N.J. Admin. Code § 13:35-2B.10

Current through Register Vol. 56, No. 21, November 4, 2024

Section 13:35-2B.10 - Supervision

(a) A physician assistant shall engage in practice only under the supervision of a physician.

(b) Supervision of a physician assistant shall be continuous but shall not be construed as necessarily requiring the physical presence of the supervising physician, provided that the supervising physician and physician assistant maintain contact through electronic or other means of communication.

(c) The supervisory ratio shall be no more than four physician assistants to one physician at any one time. Upon application to the Board, the Board may alter the supervisory ratios.

1. The supervisory ratio shall not limit the number of physician assistants with whom a supervising physician may enter into a delegation agreement.

(d) A supervising physician may assign physician assistants under his or her supervision to a physician designee, who shall be responsible for the practice of the physician assistant during the assignment.

(e) It is the obligation of each supervising physician and physician assistant to ensure that:

1. The physician assistant's scope of practice is identified;

2. Delegation of medical tasks is appropriate to the physician assistant's level of competence;

3. The relationship of, and access to, the supervising physician is defined; and

4. A process for evaluation of the physician assistant's performance is established.

(f) A physician assistant shall sign a separate written delegation agreement with each supervising physician who delegates medical services in accordance with the provisions of N.J.A.C. 13:35-2B.4(c).

1. A written delegation agreement may be executed by a single-specialty physician practice, provided it is signed by all of the delegating physicians supervising the physician assistant.

2. In the case of a multi-specialty physician practice, a written delegation agreement may be executed for each physician specialty within the practice, provided it is signed by all of the delegating physicians supervising the physician assistant in that specialty area. Nothing in this section shall authorize the execution of a global written delegation agreement between a physician assistant and a multi-specialty physician practice.

3. The delegation agreement shall:

i. State that the physician will exercise supervision over the physician assistant in accordance with the provisions of P.L. 1991, c. 378 ( N.J.S.A. 45:9-27.10et seq.), and this subchapter;

ii. Be signed and dated annually by the physician and the physician assistant and updated as necessary to reflect any changes in the practice or the physician assistant's role in the practice;

iii. Be kept on file at the practice site, be provided to the Physician Assistant Advisory Committee, and be kept on file by the Committee; and

iv. At a minimum, include the following provisions:

(1) The physician assistant's role in the practice, including any specific aspects of care that require prior consultation with the supervising physician;

(2) A determination of whether the supervising physician requires personal review of all charts and records of patients and countersignature by the supervising physician of all medical services performed under the delegation agreement, including prescribing and administering medication as authorized under N.J.A.C. 13:35-2B.12. This provision shall state the specified time period in which a review and countersignature shall be completed by the supervising physician. If no review and countersignature is necessary, the agreement must specifically state such provision; and

(3) The locations of practice where the physician assistant may practice under the delegation agreement, including licensed facilities in which the physician authorizes the physician assistant to provide medical services.

4. Notwithstanding this subsection, a supervising physician, in his or her discretion, may require a written delegation agreement with the physician assistant for all delegated medical services.

N.J. Admin. Code § 13:35-2B.10

Amended by 50 N.J.R. 1368(a), effective 6/4/2018