Register

Med 8.02 (5m) “Certificate" “ License" means documentary evidence issued by the board to applicants for certification licensure as a physician assistant who meet all of the requirements of the board.

SECTION 3. Med 8.02 (6) is amended to read:

Med 8.02 (6) “Supervision" means to coordinate, direct, and inspect continually the accomplishments of another, or to oversee with powers of direction and decision the implementation of one's own or another's intentions.

SECTION 4. Med 8.03 and 8.04 are amended to read:

Med 8.03 Council. As specified in s. 15.407 (1) and (2), Stats., the council shall advise the board on the formulation of rules on the education, examination, certification licensure and practice of a physician assistant.

Med 8.04 Educational program approval. The board shall approve only educational programs accredited and approved by the committee on allied health education and accreditation of the American medical association, the commission for accreditation of allied health education programs, or its successor agency.

SECTION 5. Med 8.05, (1) (intro.), the Note following (1) (a), and (cm) are amended to read:

Med 8.05 Panel review of applications; examinations required. The board may use a written examination prepared, administered and scored by the national commission on certification of physician assistants or its successor agency, or a written examination from other professional testing services as approved by the board.

(1) APPLICATION. (intro.) An applicant for examination for certification licensure as a physician assistant shall submit to the board:

Note: An application form may be obtained upon request to the Medical Examining Board located at Room 176, 1400 East Washington Avenue, P.O. Box 8935, Madison, Wisconsin 53702 53708.

(cm) Proof that the applicant is currently certified to assist primary care physicians by the national commission on certification of physician assistants or its successor agency.

SECTION 6. Med 8.05 (2) (b) 5. is amended to read:

Med 8.05 (2) (b) 5. Has not practiced patient care as a physician assistant for a period of 3 years prior to application, unless the applicant has been graduated from a school approved an approved educational program for physician assistants within that period.

SECTION 7. Med 8.05 (2) (b) 10. and 11. are repealed.

SECTION 8. Med 8.05 (2) (c) and (d) are amended to read:

Med 8.05 (2) (c) An application filed under this chapter shall be reviewed by an application review panel of at least 2 council members designated by the chairperson of the board to determine whether an applicant is required to complete an oral examination under par. (a). If the application review panel is not able to reach unanimous agreement on whether an applicant is eligible for certification licensure without completing an oral examination, the application shall be referred to the board for a final determination.

(d) Where both written and oral examinations are required they shall be scored separately and the applicant shall achieve a passing grade on both examinations to qualify for a certificate license.

SECTION 9. Med 8.05 (4) (title) and (4) are amended to read:

Med 8.05 (4) (title) CERTIFICATION LICENSURE; RENEWAL. At the time of certification licensure and each biennial registration of certification licensure thereafter, a physician assistant shall list with the board the name and address of the supervising physician and shall notify the board within 20 days of any change of a supervising physician.

SECTION 10. Med 8.06 (title), (1) (intro.), (b), (c), (2) (a), (b) and (3) are amended to read:

Med 8.06 (title) Temporary certificate license. (1) (intro.) An applicant` for certification licensure may apply to the board for a temporary certificate license to practice as a physician assistant if the applicant:

(b) Is a graduate of an approved school and is scheduled to take the examination for primary care physician's physician assistants required by s. Med 8.05 (1) or has taken the examination and is awaiting the results; or

(c) Submits proof of successful completion of the examination required by s. Med 8.05 (1) and applies for a temporary certificate license no later than 30 days prior to the date scheduled for the next oral examination.

(2) (a) Except as specified in par. (b), a temporary certificate license expires on the date the board grants or denies an applicant permanent certification licensure. Permanent certification licensure to practice as a physician assistant is deemed denied by the board on the date the applicant is sent notice from the board that he or she has failed the examination required by s. Med 8.05 (1) (c).

(b) A temporary certificate license expires on the first day of the next regularly scheduled oral examination for permanent certification licensure if the applicant is required to take, but failed to apply for, the examination.

(3) A temporary permit license may not be renewed.

SECTION 11. Med 8.06 (4) is created to read:

Med 8.06 (4) An applicant holding a temporary license may apply for one transfer of supervising physician and location during the term of the temporary license.

