L O U I S I A N A
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S T A T U T E
STATUTE
Louisiana Revised Statutes 37:1360.21 et seq; 37:1270.1
DATE
Enacted 1977
REGULATORY BODY
Louisiana State Board of Medical Examiners
PA DEFINED
Person who is graduate of CAHEA or its successor-accredited PA program or who has
successfully passed NCCPA certifying examination and who is approved by board to perform
medical services under supervision of physician or group of physicians approved by board to
supervise such assistant.
§1360.22
SCOPE OF PRACTICE
PA may perform those duties and responsibilities that are delegated by the supervising
physician. PA may have multiple supervising physicians in no more than 5 medical
specialties. PA considered to be agent of the physician in performance of all practice-related
activities, including but not limited to assisting in surgery and the ordering of diagnostic and
other medical services.
A PA may inject local anesthetic agents including digital blocks or apply topical anesthetic.
However, PA may not administer local anesthetics perineurally, pericurally, epidurally,
intrathecally, or intravenously, unless PA is a certified registered nurse anesthetist.
PA practice shall include medical services within the PA’s scope of education, training and
experience which are delegated by the supervising physician. May include but not limited to:
• histories and physicals
• ordering or performing diagnostic procedures as delegated by the supervising physician
• developing and implementing a treatment plan in accordance with clinical practice
guidelines and protocols of the supervising physician
• monitoring the effectiveness of therapeutic intervention
• suturing wounds as delegated
• patient counseling and education
• appropriate referrals
These activities may be performed in any setting authorized by the supervising physician
including clinics, hospitals, ambulatory surgical centers, patient homes, nursing homes, other
institutional settings and health manpower shortage areas.
§1360.31
PRESCRIBING/DISPENSING
PA scope of practice includes prescribing certain drugs and medical devices to extent
delegated by supervising physician provided PA has completed a minimum of one year of
clinical rotations during training and has practiced for a minimum of one year. PAs may
prescribe legend drugs and Schedule III-V controlled medications.
§1360.31
SUPERVISION DEFINED
Supervision means responsible direction and control, with the licensed physician assuming
legal liability for services rendered by the PA. Such supervision does not in every case require
personal presence of the supervising physician. PA and physician must have capability to be in
contact via telecommunication. Supervision shall exist when the supervising physician gives
informed concurrence of the action of a PA whether prior to or after the action, and when a
treatment plan or action is made in accordance with written clinical practice guidelines or
protocols.
§1360.22
Supervision shall be continuous but does not necessarily require the physical presence of the
supervising physician at the time and place services are rendered.
§1360.28
PAs PER PHYSICIAN
Approval may be given for physician to be the primary supervising physician for up to 2 PAs.
Physician may act as locum tenens supervisor for additional PAs, as long as physician is not
supervising more than 4 PAs at any one time.
§1360.23
APPLICATION
By PA on board-approved forms for license, may include personal interview §1360.24
Notification of intent to practice
§1360.30
By physician for approval to supervise, may include personal interview
§1360.29
QUALIFICATIONS
•
•
•
•
•
TEMPORARY PERMIT
Board may grant working permit to PA applicant who meets qualifications for licensure except
that applicant has not yet taken the national certifying exam or has taken the exam and is
awaiting results. Valid until results are available or board makes final decision on application
for licensure. May be renewed for one year.
§1360.24
TERMINATION
PA shall notify the board of changes in supervising physicians within 15 days of the date of
such change.
§1360.30
Graduation from CAHEA or its successor-accredited PA program
Passage of NCCPA certifying examination
Good moral character
Mentally and physically able to engage in PA practice
No disciplinary action in any jurisdiction unless board considers condition and agrees to
licensure
• Personal interview for initial license or if discrepancies exist
§1360.24
Physician Assistants: State Laws and Regulations • 10th edition, 2006 • American Academy of Physician Assistants
L O U I S I A N A
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S T A T U T E
Continued
CONTINUING EDUCATION
No provision
TITLE/PRACTICE PROTECTION
Person not licensed as PA guilty of misdemeanor if holds self out as PA, uses PA title, or acts
as PA without being licensed. Unlicensed physician may not use PA title unless licensed as a
PA. Only currently certified PAs may use “PA-C” designation.
