SECTION 2 creates s.
Med 20.055 relating to the requirements for issuance of a temporary certificate for applicants who are certified to practice in another jurisdiction.
Comparison with federal regulations
There is no existing or proposed federal regulation.
Comparison with rules in adjacent states
Iowa:
None.
Illinois:
There is a six month temporary license available for pending applicants until the next available examination is taken.
Michigan:
A temporary license is available for up to four years if the applicant has practiced as a full-time respiratory care practitioner for four years immediately preceding the date of application in certain, specified settings. A letter of recommendation from a Medical Director is also required.
Minnesota:
A temporary permit is issued and is valid until the board meets to decide on the application. A temporary permit is also available until the next available examination.
Summary of factual data and analytical methodologies
Analysis and supporting documents used to determine effect on small business
The Medical Examining Board did not consult supporting documents other than
2005 Wisconsin Act 195. It is merely updating its rules based on the legislative change.
Section
227.137, Stats., requires an “agency" to prepare an economic impact report before submitting the proposed rule-making order to the Wisconsin Legislative Council. The Department of Regulation and Licensing is not included as an “agency" in this section.
Small Business Impact
These proposed rules will have no significant economic impact on a substantial number of small businesses, as defined in s.
227.114 (1), Stats.
The Department's Regulatory Review Coordinator may be contacted by email at
larry.martin@wisconsin.gov, or by calling 608-266-8608.
Fiscal Estimate
The department estimates that this rule will require staff time in the Office of Legal Counsel, Division of Management Services, and the Division of Professional Credentialing. The total one-time salary and fringe costs are estimated at $3,500. The total on-going salary and fringe costs are estimated at $600.
Anticipated costs incurred by private sector
The department finds that this rule has no significant fiscal effect on the private sector.
Agency Contact Person
Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708; telephone 608-266-0495; email at pamela.haack@ wisconsin.gov.
Notice of Hearing
Medical Examining Board
NOTICE IS HEREBY GIVEN that pursuant to authority vested in the Medical Examining Board in ss.
15.08 (5) (b),
227.11 (2),
448.05 (5) and
448.40, Stats., the Medical Examining Board will hold a public hearing at the time and place indicated below to consider an order to revise ss.
Med 8.08 and
8.10 (3), relating to prescribing limitations for physician assistants.
Hearing Information
Date: March 18, 2009
Time: 8:40 a.m.
Location: 1400 East Washington Avenue
(Enter at 55 North Dickinson Street)
Room 121A
Madison, Wisconsin
Appearances at the Hearing and Submission of Written Comments
Interested persons are invited to present information at the hearing. Persons appearing may make an oral presentation but are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708, email at
pamela.haack@wisconsin.gov. Comments must be received on or before March 30, 2009, to be included in the record of rule-making proceedings.
Copies of Proposed Rule
Copies of this proposed rule are available upon request to Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, P.O. Box 8935, Madison, Wisconsin 53708, or by email at
pamela.haack@wisconsin.gov.
Analysis Prepared by the Department of Regulation and Licensing
Statutes interpreted
Statutory authority
Explanation of agency authority
The Medical Examining Board is granted the authority under s.
448.40, Stats., to promulgate rules establishing licensing and practice standards for physician assistants for the purpose of protecting the public health, safety and welfare.
Related statutes or rules
Plain language analysis
This proposed rule-making will change the countersignature requirement of the physician assistant prescribing rule which currently provides that the supervising physician must countersign the prescription or patient record within 72 hours or one week, depending on the practice site. Based on the advances in physician assistants' licensure and prescriptive authority, including a record of safe prescribing, co-signature of every prescription is no longer needed. The proposed rule will allow for more flexibility between the physician and physician assistant by allowing the supervising physician to determine the method and frequency of the review based upon the prescriptive practice, the experience of the physician assistant and the patients' needs. In addition, the proposed rule re-conceptualizes the required written guidelines for prescribing to include the categories of drugs for which prescriptive authority has been authorized and the technological advancement in electronic communications and recordkeeping.
SECTION 1 amends rules to reflect the prescribing or dispensing of a drug pursuant to written guidelines for supervised prescriptive practice.
SECTION 2 repeals rules which currently provide that the supervising physician must countersign the prescription or patient record within 72 hours or one week, based on the advances in physician assistant licensure and prescriptive authority.
