(3) Each patient health care record entry shall be dated, shall identify the physician assistant, and shall be sufficiently legible to allow interpretation by other health care practitioners.
PA 3.06 Standards for Dispensing and Prescribing Drugs. (1) PRESCRIPTIVE AUTHORITY.
(a) A physician assistant may order, prescribe, procure, dispense, and administer prescription drugs, medical devices, services, and supplies.
(b) A physician assistant practicing under the supervision and direction of a podiatrist may issue a prescription order for a drug or device in accordance with guidelines established by the supervising podiatrist and the physician assistant.
(2) PACKAGING. A prescription drug dispensed by a physician assistant shall be dispensed in a child-resistant container if it is a substance requiring special packaging under 16 CFR 1700.14 (1982) of the federal regulations for the federal poison packaging act of 1970. (3) LABELING. A prescription drug dispensed by a physician assistant shall contain a legible label affixed to the immediate container disclosing all of the following:
(a) The name and address of the facility from which the prescribed drug is dispensed.
(b) The date on which the prescription is dispensed.
(c) The name of the physician assistant who prescribed the drug.
(d) The full name of the patient.
(e) The generic name and strength of the prescription drug dispensed unless the prescribing physician assistant requests omission of the name and strength of the drug dispensed.
(f) Directions for the use of the prescribed drug and cautionary statements, if any, contained in the prescription or required by law.
(4) RECORDKEEPING. (a) Unless otherwise maintained by an organization, a physician assistant shall maintain complete and accurate records of each prescription drug received, dispensed, or disposed of in any other manner.
(b) Records for controlled substances shall be maintained as required by the federal controlled substances act and ch. 961, Stats. PA 3.07 Informed Consent. (1) Pursuant to s. 448.9785, Stats., a physician assistant shall communicate alternate modes of treatment to a patient. (2) Any physician assistant who treats a patient shall inform the patient about the availability of reasonable alternative modes of treatment and about the benefits and risks of these treatments. The reasonable physician assistant standard is the standard for informing a patient under this section. The reasonable physician assistant standard requires disclosure only of information that a reasonable physician assistant in the same or a similar medical specialty would know and disclose under the circumstances.
(3) The physician assistant’s duty to inform the patient under this section does not require disclosure of any of the following:
(a) Detailed technical information that in all probability a patient would not understand.
(b) Risks apparent or known to the patient.
(c) Extremely remote possibilities that might falsely or detrimentally alarm the patient.
(d) Information in emergencies where failure to provide treatment would be more harmful to the patient than treatment.
(e) Information in cases where the patient is incapable of consenting.
(f) Information about alternate modes of treatment for any condition the physician assistant has not included in the physician assistant’s diagnosis at the time the physician assistant informs the patient.
(4) A physician assistant’s record shall include documentation that alternate modes of treatment have been communicated to the patient and informed consent has been obtained from the patient.
PA 3.08 Telemedicine and Telehealth Practice. (1) In this section:
(a) “Emergency medical condition” means a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention will result in serious jeopardy to patient health, serious impairment of bodily functions, or serious dysfunction of a body organ or part.
(b) “Telehealth” has the meaning given in s. 440.01 (1) (hm), Stats. (c) “Telemedicine” is analogous to and has the same meaning as “telehealth.” in par. (b).
(2) The rules in this section do not prohibit any of the following:
(a) Consultations between physician assistants, or between physician assistants and other medical professionals, or the transmission and review of digital images, pathology specimens, test results, or other medical data related to the care of patients in this state.
(b) Patient care in consultations with another healthcare provider who has an established provider-patient relationship with the patient.
(c) Patient care in on-call or cross-coverage situations in which the physician assistant has access to patient records.
(d) Treating a patient with an emergency medical condition.
(3) A physician assistant-patient relationship may be established via telehealth.
(4) A physician assistant who uses telemedicine in the diagnosis and treatment of a patient located in this state shall be licensed to practice as a physician assistant by the Physician Assistant Affiliated Credentialing Board.
(5) A licensed physician assistant shall be held to the same standards of practice and conduct including patient confidentiality and recordkeeping, regardless of whether health care services are provided in person or by telemedicine.
(6) A licensed physician assistant who provides health care services by telehealth is responsible for the quality and safe use of equipment and technology that is integral to patient diagnosis and treatment.
(7) The equipment and technology used by a physician assistant to provide health care services by telehealth shall provide, at a minimum, information that will enable the physician assistant to meet or exceed the standard of minimally competent physician assistant practice.
UNPROFESSIONAL CONDUCT
PA 4.01 Unprofessional Conduct. “Unprofessional conduct” includes the following, or aiding or abetting the same:
(1) DISHONESTY AND CHARACTER. (a) Violating or attempting to violate any provision or term of subch. VIII of ch. 448, Stats., or of any valid rule of the board. (b) Violating or attempting to violate any term, provision, or condition of any order of the board.
(c) Knowingly engaging in fraud or misrepresentation or dishonesty in applying, for or procuring a physician assistant license, or in connection with applying for or procuring periodic renewal of a physician assistant license, or in otherwise maintaining such licensure.
(d) Knowingly giving false, fraudulent, or deceptive testimony while serving as an expert witness.
(e) Employing illegal or unethical business practices.
(f) Knowingly, negligently, or recklessly making any false statement, written or oral, as a physician assistant which creates an unacceptable risk of harm to a patient, the public, or both.
(g) Engaging in any act of fraud, deceit, or misrepresentation, including acts of omission to the board or any person acting on the board’s behalf.
