In 2021, the Oregon Legislature passed House Bill 3036 to modernize physician assistant (PA) practice in Oregon and remove administrative barriers. These changes took effect in phases starting January 15, 2022, and July 15, 2022. HB 3036 removed parts of state regulation and allows broader discretion at the PA practice level for employers and/or physicians to structure PA practice through a collaboration agreement and collaborative practice. The Oregon Medical Board (OMB) still regulates the individual physicians and PAs as provided in the Medical Practice Act (ORS 677) to ensure patient safety.
By the end of 2023, all Oregon-licensed PAs must transition to a collaboration agreement. The OMB will terminate all remaining practice agreements or practice descriptions on January 1, 2024. Any PA practicing on or after January 1, 2024, without a collaboration agreement in place will be practicing in violation of the Medical Practice Act.
PA collaboration agreements are not filed with the OMB and the OMB will not maintain or track agreements. Collaboration agreements must be kept on file at the PA's primary location of practice and only made available to the Oregon Medical Board upon request. The physician or employer with whom the PA enters a collaboration agreement must provide a copy of the collaboration agreement to the PA. After a PA enters a collaboration agreement, the prior supervising physician and PA must log into Applicant/Licensee Services (ALS) and select the option to terminate any open practice agreements or practice descriptions. This may also be done when renewing your license.
Resources:
Rulemaking Overview
The Board used a multi-phased rulemaking plan to implement changes:
- Rulemaking #1: Amended sections of PA rules relating to PA dispensing, prescribing, chart review, and on-site supervision, operational on January 15, 2022 (HB 3036 sections 1-2). See OAR 847-050.
- Rulemaking #2: Amended telemedicine rules to add a PA telemedicine status license, operational on January 15, 2022 (HB 3036 sections 3-6). See OAR 847-025.
- Rulemaking #3: Amended licensure fee rules to add a PA telemedicine license status, operational on January 15, 2022. See OAR 847-005-0005.
- Rulemaking #4: Amended sections of PA rules to shift PA practice from a supervision to a collaboration model and requiring collaboration agreements, operational on July 15, 2022. All PAs must transition to a collaboration agreement by December 31, 2023 (HB 3036 sections 10, 11A & 20). For development of these rules, the OMB gathered input from a workgroup of PAs, physicians, a representative from a supervising physician organization (SPO), and representatives of professional associations. See OAR 847-050.
- Rulemaking #5: The Oregon Legislator passed HB 2584 (2023) to fully implement PA collaborative practice created in HB 3036 (2021). The bill clarifies that PAs practice medicine; outlines a PA's duty of care; defines a PA's scope of practice is based on their education, training, and experience; updates the employer definition for collaboration agreements; and removes the requirement that a PA's collaboration agreement include the PA's performance assessment. The proposed rule amendments align with these updates. Additionally, all PAs are required to enter into a collaboration agreement by December 31, 2023. Practice agreements and practice descriptions will no longer be valid on January 1, 2024. The proposed rules amendments and repeals remove aspects of the PA supervision practice model, see the rulemaking notice here.
HB 3036 Workgroup
The Board hosted a workgroup to review and make recommendations to draft rules implementing HB 3036 sections 10 and 11A, shifting physician assistant practice from a supervision to a collaboration model starting July 15, 2022. The workgroup included persons with subject matter expertise who would likely be affected by the proposed rules. The workgroup included PAs, physicians, a representative from a supervising physician organization (SPO), and representatives of professional associations (Oregon Society of Physician Assistants, Oregon Medical Association, and Oregon Academy of Family Physicians). The process was designed to include a diversity of opinions and viewpoints. Although the workgroup made recommendations, the Oregon Medical Board retains decision making authority.
HB 3036 workgroup meetings were open to the public and any member of the public could attend the meetings and participate during the designated public comment period.
Workgroup Materials:
HB 3036 Summary
The summary below does not include every provision of HB 3036, but highlights areas that will be addressed in OMB rulemaking. Section numbers are provided for reference to HB 3036, along with operational dates for each section. Please review HB 3036 for detailed information.
Operational January 15, 2022:
- Updates PA requirements to dispense prescription drugs (section 1).
- Removes requirement that PAs include supervising physician information on each prescription (section 2).
- Removes requirement that PAs practice within the scope of practice of a supervising physician (section 2).
- Updates the degree of autonomous judgment that a PA may exercise can be determined at the PA's primary location of practice by the community standards of care and the PA's education, training, and experience (section 2).
- Adds PA telemedicine license and allows Oregon-licensed PAs to practice via telemedicine on Oregon patients from outside of Oregon (sections 3-6).
Operational July 15, 2022:
- Adds definitions for collaboration, collaboration agreement, and employer. Removes definitions for practice agreement, supervision, and supervising physician definitions (section 10).
- Removes requirement for PAs to practice under a supervising physician (section 11A).
- Allows PAs to enter a collaboration agreement with an Oregon physician or the PA's employer, see definition of employer (section 11A).
- Allows PAs to continue practicing under a current practice agreement or practice description until the PA enters into a collaboration agreement. Requires PAs to transition to a collaboration agreement when the PA's license is due for renewal or December 31, 2023, whichever is later (section 20).
- Collaboration agreements must be available at the PA's primary location of practice and made available to the Oregon Medical Board upon request. Collaboration agreements will not be submitted to the Oregon Medical Board (section 11A).
Please email elizabeth.ross@omb.oregon.gov with comments or questions about HB 3036 and the implementation process.