Physicians: Pay Attention to Supervision Agreements

Todd W. Collis

Pursuant to Ohio Revised Code Section 4730.19, before initiating supervision of one or more physician assistants licensed in Ohio, a physician licensed in Ohio must enter into a supervision agreement with each physician assistant who will be supervised.

A supervision agreement must provide that the physician agrees to supervise the physician assistant and the physician assistant agrees to practice under that physician’s supervision.

A supervision agreement must provide that the supervising physician is legally responsible and assumes legal liability for the services provided by the physician assistant.

A supervision agreement must be signed by the physician and the physician assistant.

A supervision agreement must include either or both of the following:

a. If a physician assistant will practice within a health care facility, the supervision agreement must include terms that require the physician assistant to practice in accordance with the policies of the health care facility; and/or

b. If a physician assistant will practice outside a health care facility, the supervision agreement must include terms that specify all of the following:

i. the responsibilities to be fulfilled by the physician in supervising the physician assistant;

ii. the responsibilities to be fulfilled by the physician assistant when performing services under the physician’s supervision;

iii. any limitations on the responsibilities to be fulfilled by the physician assistant;

iv. the circumstances under which the physician assistant is required to refer a patient to the supervising physician;

v. if the supervising physician chooses to designate physicians to act as alternate supervising physicians, the names, business addresses, and business telephone numbers of the physicians who have agreed to act in that capacity.

Additional requirements of a supervision agreement include, but are not limited to:

A physician assistant may report to more than one supervising physician, however, a physician assistant should have separate supervision agreements with each supervising physician to whom they report.

Supervision agreements are not required to be filed and approved by the State Medical Board.

Although there is not a required format for a supervision agreement, the supervision must comply with all applicable requirements of the State Medical Board.

A supervision agreement may be updated or changed at any time until terminated. Preparation and signature by the supervising physician and the physician assistant of a written addendum to reflect updates to the supervision agreement is recommended.

The supervising physician is responsible for retaining the supervision agreement in their records. The agreement must be readily accessible to the supervising physician and physician assistant as a reference document and to the Medical Board in the event of an on-site inspection. A supervision agreement may be an electronic document or a printed document.

The Board’s disciplinary authority for a violation of Ohio Revised Code Section 4730.19 includes, but is not limited to:

The State Medical Board may impose a civil penalty of not more than $5,000.00 if it finds:

a. that a physician assistant has practiced in a manner that departs from, or fails to conform to, the terms of a supervision agreement;

b. that a physician has supervised a physician assistant in a manner that departs from, or fails to conform to, the terms of a supervision agreement; and/or

c. that a physician failed to comply with this Ohio Revised Code Section 4730.19.

For Ohio’s physician assistant laws, see: codes.ohio.gov/orc/4730.

As always, if you have a question about this post or the State Medical Board of Ohio in general, please feel free to contact Todd Collis at 614-628-6962 or Beth Collis at 614-628-6945.

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