SECTION 12. Med 8.07 (1), (2) (title), (2) (intro.), (c), (e), (f) and (i) are amended to read:

Med 8.07 (1) SCOPE AND LIMITATIONS. In providing patient services medical care, the entire practice of any physician assistant shall be under the supervision of a licensed physician. The scope of practice is limited to providing patient services medical care specified in sub. (2). A physician assistant's practice may not exceed the scope of practice of the supervising physician. A medical care task assigned by the supervising physician to a physician assistant may not be delegated by the physician assistant to another person.

(2) (title) PATIENT SERVICES MEDICAL CARE. (intro.) Patient services Medical care a physician assistant may provide include includes:

(c) Performing routine therapeutic procedures, including, but not limited to, injections, immunizations, and the suturing and care of wounds.

(e) Assisting the supervising physician in a hospital or facility, as defined in s. 50.01 (1m), Stats., by assisting in surgery, making patient rounds, recording patient progress notes, compiling and recording detailed narrative case summaries and accurately writing or executing standing orders or other specific orders following consultation with and at the direction of the supervising under the supervision of a licensed physician.

(f) Assisting in the delivery of services medical care to a patient by reviewing and monitoring treatment and therapy plans.

(i) Preparing Issuing written prescription orders for drugs if specifically directed to do so by the supervising under the supervision of a licensed physician and in accordance with procedures specified in s. Med 8.08 (2).

SECTION 13. Med 8.08 (title), (1), (2) (intro.), (a), (b), (c), (d), (e) 2. and 3. are amended to read:

Med 8.08 (title) Prohibitions and Prescribing limitations. (1) ACUPUNCTURE AND INDEPENDENT PRESCRIBING PROHIBITED. A physician assistant may not practice acupuncture in any form and may not prescribe or dispense any drug independently. A supervising physician may direct a physician assistant to prepare a prescription order according to procedures specified in sub. (2).

(2) PRESCRIBING LIMITATIONS. (intro.) A physician assistant may prepare issue a prescription order only if all of the following conditions apply:

(a) The physician assistant prepares issues the prescription order only in patient situations specified and described established written protocols guidelines. The protocol guidelines shall be reviewed at least annually by the physician assistant and his or her supervising physician.

(b) The supervising physician and physician assistant determine by mutual agreement that the physician assistant is qualified through training and experience to prepare issue a prescription order as specified in the established written protocols guidelines.

(c) When practicable, the physician assistant consults directly with the supervising physician prior to preparing a prescription order. In any case the The supervising physician shall be is available for consultation as specified in s. Med 8.10 (2) (3).

(d) The prescription orders prepared under procedures in this section contain, in addition to other information required by law, the name, address and telephone number of the supervising physician , the DEA registration number of the supervising physician if the prescription is prepared for a controlled substance, the name and address of the physician assistant, legibly printed, the DEA registration number of the physician assistant if the prescription is prepared for a controlled substance and if the physician assistant is registered with DEA, and the signature of the physician assistant.

(e) 2. Reviews and countersigns within one day 72 hours the patient record prepared by the physician assistant practicing in the office of the supervising physician or at a facility or a hospital in which the supervising physician has staff privileges; or

  3. Reviews by telephone or other means, as soon as practicable but within a 48-hour 72-hour period, and countersigns within one week, the patient record prepared by the physician assistant who practices in an office facility other than the supervising physician's main office of a facility or hospital in which the supervising physician has staff privileges.

SECTION 14. Med 8.10 (1) is amended to read:

Med 8.10 (1) No physician may concurrently supervise more than 2 physician assistants unless the physician submits a written plan for the supervision of more than 2 physician assistants and the board approves the plan. A physician assistant may be supervised by more than one physician.

Fiscal Estimate

1. The anticipated fiscal effect on the fiscal liability and revenues of any local unit of government of the proposed rule is: $0.00.

2. The projected anticipated state fiscal effect during the current biennium of the proposed rule is: $0.00.

3. The projected net annualized fiscal impact on state funds of the proposed rule is: $0.00.

Initial Regulatory Flexibility Analysis

These proposed rules will be reviewed by the department through its Small Business Review Advisory Committee to determine whether there will be an economic impact on a substantial number of small businesses, as defined in s. 227.114 (1) (a), Stats.

Copies of Rule and Contact Person

Copies of this proposed rule are available without cost upon request to: Pamela Haack, Department of Regulation and Licensing, Office of Administrative Rules, 1400 East Washington Avenue, Room 171, P.O. Box 8935, Madison, Wisconsin 53708 [phone].