§1360.35
IDENTIFICATION
PA shall keep license available for inspection at primary place of employment and shall wear
name tag with identification as physician assistant.
§1360.36
PHYSICIAN LIABILITY
Supervising physician must submit statement that physician will retain professional and legal
responsibility for care rendered by PA.
§1360.29
PA employed by physician or group of physicians or professional corporation or other health
care entity is the legal responsibility of the health care organization and the supervising
physician. Legal responsibility for PA’s patient care activities, including care provided in
facilities, remains that of the supervising physician, group of physicians or medical
corporation
§1360.32
FEE/RENEWAL SCHEDULE
License valid for no more than 1 year but may be renewed annually
§1360.23
PROGRAM APPROVAL
Programs accredited by CAHEA and its successors
§1360.22
BOARD REPRESENTATION/
ADVISORY COMMITTEE
Five-member PA Advisory Committee consists of 3 PAs appointed by governor from list
of names submitted by the Louisiana Academy of PAs. At least 1 of the members shall be PA
practicing in a municipality with fewer than 20,000 people. PA members must have 3 years
experience and be in active practice at time of appointment. Two committee members shall be
licensed supervising physicians appointed by governor from list submitted by the board. The
advisory committee elects chair, vice chair and secretary. Committee appointed for 6 years and
must meet a minimum of twice each year as determined by chairman or majority of members.
Committee to advise the board on all matters dealing with licensing or discipline of PAs or the
drafting and promulgating of regulations. Committee also to advise on applications for
licensure. Board shall not act on any matter relating to PAs without first consulting the
advisory committee.
§1270.1
BOARD POWERS
Board shall have and exercise all powers and duties previously granted to it. Also the power, in
consultation with advisory committee, to make rules and regulations pertaining to approval
and regulation of PAs, the approval of physicians to supervise, and as necessary to carry out
intent of the act.
§1360.23
DISCIPLINARY POWERS
•
•
•
•
•
Refuse to grant a license
Administer public or private reprimand
Suspend, revoke, restrict or otherwise limit license
Require PA to submit to care or counseling
Place PA on probation
§1360.34
VIOLATIONS/PENALTY
•
•
•
•
•
PAYMENT FOR SERVICES
No provision
GRANDFATHER CLAUSE
Person practicing as a PA under the supervision of a licensed physician on June 16, 1993 shall
be licensed as a PA
§1360.23
STUDENTS
Trainee is defined as a person currently enrolled in an approved PA program. §1360.22
LOCUM TENENS
No provision
OTHER
PA shall not practice without supervision except in life-threatening emergencies and in
emergency situations such as man-made and natural disaster relief efforts.
§1360.31
Fraudulently obtains or uses license
Violates PA statute or regulations
Felony conviction
Habitual use of intoxicants or drugs to extent that PA is unable to practice safely
Adjudication as mentally incompetent or has mental condition that renders PA unable to
practice safely
• Commission of an act of moral turpitude
• Represents self as a physician
§1360.33
Physician Assistants: State Laws and Regulations • 10th edition, 2006 • American Academy of Physician Assistants
L O U I S I A N A
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R E G U L A T I O N S
REGULATIONS
LAC Title 46, Subpart 2: Chapter 15 and Chapter 45
DATE
Revised 1/05
REGULATORY BODY
Louisiana State Board of Medical Examiners
PA DEFINED
Person possessing a current PA license issued under the act and this chapter. As members of
the health care team, PAs provide a broad range of medical services that would otherwise be
provided by physicians.
§1503
SCOPE OF PRACTICE
Performance of medical services that are delegated by supervising physician and within the
scope of PA’s education, training and licensure. PA services may include:
• screening patients to determine need for medical attention
• histories and routine physicals
• reviewing patient records
• recording pertinent patient data
• additional duties on illustrative list (regulations specifically state that list is illustrative and
does not constitute limits or parameters of PA’s practice)
PA may suture lacerations only when specifically delegated to do so by supervising physician.
§4505
PRESCRIBING/DISPENSING
Licensed PA may not prescribe medication unless registration for prescriptive authority has
been approved by the board.
