NEW JERSEY ~ STATUTE

Transcription

1 NEW JERSEY ~ STATUTE STATUTE New Jersey Revised Statutes 45: et seq; 45:1-14 through -27 DATE Enacted 1992 REGULATORY BODY New Jersey Board of Medical Examiners PA DEFINED A person who holds a current, valid license 45: SCOPE OF PRACTICE PRESCRIBING/DISPENSING PA may perform the following procedures: take patient history, perform physical exam, identify problems, record information, interpret and present data to physician suture and care for wounds, including removing sutures and clips and changing dressings, except for facial wounds, traumatic wounds requiring suturing in layers and infected wounds patient counseling and education assisting physician in an inpatient setting by conducting patient rounds, recording progress notes, determining and implementing therapeutic plans jointly with the supervising physician, compiling and recording pertinent narrative case summaries assisting 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 facilitating patient referrals such other procedures suitable for routine performance by PAs as designated by the board PA may perform the following procedures only when directed, ordered or prescribed by the supervising physician or specified in accordance with protocols promulgated by the board: performing or assisting with non-invasive lab procedures and related studies giving injections, administering medication and requesting diagnostic studies suturing and caring for facial wounds, traumatic wounds requiring suturing in layers, and infected wounds other procedures specified in regulations PA may assist a supervising surgeon in the operating room when a qualified assistant physician is not required by the board of medical examiners and a second assistant is deemed necessary by the surgeon. PA treating patients in an inpatient setting may order medications pursuant to protocols or specific physician directions. 45: In the performance of a medical procedure, PA shall be conclusively presumed to be the agent of the supervising physician. 45: PA may write prescriptions when delegated to do so by supervising physician. Prescribing must be directed, ordered or prescribed by supervising physician or specified in accordance with protocols. 45: PAs may order or prescribe controlled medications in Schedules II-V if authorized by supervising physician and order or prescription is to: Continue or reissue order or prescription of controlled drug issued by supervising physician Adjust dose of controlled drug prescribed by physician (prior consultation with physician required) Initiate order or prescription for controlled drug with prior consultation with supervising physician Initiate order or prescription for controlled drug as part of treatment plan for patient with terminal illness. Prescriptions must contain PA s name, signature and license number and name of supervising physician. Prescription must state whether it is written pursuant to protocol or specific physician direction. Prescription for controlled drug must contain PA s DEA number. 45: SUPERVISION DEFINED PAs PER PHYSICIAN PA shall be under direct supervision of a physician when working in his official capacity. In an inpatient setting, this includes but is not limited to the continuing or intermittent presence of the physician with constant availability through electronic communications; regularly scheduled review of the PA s practice; personal review by a physician of all charts and records and countersignature of all medical orders within 24 hours. In an outpatient setting, the chart review and countersignature must occur within 7 days; charts containing medical orders, prescriptions, or administration of medication must be reviewed and countersigned within 48 hours. 45:

2 NEW JERSEY ~ STATUTE Continued APPLICATION By PA to the board for license 45: A physician, health care facility, institution or veterans home which employs a PA shall file with the board a notice of employment within 10 days after employment commences, on a form and in accordance with rules to be promulgated by the board. 45: QUALIFICATIONS At least 18 years old Good moral character Graduate of PA program accredited by CAHEA or its successor Passage of NCCPA or successor exam 45: TEMPORARY PERMIT TERMINATION CONTINUING EDUCATION TITLE/PRACTICE PROTECTION IDENTIFICATION PHYSICIAN LIABILITY FEE/RENEWAL SCHEDULE Board shall issue temporary license to applicant who meets all other requirements for licensure with exception of exam if applicant is either waiting to take the first scheduled exam following graduation or is awaiting results of the exam. Temporary license expires upon applicant s receipt of notification of failure to pass exam. 45: PA with temporary licenses must practice with continuing physical presence of physician or licensed PA. Must have regularly scheduled physician review of practice and must have all charts and records reviewed by physician within 24 hours. 45: Orders written by PA with temporary license must be countersigned by physician or licensed PA prior to execution. 45: a The board or the committee shall approve and accredit CME courses, establish CME standards and the number of CME credits required for license renewal. 45: No person shall practice as a physician assistant or present, call or represent himself as a PA unless he is licensed pursuant to this law. No person shall assume, represent himself as, or use the title or designation physician assistant or physician assistant-certified or the abbreviation PA-C or any other title or designation which indicates or implies that he is a PA unless licensed pursuant to this law. 45: PA must conspicuously wear an identification tag using the term physician assistant whenever acting in that capacity. Patients must be informed at the time services are rendered that they are to be performed by a PA. 45: The board shall establish by rule the fees for licenses, renewals or other services. Licenses shall be issued for a period of 2 years. 45: PROGRAM APPROVAL (accreditation by CAHEA or its successor agency is recognized) BOARD REPRESENTATION/ PA Advisory Committee to medical board composed of 3 PAs, 1 physician and 1 public ADVISORY COMMITTEE member, appointed by governor. 45: One PA is appointed as a member of the board. 45:9-1 BOARD POWERS PA Advisory Committee may be delegated the following powers and duties by the board: evaluate candidates for licensure take disciplinary action adopt and administer the exam adopt standards for and approve CME programs make recommendations to the board regarding any pertinent subjects. 45: The board may adopt regulations after giving consideration to advice from committee: designating additional procedures PAs may perform promulgating, establishing and adopting protocols 45: The board may: administer and enforce provisions of law adopt and promulgate rules establish professional standards for licensees conduct hearings or proceedings before any jurisdiction evaluate candidates for licensure establish standards for and approve PA educational programs adopt and administer licensing exam establish standards for CME have enforcement powers outlined in uniform enforcement law 45:

3 NEW JERSEY ~ STATUTE Continued DISCIPLINARY POWERS VIOLATIONS/PENALTY PAYMENT FOR SERVICES GRANDFATHER CLAUSE STUDENTS LOCUM TENENS OTHER The provisions of the uniform enforcement law ( 45:1-14 et seq) shall apply to this act. The authority of the board may be delegated to the committee at board s discretion. 45: See Disciplinary Powers

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5 NEW JERSEY ~ REGULATIONS REGULATIONS NJAC 13:35-2B; 13: DATE REGULATORY BODY 4/05; Rules to implement statutory change enacted in 2005 not yet adopted New Jersey Board of Medical Examiners PA DEFINED A person who holds a current valid license to practice in this state. 13:35-2B.2 SCOPE OF PRACTICE PRESCRIBING/DISPENSING SUPERVISION DEFINED PAs PER PHYSICIAN PA may: perform a history and physical, identify problems, record information and interpret and present information to the supervising physician; determine and implement therapeutic plans jointly with the supervising physician and record case summaries suture and care for wounds except facial wounds, traumatic wounds requiring suturing in layers and infected wounds provide patient counseling and education conduct rounds and record patient progress notes assist physician in delivery of services to patents requiring continuing care in home, nursing home, extended care facility, office practice or other setting facilitate referral collect fluids for diagnostic purposes place access catheters and tubes for diagnostic, therapeutic or interventional purposes perform minor surgical procedures such as excisions, I&D, debridement and packing of wounds apply and remove medical and surgical appliances and devices manage emergency and life threatening conditions perform low-risk obstetrical deliveries in licensed hospital with supervising physician or physician designee on premises other procedures established by the employer provided procedures are within training and experience of supervising physician and PA; subject to board review PA may perform the following when they are within training and experience of both PA and supervising physician when supervising physician directs PA to perform the procedure or orders or prescribes the procedure or when procedure is specified in a written board-approved protocol: non-invasive lab procedures and related studies or assist in the performance of invasive laboratory procedures and related studies give injections, administer medications and order diagnostic studies suturing and caring for facial wounds, traumatic wounds requiring suturing in layers and infected wounds ordering medications and prescribing non-controlled substances in an inpatient setting assist a supervising surgeon as a first or second assistant when deemed necessary by surgeon and qualified assistant physician is not required by law performing other procedures for diagnostic, therapeutic or interventional purpose such as introduction of contrast, endoscopy and aspiration of fluids from joints and body cavities, collection of CSF, biopsy of tissues, placement of central venous catheters or chest tubes and endotracheal intubation (credentialing guidelines for use by physician and institutions included) Physician or designee shall be available on premises for IV or intra-arterial injection of contrast, endoscopic biopsy, and elective intubation. 13:35-2B.4 PA may issue prescriptions for non-controlled medications. Prescription blanks must contain PA s name, license number, address and phone, name of supervising physician, statement indicating whether prescription is written pursuant to protocol or specific physician direction, patient information, and PA s signature. 13:35-2B.12 PA may not render care unless supervising physician or designee is continuously or intermittently present on-site with constant availability through electronic communication in the inpatient setting; supervising physician or designee is constantly available through electronic communication in outpatient setting; supervising physician regularly reviews practice of PA and reviews all charts and countersigns all orders within 24 hours in the inpatient setting and within 7 days in the outpatient setting. Charts that contain medication order or prescription in outpatient setting must be reviewed and countersigned within 48 hours. 13:35-2B.10 No supervising physician may supervise more than 2 PAs at one time in a private practice (non-hospital or institution based) or 4 PAs at one time in other settings. Board may grant exceptions. 13:35-2B.10

