subparagraph means a medical condition that results in a patient's life expectancy being 12 months or less as determined by the supervising physician;¹

(2) the physician assistant has registered with, and obtained authorization to order or prescribe controlled dangerous substances from, the federal Drug Enforcement Administration, and any other appropriate State and federal agencies; and

(3) the physician assistant complies with [all requirements which the board shall establish by regulation for the administration of controlled dangerous substances pursuant to section 15 of P.L.1991, c.378 (C.45:9-27.24) and applicable requirements with respect to educational programs approved by the board pursuant to section 17 of P.L.1991, c.378 (C.45:9-27.26) and] ¹all requirements which the board shall establish by regulation for the ordering, prescription, or administration of controlled dangerous substances pursuant to section 15 of P.L.1991, c.378 (C.45:9-27.24), applicable educational program requirements approved by the board pursuant to section 17 of P.L.1991, c.378 (C.45:9-27.26), and¹ continuing professional education programs approved pursuant to section 16 of P.L.1991, c.378 (C.45:9-27.25);

b. [the order or prescription is administered in accordance with protocols or specific physician direction pursuant to subsection b. of section 7 of P.L.1991, c.378 (C.45:9-27.16);] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

c. [the prescription states whether it is written pursuant to protocol or specific physician direction; and] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

d. [the physician assistant signs his own name, prints his name and license number and prints the supervising physician's name, and in the case of an order or prescription for a controlled dangerous substance, prints the physician assistant's Drug Enforcement Administration registration number.] ¹[(Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)] In the case of an order or prescription for a controlled dangerous substance, the physician assistant shall print thereon the physician assistant's Drug Enforcement Administration registration number.¹

e. The dispensing of medication or a medical device by a physician assistant shall comply with relevant federal and State regulations, and shall occur only if: (1) pharmacy services are not reasonably available; (2) it is in the best interest of the patient; or (3) the physician assistant is rendering emergency medical assistance.

f. A physician assistant may request, receive, and sign for prescription drug samples and may distribute those samples to patients.

(cf: P.L.2005, c.48, s.1)

8. Section 12 of P.L.1991, c.378 (C.45:9-27.21) is amended to read as follows:

12. The committee shall annually elect from among its members a president and vice-president. The committee shall meet [at least twice each year] ¹[monthly] six times a year¹ and may hold additional meetings ¹[,]¹ as necessary to discharge its duties. In addition to such meetings, the committee shall meet at the call of the president, the board, or the Attorney General.

(cf: P.L.1992, c.102, s.7)

9. Section 14 of P.L.1991, c.378 (C.45:9-27.23) is amended to read as follows:

14. a. The committee may have the following powers and duties, as delegated by the board:

(1) to evaluate and pass upon the qualifications of candidates for licensure;

(2) to take disciplinary action, in accordance with P.L.1978, c.73 (C.45:1-14 et seq.) against a physician assistant who violates any provision of this act; and

(3) [to adopt and administer the examination to be taken by applicants for licensure; and] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

(4) subject to the requirements of section 16 of [this act] P.L.1991, c.378 (C.45:9-27.25), to adopt standards for and approve continuing education programs

b. In addition to the powers and duties specified in subsection a. of this section, the committee may make recommendations to the board regarding any subjects pertinent to this act or to the practice of physician assistants.

(cf: P.L.1992, c.102, s.9)

10. Section 17 of P.L.1991, c.378 (C.45:9-27.26) is amended to read as follows:

17. [The] In consultation with the committee, the board shall, in addition to such other powers and duties as it may possess by law:

a. Administer and enforce the provisions of [this act] P.L.1991, c.378 (C.45:9-27.10 et seq.);

b. Adopt and promulgate rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to effectuate the purposes of [this act] P.L.1991, c.378 (C.45:9-27.10 et seq.);

c. Establish professional standards for persons licensed under [this act] P.L.1991, c.378 (C.45:9-27.10 et seq.);

d. Conduct hearings pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), except that the board shall have the right to administer oaths to witnesses, and shall have the power to issue subpoenas for the compulsory attendance of witnesses and the production of pertinent books, papers, or records;

e. Conduct proceedings before any board, agency, or court of competent jurisdiction for the enforcement of the provisions of [this act] P.L.1991, c.378 (C.45:9-27.10 et seq.);

f. Evaluate and pass upon the qualifications of candidates for licensure;

g. [Establish standards for and approve educational programs for physician assistants as required by paragraph (3) of subsection a. of section 4 of this act;] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

h. [Adopt and administer the examination to be taken by applicants for licensure;] (Deleted by amendment, P.L. , c. )(pending before the Legislature as this bill)

i. Subject to the requirements of section 16 of [this act] P.L.1991, c.378 (C.45:9-27.25), establish standards for and approve continuing education programs; and

j. Have the enforcement powers provided pursuant to P.L.1978, c.73 (C.45:1-14 et seq.).