(h) Obtaining any fee by fraud, deceit or misrepresentation.
(i) Directly or indirectly giving or receiving any fee, commission, rebate, or other compensation for professional services not actually and personally rendered, unless allowed by law. This prohibition does not preclude the legal functioning of lawful professional partnerships, corporations, or associations.
(j) Engaging in uninvited in-person solicitation of actual or potential patients who, because of their circumstances, may be vulnerable to undue influence.
(k) Engaging in false, misleading, or deceptive advertising.
(L)Offering, undertaking, or agreeing to treat or cure a disease or condition by a secret means, method, device, or instrumentality; or refusing to divulge to the board upon demand the means, method, device, or instrumentality used in the treatment of a disease or condition.
(2) DIRECT PATIENT CARE VIOLATIONS. (a) Practicing or attempting to practice under any license when unable to do so with reasonable skill and safety. A certified copy of an order issued by a court of competent jurisdiction finding that a person is mentally incompetent is conclusive evidence that the physician assistant was, for any period covered by the order, unable to practice with reasonable skill and safety.
(b) Departing from or failing to conform to the standard of minimally competent practice which creates an unacceptable risk of harm to a patient or the public whether or not the act or omission resulted in actual harm to any person.
(c) Prescribing, ordering, dispensing, administering, supplying, selling, giving, or obtaining any prescription medication in any manner that is inconsistent with the standard of minimal competence.
(d) Performing or attempting to perform any procedure on the wrong patient, or at the wrong anatomical site, or performing the wrong procedure on any patient.
(e) Administering, dispensing, prescribing, supplying, or obtaining controlled substances as defined in s. 961.01 (4), Stats., other than in the course of legitimate professional practice, or as otherwise prohibited by law. 1. Except as otherwise provided by law, a certified copy of a relevant finding, order, or judgement by a state or federal court or agency charged with making legal determinations shall be conclusive evidence of its findings of fact and conclusions of law.
2. A certificate copy of a finding, order, or judgement demonstrating that entry of a guilty plea, nolo contendere plea or deferred adjudication, with or without expungement, of a crime substantially related to the practice of a physician assistant is conclusive evidence of a violation of this paragraph.
(f) Engaging in sexually explicit conduct, sexual contact, exposure, gratification, or other sexual behavior with or in the presence of a patient, a patient’s immediate family, or a person responsible for the patient’s welfare.
1. Sexual motivation may be determined from the totality of the circumstances and shall be presumed when the physician assistant has contact with a patient’s intimate parts without legitimate medical justification for doing so.
2. For the purpose of this paragraph, an adult receiving treatment shall be considered a patient for 2 years after the termination of professional services.
3. If the person receiving treatment is a child, the person shall be considered a patient for the purposes of this paragraph for 2 years after termination of services or for 2 years after the patient reaches the age of majority, whichever is longer.
(g) Engaging in any sexual conduct with or in the presence of a patient or former patient who lacks the ability to consent for any reason, including medication or psychological or cognitive disability.
(h) Engaging in repeated or significant disruptive behavior or interaction with physician assistants, hospital personnel, patients, family members, or others that interferes with patient care or could reasonably be expected to adversely impact the quality of care rendered.
(i) Knowingly, recklessly, or negligently divulging a privileged communication or other confidential patient health care information except as required or permitted by state or federal law.
(j) Performing physician assistant services without required informed consent under s. 448.9785, Stats. or s. PA 3.07. (k) Aiding or abetting the practice of an unlicensed, incompetent, or impaired person or allowing another person or organization to use his or her license to practice as a physician assistant.
(L) Prescribing a controlled substance to oneself as described in s. 961.38 (5), Stats. (m) Practicing as a physician assistant in another state or jurisdiction without
appropriate licensure. A physician assistant has not violated this paragraph if, after issuing an order for services that complies with the laws of Wisconsin, their patient requests that the services ordered be provided in another state or jurisdiction.
(n) Patient abandonment occurs when a physician assistant without reasonable justification unilaterally withdraws from a physician assistant-patient relationship by discontinuing a patient’s treatment regimen when further treatment is medically indicated and any of the following occur:
1. The physician assistant fails to give the patient at least 30 days’ notice in advance of the date on which the physician assistant’s withdrawal becomes effective.
2. The physician assistant fails to allow for patient access to or transfer of the patient’s health record as required by law.
3. The physician assistant fails to provide for continuity of prescription medications between the notice of intent to withdraw from the physician assistant-patient relationship and the date on which the physician assistant- patient relationship ends, if the prescription medications are necessary to avoid unacceptable risk of harm.
4. The physician assistant fails to provide for continuity of care during the period between the notice of intent to withdraw from the physician assistant-patient relationship and the date on which the physician assistant-patient relationship ends. Nothing in this section shall be interpreted to imposed upon the physician assistant a greater duty to provide continuity care to a patient than otherwise required by law.
(3) LAW VIOLATIONS, ADVERSE ACTION, AND REQUIRED REPORTS TO THE BOARD.
(a) Failing, within 30 days to report to the board any final adverse action taken against the licensee’s authority to practice by another licensing jurisdiction.
(b) Failing, within 30 days, to report the board any adverse action taken by the Drug Enforcement Administration against the licensee’s authority to prescribe controlled substances.
(c) Failing to comply with state and federal laws regarding access to patient health care records.
(d) Failure by a licensee to establish and maintain patient health care records consistent with the requirements of ss. PA 3.05 and 3.06 (4), or as otherwise required by law. (e) Violating the duty to report under s. 448.9795, Stats.