SECTION 3 creates rules to allow for more flexibility between the physician and physician assistant by allowing the supervising physician to determine the method and frequency of the review based upon prescriptive practice, experience of the physician assistant, and patient needs.
SECTION 4 amends rules to incorporate the technological advancement in electronic communications.
Comparison with federal regulations
There is no existing or proposed federal regulation.
Comparison with rules in adjacent states
Iowa:
Physician assistants may prescribe non-controlled and controlled substances (except schedule II depressants). They may dispense under certain conditions. Physician assistants who prescribe controlled medications must register with the DEA.
Supervision: A physician need not be physically present, but must be readily available by telecommunication.
Illinois:
A physician may delegate prescriptive authority for non-controlled and schedules III-V medications to physician assistants, with periodic review by the supervising physician. A physician must file notice of delegation of prescriptive authority to the physician assistant with the Department of Professional Regulation. The physician and physician assistant adopt written guidelines for prescribing. Physician assistants who prescribe controlled substances must register with state controlled substance authority and the DEA.
Supervision: Physical presence of a physician is not required. The physician must be able to consult by radio, telephone, or telecommunications. The supervising physician may designate an alternate supervising physician in accordance with statutes. Physicians within a practice group of the supervising physician may supervise the physician assistant with respect to their patients without being deemed an alternate supervising physician.
Michigan:
Physician assistants may prescribe non-controlled and schedules III-V medications as delegated by a supervising physician. Physician assistants may prescribe a 7-day supply of schedule II drugs as discharge medications. Supervising physicians' and physician assistants' names must be indicated on the prescription. Physician assistant prescribers of controlled medications must register with the DEA.
Supervision: A physician must be continuously available for direct communication in person or by radio, telephone, or telecommunication and must regularly review the physician assistant's performance and patient records, consult, and educate.
Minnesota:
Physician assistants may prescribe controlled (schedules II-V) and non-controlled drugs. The physician reviews prescribing by the physician assistant weekly. Physician assistants authorized to prescribe controlled medications must register with the DEA.
Supervision: Physical presence of a physician is not required. The physician assistant and supervising physician must be able to be in touch via telecommunication.
Summary of factual data and analytical methodologies
The Wisconsin Council on Physician Assistants initiated this rule by a request to the Medical Examining Board. The board's attorney drafted the rule in accordance with instructions from the Council. Council members sought the collaborative support of several groups and individuals interested in the rules governing prescribing by physician assistants and discussed the rule thoroughly at Council meetings. The Council examined the experience of other states, particularly that of Minnesota.
Analysis and supporting documents used to determine effect on small business
It is anticipated that the impact on small businesses will be positive because of the additional flexibility built into the supervisory relationship. The guidelines, which govern the relationship between the physician and the physician assistant, remain in place though the form will change slightly to include a section outlining the categories of drugs the physician assistant may prescribe.
Section
227.137, Stats., requires an “agency" to prepare an economic impact report before submitting the proposed rule-making order to the Wisconsin Legislative Council. The Department of Regulation and Licensing is not included as an “agency" in this section.
Small Business Impact
These proposed rules will have no significant economic impact on a substantial number of small businesses, as defined in s.
227.114 (1), Stats.
The Department's Regulatory Review Coordinator may be contacted by email at
larry.martin@wisconsin.gov, or by calling 608-266-8608.
Fiscal Estimate
The department estimates that this rule will require staff time in the Office of Legal Counsel. The total one-time salary and fringe costs are estimated at $4,300. The total on-going salary and fringe costs are estimated at $2,400.
Anticipated costs incurred by private sector
The department finds that this rule has no significant fiscal effect on the private sector.
Agency Contact Person
Pamela Haack, Paralegal, Department of Regulation and Licensing, Office of Legal Counsel, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708; telephone 608-266-0495; email at pamela.haack@ wisconsin.gov.
Notice of Hearing
Regulation and Licensing
NOTICE IS HEREBY GIVEN that pursuant to authority vested in the Department of Regulation and Licensing in ss.
227.11 (2),
461.02 (7) and
461.06, Stats., the Department of Regulation and Licensing will hold a public hearing at the time and place indicated below to consider an order to create Chapter
RL 186, relating to the registration and regulation of professional employer organizations and groups.
Hearing Information
Date: March 2, 2009