(cf: P.L.1992, c.102, s.12)

¹11. (New Section) A physician assistant who engages in clinical practice in this State is required to be covered by medical malpractice liability insurance, or if such liability coverage is not available, by a letter of credit. The board shall establish by regulation the minimum amount for medical malpractice liability insurance coverage or lines of credit.

The physician assistant shall notify the board of the name and address of the insurance carrier or the institution issuing the letter of credit on the physician assistant's license renewal form.

A physician assistant who is in violation of this section is subject to disciplinary action and civil penalties pursuant to sections 8, 9, and 12 of P.L.1978, c.73 (C.45:1-21 to 22 and 45:1-25).

The board shall notify all licensed physician assistants of the requirements of this section within 30 days of the date of enactment of P.L. , c. (C. ) (pending before the Legislature as this bill).¹

¹[11.] 12.¹ (New section) a. A physician assistant licensed in this State, or licensed or authorized to practice in any other jurisdiction of the United States or credentialed as a physician assistant by a federal employer, who is responding to a need for medical care created by an emergency or a State or local disaster, excluding an emergency situation that occurs in the place of the physician assistant's employment, may render such care as the physician assistant is able to provide without supervision, or with such supervision as is available.

b. A physician who supervises a physician assistant providing medical care in response to an emergency or a State or local disaster shall not be required to meet the requirements set forth for a supervising physician in P.L.1991, c.378 (C.45:9-27.10 et seq.).

c. A physician assistant licensed in this State, or licensed or authorized to practice in any other jurisdiction of the United States, who voluntarily and gratuitously, and other than in the ordinary course of employment or practice, renders emergency medical assistance, shall not be liable for civil damages for any personal injury that results from an act or omission by the physician assistant in rendering emergency care that may constitute ordinary negligence. The immunity granted by this section shall not apply to an act or omission constituting gross, willful, or wanton negligence or when the medical assistance is rendered at a hospital, physician's office, or other health care delivery entity where those services are normally rendered. A physician who supervises a physician assistant voluntarily and gratuitously providing emergency care as described in this subsection shall not be liable for civil damages for any personal injury that results from an act or omission by the physician assistant rendering emergency care.

¹[12.] 13.¹ Section 4 of P.L.1983, c.308 (C.26:6-8.1) is amended to read as follows:

4. a. Where there has been an apparent death that is not governed by the provisions of section 4 of P.L.1991, c.90 (C.26:6A-4), a registered professional nurse licensed by the New Jersey Board of Nursing under P.L.1947, c.262 (C.45:11-23 et seq.) , or a physician assistant licensed pursuant to P.L.1991, c.378 (C.45:9-27.10 et seq.) may make the actual determination and pronouncement of death and shall attest to this pronouncement by: signing in the space designated for this signature on the certificate of death under R.S.26:6-7; or, for the purposes of the NJ-EDRS, transmitting orally or in writing a report of the pronouncement to the attending, covering or resident physician, or the county medical examiner.

b. (Deleted by amendment, P.L.2006, c.86).

(cf: P.L.2006, c.86, s.1)

¹[13.] 14.¹ Section 1 of P.L.1988, c.125 (C.26:6-8.2) is amended to read as follows:

1. If the attending physician, registered professional nurse, physician assistant, or State or county medical examiner who makes the actual determination and pronouncement of death determines or has knowledge that the deceased person was infected with human immunodeficiency virus (HIV) or hepatitis B virus or that the deceased person suffered from acquired immune deficiency syndrome (AIDS), AIDS related complex (ARC), or any of the contagious, infectious, or communicable diseases as shall be determined by the Commissioner of the Department of Health, the attending physician, registered professional nurse, physician assistant, or State or county medical examiner shall immediately place with the remains written notification of the condition and shall provide written notification of the condition to the funeral director who is responsible for the handling and the disposition of the body.

(cf: P.L.1988, c.125, s.1)

¹[14.] 15.¹ The following sections are repealed:

Section 5 of P.L.1991, c.378 (C.45:9-27.14);

Section 15 of P.L.1991, c.378 (C.45:9-27.24); and

Section 3 of P.L.1993, c.337 (C.45:9-27.19a)

¹[15.] 16.¹This act shall take effect on the first day of the seventh month next following the date of enactment, but the State Board of Medical Examiners and the Physician Assistant Advisory Committee may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.