6 NEW JERSEY REGULATIONS Continued APPLICATION By PA for license on board forms 13:35-2B.5 QUALIFICATIONS TEMPORARY PERMIT PA shall file notice of employment for each place of employment on board forms within 10 days after employment commences. 13:35-2B.3 18 years of age Good moral character Graduation from PA program accredited by CAHEA or successor Passage of NCCPA exam Applicant who holds license in state with substantially equivalent requirements shall be deemed to satisfy exam requirements. 13:35-2B.5 Applicant for licensure who is awaiting next scheduled NCCPA exam or awaiting results of exam may apply for temporary license to be employed under direct supervision of physician. 13:35-2B.13 Temporary licensee may not issue prescriptions. 13:35-2B.14 Temporary licensee must practice with on-site supervision of supervising physician, designee, or licensed PA who countersigns any order immediately after chart entry. Supervising physician or physician designee must review all charts and records within 24 hours of chart entry and must countersign medication order written by temporary licensee and countersigned by PA. 13:35-2B.15 Temporary license expires immediately upon notification of exam failure or 30 days after notification of successful completion of exam. Temporary license may not be renewed except in extenuating circumstances such as applicant s critical illness or incapacitation. 13:35-2B.16 TERMINATION PA must file report on change in employment or supervisor to board within 10 days. 13:35-2B.3 CONTINUING EDUCATION 40 Category I hours biennially; may be waived for hardship. 13:35-2B.8,.9 TITLE/PRACTICE PROTECTION IDENTIFICATION PHYSICIAN LIABILITY Upon initial patient contact, PA or supervising physician must advise that PA is a physician assistant. PAs must conspicuously wear an identification tag which uses the term physician assistant. 13:35-2B.3 Supervising physician who is department head may assign PA under his or her supervision to attending and staff physicians who shall be responsible for PA practice during assignment. In all other settings in which PA is employed, supervising physician of record is considered to be person responsible for practice of PA. 13:35-2B.10 FEE/RENEWAL SCHEDULE Biennial renewal. 13:35-2B.7 PROGRAM APPROVAL BOARD REPRESENTATION/ ADVISORY COMMITTEE BOARD POWERS $125 application fee $220 initial license fee $220 biennial renewal DISCIPLINARY POWERS Board may refuse to issue, suspend, or revoke any license. 13:35-2B.6 VIOLATIONS/PENALTY PAYMENT FOR SERVICES GRANDFATHER CLAUSE STUDENTS LOCUM TENENS OTHER To the extent a PA is charged with independent responsibility for the provision of information used to prepare bills and claim forms, such information shall accurately reflect the treatment or services rendered. 113:35-2B.11