Don't forget to check the "News and Announcements" Section for information on the new PA laws including guidance documents, model supervision agreement and information on Botox and Light Based Devices.

 

LICENSURE AND PRESCRIPTIVE AUTHORITY

What do I Need to Get a License in Ohio?

A physician assistant license includes prescriptive authority only under the following conditions:

You have master’s degree or higher from an ARC-PA program
OR  
You have a degree from and ARC-PA program AND a master’s degree with clinical relevance to PA practice.

If you do not have a master’s degree you will be eligible for a license if:

You hold a current, valid license to practice as a PA in another jurisdiction and have been in active practice with prescriptive authority in any jurisdiction through the three-year period immediately preceding the date of application.

You hold an ARC-PA degree and have experience practicing with prescriptive authority as a PA for at least three consecutive years while on active duty, with evidence of service under honorable conditions, in any of the armed forces of the United States or the national guard of any state, including any experience attained while practicing as a physician assistant at a health care facility or clinic operated by the United States department of veterans affairs.

You hold an ARC-PA degree and have experience practicing with prescriptive authority as a physician assistant for at least three consecutive years while on active duty in the United States public health service commissioned corps.

If you did not hold prescriptive authority in another jurisdiction, the military or in the public health service, you will not be issued prescriptive authority with your license. To obtain prescriptive authority, you will need to obtain a master’s degree.  Upon receipt of proof of your master's degree, the Medical Board will give you prescriptive authority.

How do I Apply for a License?

Background checks are required and the application for a license is online.

Background Check Information

Information and Application

You will not be notified by the Medical Board of your approval so you will need to check the Medical Board website for the status of your license on the Licensee Profile and Status page.

Renewal of your Certificate to Practice is every two years in even years regardless of when it was issued to you.  Renewal of prescriptive authority is every two years in odd years regardless of when it was issued to you.

New Licensee Prescriptive Authority Requirement

During the first five hundred hours you may only prescribe under the on-site supervision of a supervising physician.

You are excused from this requirement if you held a prescriber number from another jurisdiction and practiced with prescriptive authority in that jurisdiction for not less than one thousand hours.

A record of a physician assistant's completion of the hours required shall be kept in the records maintained by a supervising physician of the physician assistant. The record shall be made available for inspection by the board.

Supervision Agreement

Required of all PAs and supervising physicians. This agreement states that the PA is agreeing to be supervised by the physician and that the physician agrees to supervise the PA. A physician can have supervisory agreements with an unlimited number of PAs but the physician can only supervise up to three PAs at one time.

Effective immediately there are no renewals, no 5 day waiting period and the eLicense system for submitting supervision agreements has been disabled.  Effective immediately for new hires the supervision agreement is signed and kept on file at the practice site and they may begin to work immediately.  You may use any form you like but the OSMB recommends that you use their form(s) as those forms meet the statutory requirements.

Supervision agreements on file at the practice site remain in effect indefinitely until the physician ceases supervision of the PA(s).

For those with existing supervision agreements nothing needs to be done (except make sure there is a copy on file at the practice site) even if they are scheduled for renewal.  Make sure that any changes you make to the agreements between now and September 26, 2018 generate a new supervision agreement that is kept on file.  Make sure that all the supervision agreements you have on file on September 26, 2018 are correct.  After September 26 the Medical Board will begin the audit process and there are penalties for non-compliance.

The July 6, 2018 email from the Medical Board states:

"According to HB 111, the requirement that each supervision agreement be submitted to, and reviewed by, the Medical Board, is eliminated. 

For more information, a legislative summary of the new law can be found here.    

A link to the new legislation can be found by visiting this site and selecting the View Current Version option next to Legislation Text.

The Board is proactively implementing this legislation so that licensees can immediately avail themselves of this new streamlined process. Therefore, the filing of supervision agreements through eLicense is no longer necessary.

For convenience, the Board has updated the supervision agreement forms that can be found at the following links.

Supervision Agreement Application (for Health Care Facility Practice Only)

Supervision Agreement Application (or Practice Outside of a Health Care Facility Only)

Supervision Agreement Addendum for Multiple Supervising Physicians

Supervision Agreement Alternate Supervising Physician Form

Please note that use of these specific forms is not required; you may create your own documents that meet the requirements of the law.

