CHAPTER 5. SCOPE OF PRACTICE
IC 25-27.5-5
Chapter 5. Scope of Practice
IC 25-27.5-5-1
Application of chapter; prohibitions
Sec. 1. (a) This chapter does not apply to the practice of otherhealth care professionals set forth under IC 25-22.5-1-2(a)(1) throughIC 25-22.5-1-2(a)(19).
(b) This chapter does not allow the independent practice by aphysician assistant, including any of the activities of other healthcare professionals set forth under IC 25-22.5-1-2(a)(1) throughIC 25-22.5-1-2(a)(19).
(c) This chapter does not exempt a physician assistant from therequirements of IC 16-41-35-29.
As added by P.L.227-1993, SEC.11. Amended by P.L.90-2007,SEC.23.
IC 25-27.5-5-2
Practice with supervising physician; examination by physician;supervisory agreement
Sec. 2. (a) A physician assistant must engage in a dependentpractice with physician supervision. A physician assistant mayperform, under the supervision of the supervising physician, theduties and responsibilities that are delegated by the supervisingphysician and that are within the supervising physician's scope ofpractice, including prescribing and dispensing drugs and medicaldevices. A patient may elect to be seen, examined, and treated by thesupervising physician.
(b) If a physician assistant determines that a patient needs to beexamined by a physician, the physician assistant shall immediatelynotify the supervising physician or physician designee.
(c) If a physician assistant notifies the supervising physician thatthe physician should examine a patient, the supervising physicianshall:
(1) schedule an examination of the patient in a timely mannerunless the patient declines; or
(2) arrange for another physician to examine the patient.
(d) If a patient is subsequently examined by the supervisingphysician or another physician because of circumstances describedin subsection (b) or (c), the visit must be considered as part of thesame encounter except for in the instance of a medically appropriatereferral.
(e) A supervising physician or physician assistant who does notcomply with subsections (b) through (d) is subject to discipline underIC 25-1-9.
(f) A physician assistant's supervisory agreement with asupervising physician must:
(1) be in writing;
(2) include all the tasks delegated to the physician assistant bythe supervising physician; (3) set forth the supervisory plans for the physician assistant,including the emergency procedures that the physician assistantmust follow; and
(4) specify the name of the drug or drug classification beingdelegated to the physician assistant and the protocol thephysician assistant shall follow in prescribing a drug.
(g) The physician shall submit the supervisory agreement to theboard for approval. The physician assistant may not prescribe a drugunder the supervisory agreement until the board approves thesupervisory agreement. Any amendment to the supervisoryagreement must be resubmitted to the board for approval, and thephysician assistant may not operate under any new prescriptiveauthority under the amended supervisory agreement until theagreement has been approved by the board.
(h) A physician or a physician assistant who violates thesupervisory agreement described in this section may be disciplinedunder IC 25-1-9.
As added by P.L.227-1993, SEC.11. Amended by P.L.90-2007,SEC.24; P.L.177-2009, SEC.55.
IC 25-27.5-5-3
Agents of supervising physicians
Sec. 3. A physician assistant is the agent of the supervisingphysician in the performance of all practice related activities,including the ordering of diagnostic, therapeutic, and other medicalservices.
As added by P.L.227-1993, SEC.11.
IC 25-27.5-5-4
Prescribing, dispensing, and administering drugs and medicaldevices
Sec. 4. (a) Except as provided in this section, a physician assistantmay prescribe, dispense, and administer drugs and medical devicesor services to the extent delegated by the supervising physician.
(b) A physician assistant may not prescribe, dispense, oradminister ophthalmic devices, including glasses, contact lenses, andlow vision devices.
(c) As permitted by the board, a physician assistant may use ordispense only drugs prescribed or approved by the supervisingphysician. A physician assistant may not prescribe or dispense thefollowing drugs:
(1) A schedule I substance listed in IC 35-48-2-4.
(2) A schedule II substance listed in IC 35-48-2-6.
(3) A schedule III, schedule IV, or schedule V drug if the drugcontains oxycodone.
However, a physician assistant may prescribe one (1) dose of a druglisted in subdivision (2) or (3) for immediate administration if thepatient is in an inpatient hospital post-operative setting and thephysician is unavailable to make the prescription.
(d) A physician assistant may request, receive, and sign for
professional samples and may distribute professional samples topatients if the samples are within the scope of the physicianassistant's prescribing privileges delegated by the supervisingphysician.
