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Expansion of Practice Autonomy of Physician Assistants Summary

As part of a flurry of activity at the end of 2016, Public Act 379 was enacted by the Michigan legislature and signed by Governor Snyder. That Act amends various provisions of the Michigan Public Health Code (the “Code”) regarding the professional relationship of physician assistants (“PAs”) with physicians and podiatrists and regarding the professional independence of PAs. The Act’s provisions take effect on March 22, 2017. Physician practices and other entities that employ PAs will need to address these changes by that date.

Previously, Michigan law required PAs to work under the supervision and delegation of a physician or a podiatrist. The new Act deletes those terms from the Code.  The intent behind these changes is to create a legal structure that fosters a more collaborative approach to patient care between PAs and physicians and that authorizes greater independence and autonomy for PAs treating patients within their general scope of practice.

Other changes include PAs as independent prescribers, PAs entering into a mandatory practice agreement, physician to PA ratio and licensing board authority, liability and professional liability insurance, billing and reimbursement, as well as independent rounding and house calls.

Physician group practices and other entities that employ PAs should begin addressing these matters soon to allow enough time to implement these new requirements before March 22, 2017. 

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About this Author

Brian S. Fleetham, Dickinson Wright, Corporate Governance Lawyer, Joint Ventures Attorney

Brian Fleetham, a Member of Dickinson Wright, specializes in health law and general business and corporate law. He has extensive experience representing physicians, other health care providers and professional entities on business transactions, joint ventures, corporate governance, arrangements with hospital and other facilities, and regulatory matters such as Stark, HIPAA, fraud and abuse, and compliance matters.

Rose Willis, Dickinson Wright, Healthcare Regulatory Matters Lawyer, HIPAA Privacy Attorney

Rose's practice focuses on healthcare regulatory, transactional and corporate law in her representation of healthcare providers and suppliers and other current or prospective participants in the healthcare industry. Rose regularly counsels healthcare industry clients on matters regarding:

  • Entity governance documents such as Bylaws, Operating Agreements, Shareholder Agreements, Buy-Sell Agreements and Deferred Compensation Agreements

  • HIPAA privacy and security laws

  • Mergers and acquisitions involving physician practices and hospitals

  • Joint ventures and block leasing concepts

  • Turnkey leases involving equipment, real estate and services

  • Physician and midlevel provider employment agreements

  • Corporate compliance programs

  • Professional service agreements

  • Stark, Anti-Kickback and other federal and state fraud and abuse laws in structuring hospital, physician and other healthcare ventures

  • Certificate of Need letters of intent and applications

  • Corporate practice of medicine issues

  • Healthcare software license agreements and meaningful use requirements

  • Accountable care organizations, clinically integrated networks and other structural options in the post-healthcare reform environment for increasing quality while reducing costs

  • Homes for the Aged and Adult Foster Care facility licensure matters