Since supervision agreements are no longer filed with the board, there is no renewal of them. They are living documents that remain active and can be amended at any time until the physician ceases supervision of the physician assistant."

 

Model Supervision Agreement

Recommended answers to the four new questions on the agreement for Outside a Healthcare Facility.

PA Formulary

For the most recent PA Formulary go to the PA page of the Medical Board website and then go to "Resources."  Medical Board Website

Information on Prescribing Schedule II


From the Formulary: Opioids for treatment of drug addiction:

The wording on the February 2013 formulary is taken from ORC 4730.411, Divisions A, B, C.  OAPA comments are in italics.

NOTE restrictions in the law regarding ANY/ALL Schedule II drugs:

Schedule II drugs may only be prescribed, as per ORC Section 4730.411, division (A), ONLY IF:

1) The patient is in a terminal condition (as defined in ORC 2133.01); AND

2) The physician assistant's supervising physician initially prescribed the substance for the patient;

AND

3) The prescription is for an amount that does not exceed the amount necessary for the patient's use in a single twenty-four-hour period.

Number 1 through 3 above only apply to patients in a terminal condition.  If your patient is not terminal, this does not apply to you.

The restrictions on prescriptive authority in ORC Section 4730.411, division (A) of this section (terminal patients) do not apply if a physician assistant issues the prescription to the patient from any of the following locations:

(1) A hospital registered under section 3701.07 of the Revised Code;

(2) An entity owned or controlled, in whole or in part, by a hospital or by an entity that owns or controls, in whole or in part, one or more hospitals;

(3) A health care facility operated by the department of mental health or the department of developmental disabilities;

(4) A nursing home licensed under section 3721.02 of the Revised Code or by a political subdivision certified under section 3721.09 of the Revised Code;

(5) A county home or district home operated under Chapter 5155. of the Revised Code that is certified under the medicare or medicaid program;

(6) A hospice care program, as defined in section 3712.01 of the Revised Code;

(7) A community mental health agency, as defined in section 5122.01 of the Revised Code;

(8) An ambulatory surgical facility, as defined in section 3702.30 of the Revised Code;

(9) A freestanding birthing center, as defined in section 3702.51 of the Revised Code;

(10) A federally qualified health center, as defined in section 3701.047 of the Revised Code;

(11) A federally qualified health center look-alike, as defined in section 3701.047 of the Revised Code;

(12) A health care office or facility operated by the board of health of a city or general health district or the authority having the duties of a board of health under section 3709.05 of the Revised Code;

Numbers 1 through 12 are practice locations regulated by the state.  Those locations may have their own policies that dictate PA prescribing.  The law, though, allows PAs to prescribe up to 7 days of Schedule II without the patient being seen by your supervising physician.

(13) A site where a medical practice is operated, but only if the practice is comprised of one or more physicians who also are owners of the practice; the practice is organized to provide direct patient care; and the physician assistant has entered into a supervisory agreement with at least one of the physician owners who practices primarily at that site.

Number 13 refers to private practices BUT only those practices that are owned by a physician(s).  If your private practice is NOT OWNED by a physician, you cannot prescribe any Schedule II medications.

If the practice is owned by a physician, a PA can prescribe up to 7 days of Schedule II without the patient seeing the supervising physician.  If your supervising physician has seen the patient before, and the patient is seeking a refill, you may prescribe any amount, but common sense would indicate no more than 30 days.

A physician assistant shall not issue to a patient a prescription for a schedule II controlled substance from a convenience care clinic even if the clinic is owned or operated by an entity specified in Section 4730.411 (B) ORC.

 Formulary Update Requests

If you would like to request formulary updates for specific drugs either not appearing on the PA formulary or in a different category, please use this FORM and send it to the Physician Assistant Policy Committee at the Ohio State Medical Board.

DEA Number

Ohio PAs may apply for their DEA number during their provisional period.

Ohio PAs may prescribe Schedule II-V.

Application

Add Schedule II to your current DEA registration.

Once you have updated your registration on the DEA website for Schedule II, you will need to wait to prescribe Schedule II until you receive a new certificate from the DEA.  This will come by regular mail and will take about a week.