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 other
health care professionals set forth under IC 25-22.5-1-2(a)(1) through
IC 25-22.5-1-2(a)(19).
(b) This chapter does not allow the independent practice by a
physician assistant, including any of the activities of other health
care professionals set forth under IC 25-22.5-1-2(a)(1) through
IC 25-22.5-1-2(a)(19).
(c) This chapter does not exempt a physician assistant from the
requirements 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 dependent
practice with physician supervision. A physician assistant may
perform, under the supervision of the supervising physician, the
duties and responsibilities that are delegated by the supervising
physician and that are within the supervising physician's scope of
practice, including prescribing and dispensing drugs and medical
devices. A patient may elect to be seen, examined, and treated by the
supervising physician.
(b) If a physician assistant determines that a patient needs to be
examined by a physician, the physician assistant shall immediately
notify the supervising physician or physician designee.
(c) If a physician assistant notifies the supervising physician that
the physician should examine a patient, the supervising physician
shall:
(1) schedule an examination of the patient in a timely manner
unless the patient declines; or
(2) arrange for another physician to examine the patient.
(d) If a patient is subsequently examined by the supervising
physician or another physician because of circumstances described
in subsection (b) or (c), the visit must be considered as part of the
same encounter except for in the instance of a medically appropriate
referral.
(e) A supervising physician or physician assistant who does not
comply with subsections (b) through (d) is subject to discipline under
IC 25-1-9.
(f) A physician assistant's supervisory agreement with a
supervising physician must:
(1) be in writing;
(2) include all the tasks delegated to the physician assistant by
the supervising physician;
(3) set forth the supervisory plans for the physician assistant,
including the emergency procedures that the physician assistant
must follow; and
(4) specify the name of the drug or drug classification being
delegated to the physician assistant and the protocol the
physician assistant shall follow in prescribing a drug.
(g) The physician shall submit the supervisory agreement to the
board for approval. The physician assistant may not prescribe a drug
under the supervisory agreement until the board approves the
supervisory agreement. Any amendment to the supervisory
agreement must be resubmitted to the board for approval, and the
physician assistant may not operate under any new prescriptive
authority under the amended supervisory agreement until the
agreement has been approved by the board.
(h) A physician or a physician assistant who violates the
supervisory agreement described in this section may be disciplined
under 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 supervising
physician in the performance of all practice related activities,
including the ordering of diagnostic, therapeutic, and other medical
services.
As added by P.L.227-1993, SEC.11.
IC 25-27.5-5-4
Prescribing, dispensing, and administering drugs and medical
devices
Sec. 4. (a) Except as provided in this section, a physician assistant
may prescribe, dispense, and administer drugs and medical devices
or services to the extent delegated by the supervising physician.
(b) A physician assistant may not prescribe, dispense, or
administer ophthalmic devices, including glasses, contact lenses, and
low vision devices.
(c) As permitted by the board, a physician assistant may use or
dispense only drugs prescribed or approved by the supervising
physician. A physician assistant may not prescribe or dispense the
following 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 drug
contains oxycodone.
However, a physician assistant may prescribe one (1) dose of a drug
listed in subdivision (2) or (3) for immediate administration if the
patient is in an inpatient hospital post-operative setting and the
physician is unavailable to make the prescription.
(d) A physician assistant may request, receive, and sign for
professional samples and may distribute professional samples to
patients if the samples are within the scope of the physician
assistant's prescribing privileges delegated by the supervising
physician.
(e) A physician assistant may not prescribe drugs unless the
physician assistant has successfully completed at least thirty (30)
contact hours in pharmacology from an educational program that is
approved by the committee.
(f) A physician assistant may not prescribe, administer, or monitor
general anesthesia, regional anesthesia, or deep sedation as defined
by the board. A physician assistant may not administer moderate
sedation:
(1) if the moderate sedation contains agents in which the
manufacturer's general warning advises that the drug should be
administered 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 diagnostic
procedure; and
(2) during diagnostic tests, surgical procedures, or obstetric
procedures unless the following conditions are met:
(A) A physician is physically present in the area, is
immediately available to assist in the management of the
patient, and is qualified to rescue patients from deep
sedation.
(B) The physician assistant is qualified to rescue patients
from deep sedation and is competent to manage a
compromised airway and provide adequate oxygenation and
ventilation by reason of meeting the following conditions:
(i) The physician assistant is certified in advanced
cardiopulmonary life support.
(ii) The physician assistant has knowledge of and training
in the medications used in moderate sedation, including
recommended doses, contraindications, and adverse
reactions.
(g) Before a physician assistant may prescribe drugs, the
physician assistant must have been continuously employed as a
physician assistant for not less than one (1) year after graduating
from a physician assistant program approved by the committee. To
be considered to have been continuously employed as a physician
assistant for a year for purposes of this subsection, a person must
have worked as a physician assistant more than one thousand eight
hundred (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 inspection
at the primary place of business; and
(2) when engaged in the physician assistant's professional
activities, wear a name tag identifying the individual as a
physician 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, a
supervising physician may delegate authority to a physician assistant
to prescribe:
(1) legend drugs, except as provided in section 4(c) of this
chapter; and
(2) medical devices (except ophthalmic devices, including
glasses, contact lenses, and low vision devices).
(b) Any prescribing authority delegated to a physician assistant
must be expressly delegated in writing by the physician assistant's
supervising physician, including:
(1) the name of the drug or drug classification being delegated
by the supervising physician; and
(2) the protocols the physician assistant shall use when
prescribing the drug.
(c) A physician assistant who is delegated the authority to
prescribe legend drugs or medical devices must do the following:
(1) Enter the following on each prescription form that the
physician assistant uses to prescribe a legend drug or medical
device:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to the
physician assistant by the NCCPA.
(C) The physician assistant's state license number.
(2) Comply with all applicable state and federal laws
concerning prescriptions for legend drugs and medical devices.
(d) A supervising physician may delegate to a physician assistant
the authority to prescribe only legend drugs and medical devices that
are within the scope of practice of the licensed supervising physician
or the physician designee.
(e) A physician assistant who is delegated the authority to
prescribe controlled substances under subsection (a), and in
accordance with the limitations specified in section 4(c) of this
chapter, must do the following:
(1) Obtain an Indiana controlled substance registration and a
federal Drug Enforcement Administration registration.
(2) Enter the following on each prescription form that the
physician assistant uses to prescribe a controlled substance:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to the
physician 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 laws
concerning prescriptions for controlled substances.
(f) A supervising physician may only delegate to a physician
assistant the authority to prescribe controlled substances:
(1) that may be prescribed within the scope of practice of the
licensed 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 acute
episode of a condition or injury; or
(B) if a controlled substance cannot be dispensed in an
amount that is small enough to meet the requirement of
clause (A), the smallest dispensable amount; and
(3) in accordance with the limitations set forth in section 4(c) of
this chapter.
As added by P.L.90-2007, SEC.27.