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H 7274Healthcare: Licensing & Accreditation

Businesses and Professions - Physician Assistants

This bill expands the Physician Assistant licensure board, grants PAs greater practice autonomy, and allows them to directly bill Medicaid.

Introduced
Population
Affected
28
Email Legislator
Introduced Jan 23, 2026Committee House Health & Human Services

Plain-English Summary

This legislation updates the professional regulations for physician assistants (PAs) in Rhode Island. It increases the size of the Board of Licensure for Physician Assistants from seven to nine members, ensuring a majority of the board is composed of PAs. The bill removes the requirement for a specific written collaborative agreement between a PA and a physician, shifting to a model of consultation and referral. It establishes that PAs are responsible for the care they provide and allows them to be designated as primary care providers. Furthermore, it authorizes PAs to receive direct payments from the state’s medical assistance program.

For younger readers

This new law changes rules for Physician Assistants, who are medical workers known as PAs. It puts more PAs on the group that makes the rules for their jobs. The law also says that PAs do not need to sign a specific paper agreement with a doctor to work anymore; they can just ask a doctor for help when they need it. Additionally, it allows the government to pay PAs directly for the medical help they give to people, instead of the money having to go through a doctor's office first.

Who & Where It Applies

Impacted groups
Physician AssistantsPhysiciansMedicaid RecipientsHospitals and Healthcare FacilitiesDepartment of Health
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Expands access to healthcare for low-income populations by allowing physician assistants to receive direct reimbursement from the state medical assistance program, potentially increasing the number of providers accepting Medicaid.
  • Empowers healthcare workers by granting physician assistants greater professional autonomy and representation on their own licensure board, recognizing their expertise and labor.
  • Modernizes the healthcare delivery model to be more efficient, potentially reducing wait times for primary care in underserved communities where doctors may be scarce.
  • Removing mandatory written collaborative agreements could theoretically lead to a two-tiered healthcare system where low-income patients see PAs with less oversight while wealthy patients see physicians.
  • Might encourage corporate healthcare systems to replace unionized or higher-paid physicians with PAs to cut labor costs, prioritizing profit over the highest level of specialized training.
  • Could lead to fragmentation in patient care if the consultation and referral processes are not strictly monitored, potentially impacting the continuity of care for vulnerable patients with complex needs.
For Conservatives
  • Reduces government red tape and regulatory burdens on medical professionals by eliminating the mandate for written collaborative agreements between physicians and physician assistants.
  • Promotes free-market competition in healthcare by allowing physician assistants to operate more independently, which could potentially lower the cost of services through increased supply.
  • Streamlines billing processes by allowing direct payment, cutting through some of the bureaucratic layers required for providers to get paid for their services.
  • Expands the size of a state regulatory board, increasing the size of government and the administrative state.
  • Facilitates direct government payments to a wider pool of providers through Medicaid, which could increase total state welfare spending and utilization.
  • Undermines the traditional hierarchy of the medical profession by removing the strict requirement for physician supervision, potentially devaluing the extensive education and authority of doctors.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 20 additions · 7 deletions

SECTION 1. Sections 5-54-5 and 5-54-8 of the General Laws in Chapter 5-54 entitled "Physician Assistants" are hereby amended to read as follows: 5-54-5. Board of licensure.

(a) The director of the department of health, with the approval of the governor, shall appoint a board consisting of seven (7) nine (9) persons, residents of the state, to constitute a board of licensure for physician assistants with the duties, powers, and authority as stated in this chapter, and that board shall be composed of the following:

(1) Two (2) members shall be licensed physicians under the provisions of chapter 37 of this title who have been actively engaged in the practice of medicine;

(2) [Deleted by P.L. 2019, ch. 197, § 1 and P.L. 2019, ch. 230, § 1.]

(3) Two (2) members who are representatives of the general public not employed in any health-related field; and

(4) Three (3) Five (5) members shall be physician assistants.

(b) Members shall be appointed for terms of three (3) years each. No member shall be appointed to more than two (2) consecutive terms. Upon expiration of the term of office, a member shall continue to serve until a successor is appointed and qualified.

(c) In the director’s initial appointment, the The director shall designate the members of the board of licensure for physician assistants as follows: two (2) three (3) members to serve for terms of three (3) years; two (2) three (3) members to serve for a term of two (2) years; and three

(3) members to serve for a term of one year. Any additional appointments shall serve for one year.

(d) The director of the department of health may remove any member of the board for cause.

(e) Vacancies shall be filled for the unexpired portion of any term in the same manner as the original appointment. 5-54-8. Permitted healthcare practices by physician assistants.

(a) Physician assistants shall practice in collaboration collaborate with, consult with, or refer to the appropriate member of the healthcare team as indicated by the condition of the patient, the education, experience, and competence of the physician assistant, and the standard of care physicians. The degree of collaboration shall be determined at the practice which may include decisions made by the employer, group, hospital service, and the credentialing and privileging systems of a licensed facility. A physician assistant is responsible for the care provided by that physician assistant and a written agreement related to the items in this chapter is not required. A physician assistant may provide any medical or surgical services that are within the physician assistant’s skills, education, and training. Whenever any provision of general or public law or regulation requires a signature, certification, stamp, verification, affidavit, or endorsement by a physician, it shall be deemed to include a signature, certification, stamp, verification, affidavit, or endorsement by a physician assistant. Physician assistants may perform those duties and responsibilities consistent with the limitations of this section, including prescribing, administering, procuring, and dispensing of drugs and medical devices. Physician assistants may request, receive, sign for, and distribute professional samples of drugs and medical devices to patients only within the limitations of this section. Notwithstanding any other provisions of law, a physician assistant may provide medical and surgical services when those services are rendered in collaboration with a licensed physician.

(b) [Deleted by P.L. 2019, ch. 197, § 1 and P.L. 2019, ch. 230, § 1].

(c) Physician assistants may write prescriptions and medical orders to the extent provided in this paragraph. When extended medical staff privileges by a licensed hospital or other licensed healthcare facility in accordance with subsection (e) of this section, a physician assistant may write medical orders for inpatients as delineated by the medical staff bylaws of the facility as well as its credentialing process and applicable governing authority. Physician assistants may prescribe legend medications including Schedule II, III, IV, and V medications under chapter 28 of title 21 of the Rhode Island uniform controlled substances act, medical therapies, medical devices, and medical diagnostics.

(d) When collaborating with a physician licensed under chapter 29 of this title, the service rendered by the physician assistant shall be limited to the foot. The “foot” is defined as the pedal extremity of the human body and its articulations, and includes the tendons and muscles of the lower leg only as they are involved in conditions of the foot.

(e) Hospitals and other licensed healthcare facilities have discretion to grant privileges to a physician assistant and to define the scope of privileges or services that a physician assistant may deliver in a facility.

(f) A physician assistant shall not undertake or represent that he or she is qualified to provide a medical or surgical care service that he or she knows or reasonably should know to be outside his or her competence or is prohibited by law.

(g) Notwithstanding any other provision of law or regulation, a physician assistant shall be considered to be a primary care provider when the physician assistant is practicing in the medical specialties required for a physician to be a primary care provider.

SECTION 2. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby amended by adding thereto the following section: 40-8-33. Direct payments to physician assistants. Licensed physician assistants shall be permitted to receive payments directly from the department for medical services provided under this chapter. The director shall make and promulgate rules, regulations, and fee schedules consistent with the provisions of the federal Social Security Act, 42 U.S.C. § 1396 et seq., and any rules or regulations promulgated pursuant thereto to ensure direct payments to licensed physician assistants.

SECTION 3. This act shall take effect upon passage.