2010 Tennessee Code
Title 63 - Professions Of The Healing Arts
Chapter 19 - Physician Assistants
Part 1 - General Provisions
63-19-107 - Restrictions on supervising physicians and assistants.

63-19-107. Restrictions on supervising physicians and assistants.

A licensed physician supervising physician assistants shall comply with the following practices:

     (1)  More than one (1) physician may supervise the same physician assistant; provided, each physician assistant shall have a primary supervising physician and may have additional alternate supervising physicians who shall supervise the physician assistant in the absence or unavailability of the primary supervising physician. Each physician assistant shall notify the committee of the name, address, and license number of the physician assistants' primary supervising physician and shall notify the committee of any change in such primary supervising physician within fifteen (15) days of the change. The number of physician assistants for whom a physician may serve as the supervising physician shall be determined by the physician at the practice level, consistent with good medical practice. The supervising physician shall designate one (1) or more alternate physicians who have agreed to accept the responsibility of supervising the physician assistant on a prearranged basis in the supervising physician's absence;

     (2)  (A)  In accordance with rules adopted by the board and the committee, a supervising physician may delegate to a physician assistant working under the physician's supervision the authority to prescribe and/or issue legend drugs and controlled substances listed in Schedules II, III, IV, and V of title 39, chapter 17, part 4. The rules adopted prior to March 19, 1999, by the board and the committee governing the prescribing of legend drugs by physician assistants shall remain effective after March 19, 1999, and may be revised from time to time as deemed appropriate by the board and the committee. The board and the committee may adopt additional rules governing the prescribing of controlled substances by physician assistants. A physician assistant to whom is delegated the authority to prescribe and/or issue controlled substances must register and comply with all applicable requirements of the drug enforcement administration.

          (B)  A physician assistant to whom the authority to prescribe legend drugs and controlled substances has been delegated by the supervising physician shall file a notice with the committee, containing the name of the physician assistant, the name of the licensed physician having supervision, control and responsibility for prescriptive services rendered by the physician assistant, and a copy of the formulary describing the categories of legend drugs and controlled substances to be prescribed and/or issued by the physician assistant. The physician assistant shall be responsible for updating this information;

          (C)  The prescriptive practices of physician assistants, and the supervision by physicians under whom such physician assistants are rendering service, shall be monitored by the board and committee. As used in this section, “monitor” does not include the regulation of the practice of medicine or the regulation of the practice of a physician assistant, but may include site visits by members of the board and committee;

          (D)  Any complaints against physician assistants and/or supervising physicians shall be reported to the director of the division of health related boards, the committee on physician assistants, and the board of medical examiners, as appropriate;

     (E)  (i)  Every prescription order issued by a physician assistant pursuant to this section shall be entered in the medical records of the patient and shall be written on a preprinted prescription pad bearing the name, address, and telephone number of the supervising physician and of the physician assistant, and the physician assistant shall sign each prescription order so written. Where the preprinted prescription pad contains the names of more than one (1) physician, the physician assistant shall indicate on the prescription which of those physicians is the physician assistant's primary supervising physician by placing a checkmark beside or a circle around the name of that physician.

          (ii)  Any handwritten prescription order for a drug prepared by a physician assistant who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription. The handwritten prescription order must contain the name of the prescribing physician assistant; the name and strength of the drug prescribed; the quantity of the drug prescribed, handwritten in both letters and numerals; instructions for the proper use of the drug; and the month and day that the prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing physician assistant must sign the handwritten prescription order on the day it is issued, unless it is a standing order issued in a hospital, a nursing home or an assisted care living facility as defined in § 68-11-201.

          (iii)  Any typed or computer-generated prescription order for a drug issued by a physician assistant who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription order. The typed or computer-generated prescription order must contain the name of the prescribing physician assistant; the name and strength of the drug prescribed; the quantity of the drug prescribed, recorded in letters or in numerals; instructions for the proper use of the drug; and the month and day that the typed or computer-generated prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing physician assistant must sign the typed or computer-generated prescription order on the day it is issued, unless it is a standing order issued in a hospital, nursing home or an assisted care living facility as defined in § 68-11-201.

          (iv)  Nothing in this section shall be construed to prevent a physician assistant from issuing a verbal prescription order.

          (v)  (a)  All handwritten, typed or computer-generated prescription orders must be issued on tamper-resistant prescription paper that meets the current centers for medicare and medicaid service guidance to state medicaid directors regarding § 7002(b) of the U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007, P.L. 110-28, and meets or exceeds specific TennCare requirements for tamper-resistant prescription paper.

                (b)  Subdivision (2)(E)(v)(a ) shall not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the doctor, or other person authorized to write prescriptions, writes the order into the hospital medical record and then the order is given directly to the hospital pharmacy and the patient never has the opportunity to handle the written order, a nursing home or an assisted care living facility as defined in § 68-11-201 or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state or federal correctional facility.

          (F)  No drugs shall be dispensed by a physician assistant except under the supervision, control, and responsibility of the supervising physician;

     (3)  The patient of any physician receiving services from that physician assistant shall be fully informed that the individual is a physician assistant and/or a sign shall be conspicuously placed within the office of the physician indicating that certain services may be rendered by a physician assistant; and

     (4)  A physician who does not normally provide patient care is not authorized to supervise or utilize the services of a physician assistant.

[Acts 1985, ch. 376, § 1; T.C.A., § 63-19-207; Acts 1994, ch. 722, § 2; 1996, ch. 659, §§ 4, 5; 1998, ch. 842, §§ 5-7; 1999, ch. 33, §§ 2, 3; 2000, ch. 584, § 3; 2002, ch. 527, § 1; 2004, ch. 678, § 10; 2005, ch. 12, § 8; 2008, ch. 1035, §§ 8, 9.]