(e) A physician assistant may not prescribe drugs unless thephysician assistant has successfully completed at least thirty (30)contact hours in pharmacology from an educational program that isapproved by the committee.
(f) A physician assistant may not prescribe, administer, or monitorgeneral anesthesia, regional anesthesia, or deep sedation as definedby the board. A physician assistant may not administer moderatesedation:
(1) if the moderate sedation contains agents in which themanufacturer's general warning advises that the drug should beadministered and monitored by an individual who is:
(A) experienced in the use of general anesthesia; and
(B) not involved in the conduct of the surgical or diagnosticprocedure; and
(2) during diagnostic tests, surgical procedures, or obstetricprocedures unless the following conditions are met:
(A) A physician is physically present in the area, isimmediately available to assist in the management of thepatient, and is qualified to rescue patients from deepsedation.
(B) The physician assistant is qualified to rescue patientsfrom deep sedation and is competent to manage acompromised airway and provide adequate oxygenation andventilation by reason of meeting the following conditions:
(i) The physician assistant is certified in advancedcardiopulmonary life support.
(ii) The physician assistant has knowledge of and trainingin the medications used in moderate sedation, includingrecommended doses, contraindications, and adversereactions.
(g) Before a physician assistant may prescribe drugs, thephysician assistant must have been continuously employed as aphysician assistant for not less than one (1) year after graduatingfrom a physician assistant program approved by the committee. Tobe considered to have been continuously employed as a physicianassistant for a year for purposes of this subsection, a person musthave worked as a physician assistant more than one thousand eighthundred (1,800) hours during the year.
As added by P.L.227-1993, SEC.11. Amended by P.L.90-2007,SEC.25.
IC 25-27.5-5-5
Display of license; name tags
Sec. 5. A physician assistant licensed under IC 25-27.5 shall:
(1) keep the physician assistant's license available for inspectionat the primary place of business; and (2) when engaged in the physician assistant's professionalactivities, wear a name tag identifying the individual as aphysician assistant.
As added by P.L.227-1993, SEC.11. Amended by P.L.90-2007,SEC.26.
IC 25-27.5-5-6
Delegation of authority to prescribe drugs and medical devices
Sec. 6. (a) Except as provided in section 4(d) of this chapter, asupervising physician may delegate authority to a physician assistantto prescribe:
(1) legend drugs, except as provided in section 4(c) of thischapter; and
(2) medical devices (except ophthalmic devices, includingglasses, contact lenses, and low vision devices).
(b) Any prescribing authority delegated to a physician assistantmust be expressly delegated in writing by the physician assistant'ssupervising physician, including:
(1) the name of the drug or drug classification being delegatedby the supervising physician; and
(2) the protocols the physician assistant shall use whenprescribing the drug.
(c) A physician assistant who is delegated the authority toprescribe legend drugs or medical devices must do the following:
(1) Enter the following on each prescription form that thephysician assistant uses to prescribe a legend drug or medicaldevice:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to thephysician assistant by the NCCPA.
(C) The physician assistant's state license number.
(2) Comply with all applicable state and federal lawsconcerning prescriptions for legend drugs and medical devices.
(d) A supervising physician may delegate to a physician assistantthe authority to prescribe only legend drugs and medical devices thatare within the scope of practice of the licensed supervising physicianor the physician designee.
(e) A physician assistant who is delegated the authority toprescribe controlled substances under subsection (a), and inaccordance with the limitations specified in section 4(c) of thischapter, must do the following:
(1) Obtain an Indiana controlled substance registration and afederal Drug Enforcement Administration registration.
(2) Enter the following on each prescription form that thephysician assistant uses to prescribe a controlled substance:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to thephysician assistant by the NCCPA.
(C) The physician assistant's state license number.
(D) The physician assistant's federal Drug Enforcement
Administration (DEA) number.
(3) Comply with all applicable state and federal lawsconcerning prescriptions for controlled substances.
(f) A supervising physician may only delegate to a physicianassistant the authority to prescribe controlled substances:
(1) that may be prescribed within the scope of practice of thelicensed supervising physician or the physician designee;
(2) in an amount that does not exceed:
(A) a seven (7) day supply for treatment of a single acuteepisode of a condition or injury; or
(B) if a controlled substance cannot be dispensed in anamount that is small enough to meet the requirement ofclause (A), the smallest dispensable amount; and
(3) in accordance with the limitations set forth in section 4(c) ofthis chapter.
As added by P.L.90-2007, SEC.27.