§1505
To be registered as prescribing PA, physician assistant must have completed a minimum of
one year of clinical rotations during training and one year of practice under supervising
physician or two years of practice. Prescribing must be as delegated by physician. PA and
physician must practice under practice guidelines or protocols that must include methods of
supervision, types of medication and medical devices that PA is delegated to prescribe and a
plan for emergency services and referrals. PA who prescribes controlled medications must
register with DEA. PA with history of drug violations or history of drug abuse ineligible for
registration for authority to prescribe controlled drugs.
§1521
Supervising physician must apply and register for ability to delegate prescriptive authority. PA
must apply for registration to prescribe. Physician who delegates prescriptive authority for
controlled substances to PA may not be employee or independent contractor to PA. Board may
waive this restriction. Registrations renewed annually
§1523, 1525,
1527, 1529
PA may prescribe legend drugs and Schedule III-V substances and medical devices. PA may
not complete and issue prescription blanks previously signed by physician. §4505
PA who is registered as a prescriber may issue prescriptions for medication or medical devices
to patient of supervising physician. Prescribing PA may request, receive, sign for and deliver
to a patient a medication sample. Prescription written by PA must include preprinted name,
address, telephone number and prescriptive authority registration number of PA. If
prescription is for controlled substance, must contain PA’s DEA number. PA must prescribe
within education and experience, within clinical practice guidelines and within the specialty of
the supervising physician. PA may not utilize controlled substances to treat non-cancer
intractable pain as defined, obesity as defined, or self or family except in life-threatening
emergencies. PA may not dispense or deliver controlled substance sample.
§4506
PAs who are not registered as prescribing physician assistants may administer medication or
transmit physician’s prescription orally or in writing on patient’s record. Must be based on
patient-specific order. PA may hand to a patient a properly labeled prepackaged prescription
drug on patient-specific order of physician. Patient record must be countersigned by
supervising physician within 72 hours.
§4505
SUPERVISION DEFINED
Supervision is defined as responsible direction and control, with the supervising physician
assuming legal liability for services rendered by PA. Supervision does not require the physical
presence of supervising physician, but physician and PA be able to contact each other by
telecommunication. Supervision exists when physician responsible for the patient gives
informed concurrence of the actions of the PA whether prior to or after the action, and when a
medical treatment plan or action is made in accordance with written clinical practice
guidelines or protocols set forth by the supervising physician.
§1503
PA and supervising physician shall insure that, with respect to each patient, all activities,
functions, services and treatment measures are immediately and properly documented in
written form by PA. Each and every such written entry shall be reviewed and countersigned by
supervising physician within 24 hours for inpatients in acute care settings and hospital
emergency departments; 48 hours for nursing home patients and other subacute settings, and
72 hours in all other cases.
§4511
Physician Assistants: State Laws and Regulations • 10th edition, 2006 • American Academy of Physician Assistants
LOUISIANA REGULATIONS
Continued
PAs PER PHYSICIAN
Physician may be primary supervising physician for up to 2 PAs; however, supervising
physician may act as supervisor on a locum tenens basis provided that physician shall not
supervise more than 4 PAs at any one time.
§4507
APPLICATION
PA applies for license on board forms. Personal interview may be required if there are prior
actions against license or when discrepancies exist.
§1509
Physician applies on board forms for approval and registration as a supervising physician.
Includes information on physician’s background and specialty, scope of practice and practice
information, and plan for utilization of PA. Personal interview may be required.
§1510
QUALIFICATIONS
To be eligible for licensure, an applicant shall:
• be at least 20 years of age and of good moral character
• present diploma from PA program accredited by CAHEA (or its successor) and evidence of
passage of NCCPA certifying exam together with documentation of current NCCPA
certification; or
• present valid, current PA license, certificate or permit from another state, provided the other
state’s requirements are substantially equivalent
• certify that applicant is mentally and physically able to engage in practice as PA
• not be subject to discipline in any jurisdiction for cause resulting from applicant’s practice
as a PA (may be waived by the board)
§1507
TEMPORARY PERMIT
Board may grant working permit (temporary license) to applicant who otherwise meets
qualifications for licensure except that applicant has not yet taken or is awaiting results of
certification exam. Expires when exam results are available if applicant has failed to pass or
when board takes final action on application for licensure. PA practicing with working permit
may not prescribe.