Notice of Hearing

Revenue

Notice is hereby given that pursuant to s. 227.11 (2) (a), Stats., and interpreting s. 77.54 (9a), Stats., s. 77.51 (18) and (22) (a), Stats., as amended by 1997 Wis. Act 27 and s. 77.54 (43), Stats., as created by 1997 Wis. Act 27, the Department of Revenue will hold a public hearing at the time and place indicated below, to consider the amendment of rules relating to printed material exemptions and the sales and use tax treatment of advertising agencies.

Hearing Information

February 26, 1999   Room #207, GEF 3

Friday   125 South Webster St.

10:00 a.m.   MADISON, WI

Handicap access is available at the Butler Street entrance of the building.

Written Comments

Interested persons are invited to appear at the hearing and may make an oral presentation. It is requested that written comments reflecting the oral presentation be given to the Department at the hearing. Written comments may also be submitted to the contact person shown below no later than March 5, 1999, and will be given the same consideration as testimony presented at the hearing.

Contact Information

Mark Wipperfurth, [phone]

Department of Revenue

125 South Webster St.

P.O. Box 8933

Madison, WI 53708-8933

Analysis by the Dept. of Revenue

Statutory authority: s. 227.11 (2) (a), Stats.

Statutes interpreted: s. 77.54 (9a), Stats., s. 77.51 (18)
and (22) (a), Stats., as amended
by 1997 Wis. Act 27, and
s. 77.54 (43), Stats., as created
by 1997 Wis. Act 27

SECTION 1. Tax 11.19 (2) (d) and (f) and (5) (intro.) and (b) are amended to reflect the amendment of s. 77.51(18) and (22) (a), Stats., and the creation of s. 77.54 (43), Stats., by 1997 Wis. Act 27. These changes provide a sales tax exemption for raw materials of printed materials transported and used solely outside of Wisconsin. Previously, these materials were only exempt from use tax.

Section Tax 11.19 (6) is amended, to clarify that the exemption for governmental units applies only to Wisconsin governmental units, and to reflect that certificate of exempt status numbers are being given to governmental units.

SECTION 2. Tax 11.70 (3) (m) is created, to reflect the amendment of s. 77.51 (18) and (22) (a), Stats., and the creation of s. 77.54 (43), Stats., by 1997 Wis. Act 27.

Text of Rule

SECTION 1. Tax 11.19 (2) (d) and (f), (5) (intro.) and (b) and (6) are amended to read:

Tax 11.19 (2) (d) Section 77.54 (2m), Stats., provides an exemption for the “gross receipts from the sales of and the storage, use or other consumption of tangible personal property or services that become an ingredient or component of shoppers guides, newspapers or periodicals or that are consumed or lose their identity in the manufacture of shoppers guides, newspapers or periodicals, whether or not the shoppers guides, newspapers or periodicals are transferred with charge to the recipient." This exemption applies to newspapers, shoppers guides and periodicals which are issued at average intervals not exceeding 3 months. It does not apply to advertising supplements that are not newspapers as defined in s. 77.51 (8), Stats.

(f) Section 77.51 (18) and (22) 77.54 (43), Stats., provides that storage and use for purposes of imposing Wisconsin use tax does not include the keeping, retaining or exercising any right or power over a sales and use tax exemption for raw materials for used for the processing, fabricating or manufacturing into, attachment of, attaching to or incorporation into incorporating into, printed materials to be that are transported outside Wisconsin and thereafter used solely outside Wisconsin.

(5) Wisconsin sales and use tax is not imposed on raw materials that would otherwise be subject to use tax under s. 77.53 (1), Stats., purchased by a publisher or printer of printed materials if both of the following conditions are met:

(b) The resulting printed materials will be shipped outside Wisconsin for use transported and used solely outside Wisconsin.

(6) EXEMPT PURCHASERS. Sales of printed material to federal and Wisconsin governmental units, and Wisconsin public schools, and certain nonprofit religious, charitable, educational or scientific organizations holding a certificate of exempt status are exempt under s. 77.54 (9a) or 77.55 (1), Stats. Sales to federal and Wisconsin governmental units and public schools need not be supported by exemption certificates, if a copy of the purchase order from the organization is retained or the governmental unit's certificate of exempt status number is recorded on the bill of sale. Sales to persons nonprofit organizations holding a certificate of exempt status can be shown to be exempt by recording the certificate of exempt status number on the bill of sale.

  Note to Revisor: 1) In sub. (3), all quoted statutory material should be in italics.