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Bill Summary · SB 345

SB 345 — PA Team‑Based Practice

Status: Passed 2nd Reading (introduced Feb 12, 2025)

Purpose / Intent

SB 345 changes how physician assistants (PAs) may be supervised and practice by creating a defined “team‑based” practice model. The bill aims to allow experienced PAs greater practice flexibility within physician‑led teams while preserving physician oversight and patient‑safety safeguards.

Key provisions

  • Definition — “Team‑based setting/practice” includes:

    • Medical practices majority‑owned by one or more licensed physicians where physician‑owners have “consistent and meaningful participation” in designing/implementing services;
    • Hospitals, clinics, nursing homes and similar facilities with active credentialing and quality programs and physician participation;
    • Explicit exclusion: practices that specialize in pain management are not eligible as team‑based settings.

  • Team‑based PA eligibility (new § 90‑9.3A):

    • Must practice in a qualifying team‑based setting.
    • Must document >4,000 hours of clinical practice as a licensed PA and >1,000 hours of clinical experience in the specific specialty with a physician in that specialty.
    • Must submit proof as required by the Medical Board (the Board may set additional requirements by rule).

  • Supervision / notification changes:

    • PAs practicing under the team‑based model are exempt from the statutory requirement to provide the Board the name/address/phone of a single supervising physician before initiating practice (existing notification still required for non‑team practices).
    • Limited volunteer PA license provisions amended to allow team‑based exemption for notification requirements.

  • Clinical responsibilities and oversight:

    • Team‑based PAs must collaborate, consult, or refer as appropriate; degree of collaboration can be set by employers, credentialing/privileging systems, and the Board by rule.
    • Perioperative (surgical or anesthesia‑related) services provided by team‑based PAs still must be supervised by a physician.

  • Prescribing and controlled substances:

    • Standard requirement that supervising physician supply written prescribing guidance and periodic review does not apply to PAs practicing in approved team‑based settings.
    • Separate restriction: when prescribing certain targeted controlled substances for pain (in facilities that primarily treat pain), the PA must personally consult the supervising physician before prescribing if therapy will exceed 30 days; ongoing prescriptions require physician consultation at least every 90 days.

  • Other technical changes:

    • Clarifies credential display (PAs must clearly designate PA credentials).
    • Board authorized to adopt rules to implement/substantiate team‑based practice requirements.

Who is affected

  • Primary: licensed physician assistants (expanded practice options if experienced), supervising physicians, medical practices, hospitals, clinics, and credentialing bodies.
  • Secondary: patients (may see expanded PA role and access to care), state medical board (rulemaking/oversight), employers (credentialing/privileging policies).

Implementation & procedural notes

  • The Board is authorized to adopt implementing rules and may require additional documentation.
  • As provided, SB 345 had passed second reading. If enacted, implementation will rely on Board rulemaking to define documentation and operational details (e.g., what constitutes “consistent and meaningful participation,” evidence required for hours worked, and credentialing standards).
  • Potential impacts to monitor: access to care improvements in team settings, quality/oversight outcomes, and specific safeguards around pain management and controlled‑substance prescribing.

Compiled from official sources — confirm details with the bill’s official record.

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