§1513
TERMINATION
PA and supervising physician shall notify board in writing within 15 days of PA termination,
physician retirement, withdrawal from active practice, any other change in employment,
functions or activities, including delegation of prescriptive authority.
§1513, §4511
CONTINUING EDUCATION
No provision [NCCPA certification must be maintained]
PA registered to prescribe must complete NCCPA required CME, maintain current NCCPA
certification and maintain record of CME for at least 4 years and make record available to
board upon request.
§1529
TITLE/PRACTICE PROTECTION
No person may act as or undertake to perform functions of PA unless he has in his personal
possession a current PA license issued to him by the board.
§1505
IDENTIFICATION
PA may not render any service to patient unless PA has clearly identified himself as PA by any
method reasonably calculated to advise patient that the PA is not a physician. §4505
PHYSICIAN LIABILITY
Physician is responsible for supervision, control and direction of PA; retains responsibility to
patient for competence and performance of PA.
§4507
FEE/RENEWAL SCHEDULE
$155 fee with application for licensure
§1509
$75 fee with application for approval and registration as supervising physician
§1510
License must be renewed annually on first day of month licensee was born. Renewal
applications must contain documentation of current NCCPA certification and $100 renewal
fee.
§1517
PROGRAM APPROVAL
No provision
BOARD REPRESENTATION/
ADVISORY COMMITTEE
Advisory committee shall advise board on all matters dealing with licensing or discipline of
PAs or the drafting and promulgating of regulations relating to PAs. Advisory committee shall
review applications for licensure and make recommendations to the board. Board shall not act
on any matter relating to PAs without first consulting with the advisory committee. Committee
to meet not less than twice a year, or more frequently as necessary and approved by the board
at the call of the chairman.
§1511
BOARD POWERS
[See statute]
DISCIPLINARY POWERS
• Refuse to issue, suspend or revoke license
• Impose probationary or other restrictions on any license issued
• Issue a private or public reprimand
§4513
Physician Assistants: State Laws and Regulations • 10th edition, 2006 • American Academy of Physician Assistants
LOUISIANA REGULATIONS
Continued
VIOLATIONS/PENALTY
Grounds for discipline include:
• conviction of a criminal offense
• fraud, deceit or perjury in obtaining a license
• providing false testimony before the board
• habitual or recurring drunkenness, use of narcotics or other addictive drugs
• efforts to defraud or deceive the public
• incompetence
• aiding physician in violation of medical practice act
• disciplinary action by another jurisdiction
• violation of applicable law or regulations
• immoral conduct in exercising privileges provided for by license
• persistent violation of federal or state laws relative to control of social diseases
• inability to perform with reasonable skill or safety due to various factors
• refusing to submit to board-ordered examination
• violation of rules or statute pertaining to PAs
• conviction or entry of guilty or nolo contendere plea to any crime related to manufacture,
production, distribution, sale or exchange of controlled substance
• prescribing without legitimate medical justification
Board may, as probationary condition or condition of reinstatement of certificate, require PA
and/or physician to pay all costs of board proceedings and a fine not to exceed $5,000.
§4513
PAYMENT FOR SERVICES
PA may receive compensation, salary or wages only from employer; may neither render a
statement for services directly to any patient nor receive any payment, compensation or fee for
services directly from any patient. Nothing shall prohibit charges from being submitted to any
governmental or private payer for services rendered by PA.
§4503
GRANDFATHER CLAUSE
[See statute]
STUDENTS
PA students enrolled in accredited programs are exempted from rule that prohibits unlicensed
PA from functioning as PA. Student may not prescribe.
§1505
LOCUM TENENS
Proposed supervising physician may in his application designate as locum tenens a physician
who will assume his obligations and responsibilities when he is absent or unavailable as a
result of illness, medical emergency or other causes. To be eligible for designation as locum
tenens, physician must be licensed in the state, have practiced for 3 years since being awarded
MD or DO degree, practice in same or related medical specialty. Application must include
detailed information and signed statement from designated locum tenens.
§4501, 4509
OTHER
PA may practice outside approved job description in emergencies, disasters, or relief efforts or
if PA is volunteering services to a non-profit charitable organization and performs services
under supervision of physician who is physically present.
§4505
Physician Assistants: State Laws and Regulations • 10th edition, 2006 • American Academy of Physician Assistants