Physician Associate Collaboration Agreements

As of December 31, 2023 all physician assistants must be practicing under the updated agreement model.  Please see the additional resources below if you need more information.

Beginning July 15, 2022, physician assistants in Oregon will begin to practice under a new form of agreement which transitions away from “practice” to “collaboration” agreements. This change to the Medical Practices Act is the result of House Bill 3036 passed by the Oregon Legislature in 2021. The purpose of the bill was to modernize physician assistant practice and remove administrative barriers.

Given the significance of the changes, the Oregon Medical Board conducted a series of rule-makings to translate the broad statutory changes into more detailed administrative rules. The last set of those rules become effective in July 2022. There will be a transition period permitted for traditional practice agreements that are not needed to be changed just yet, but all physician assistants must be practicing under the new collaboration agreement model after December 31, 2023.

 

Past Timeline

January 15, 2022: Physician assistants located outside the state may obtain a telemedicine active status license (a separate telemedicine status license is not needed for physician assistants located in the state with an active license).

July 15, 2022: Physician assistants will need to begin practicing under a collaboration agreement for any new practice or if there is a change needed in an existing practice agreement.

December 31, 2023: All physician assistants must begin practicing under a collaboration agreement after this date.

What do you need to know?

Physician assistants, physicians, and employers will want to become familiar with the changes created by the modernization bill. The FAQ Page and sample collaboration agreement template under the Resources heading below will help orient everyone quickly.

One question already being asked is whether the changes authorize completely independent practice, and the short answer is they do not. Physician assistants must practice under a collaboration agreement and the degree of autonomous judgment in that setting will be determined by the community standard of care and the physician assistant’s education, training, and experience.

Another emerging question is whether a physician must sign the collaboration agreement. While a physician or podiatrist (both licensees of the Oregon Medical Board) may sign a collaboration agreement an employer of the physician assistant (and the physician or podiatrist) may sign the agreement as well to help streamline administrative requirements. Copies of agreements no longer have to be kept on file with the medical board.

There are concerns, too, about liability issues for physician assistants and physicians in a collaborative agreement setting. The agreement itself is not intended to create supervisory responsibility or represent legal responsibility by a physician for the care provided by the physician assistant. A medical practice should consult with their professional liability carrier about appropriate coverage related to a collaboration agreement.

Resources

A good place to start is with the Oregon Medical Board FAQ page. This page will be updated as implementation questions emerge so check back often in the initial year of the transition.

To learn more about the rulemaking process, here is a temporary page outlining all the rule changes.

The medical board also drafted a sample collaborative agreement template that could be used as a starting point for tailoring agreements to individual practice settings.

As medical practices come across issues with implementation of the new law and rules, please reach out to the OMA’s Knowledge Center team who will compile those questions and begin seeking answers from agencies and other organizations. The team also can provide contacts for health law attorneys and other business consultants.

Last updated: July 6, 2022

Disclaimer: This material is for informational purposes only and is not intended to constitute legal advice. The information, examples, and suggestions presented in this material (though reliable) should not be construed as legal or other professional advice. Before applying this information in legal situations, we recommend you consult with legal counsel or other professional advisors.