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S 2572Healthcare: Licensing & Accreditation

Businesses and Professions - Physician Assistants

This bill increases the number of Physician Assistants on their licensing board, expands their practice independence, and allows direct Medicaid billing.

Held for study
Population
Affected
35
Email Legislator
Introduced Feb 13, 2026Committee Senate Health & Human Services

Plain-English Summary

This legislation modifies the governance and practice standards 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 are PAs. The bill updates practice regulations, removing the requirement for a specific written collaboration agreement with a physician, though collaboration or consultation remains part of the practice. It allows PAs to be designated as primary care providers and permits them to receive direct payments from the Department of Human Services for medical services provided under the state's medical assistance program.

For younger readers

This new rule changes how Physician Assistants work. Physician Assistants are medical workers who help doctors and treat sick people. This bill puts more of them on the special group that makes the rules for their jobs. It also says they don't need a specific paper contract to work with other doctors anymore, giving them a little more independence. They can now be called "primary care providers," which is the main doctor you see for checkups. Also, the government can now pay them directly for the help they give to people who use state health insurance.

Who & Where It Applies

Impacted groups
Physician AssistantsPhysicians (MDs/DOs)Medicaid 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 serve as primary care providers and bill Medicaid directly, potentially reducing wait times for patients using government assistance.
  • Empowers healthcare workers by increasing the representation of Physician Assistants on their own licensing board, ensuring that the people actually doing the work have a majority voice in regulating their profession.
  • Modernizes the healthcare workforce by removing bureaucratic barriers like mandatory written agreements, allowing for a more flexible and responsive healthcare system that values the competence of mid-level practitioners.
  • Could potentially create a two-tiered healthcare system where low-income patients on state assistance are primarily treated by Physician Assistants while wealthier patients retain greater access to Medical Doctors.
  • Grants private hospitals and corporate healthcare facilities significant discretion to define the scope of privileges for PAs, potentially prioritizing corporate efficiency over standardized public oversight.
  • Reducing the strict requirement for written collaboration agreements with physicians might raise concerns about the level of oversight and mentorship available to ensure patient safety in complex medical cases.
For Conservatives
  • Reduces government red tape and administrative burdens by eliminating the mandate for written collaboration agreements, allowing medical professionals to operate more freely without unnecessary paperwork.
  • Promotes free market competition in healthcare by allowing Physician Assistants to bill directly and practice more independently, which could increase consumer choice and drive down costs.
  • Decentralizes decision-making by allowing private practices and hospitals to determine the degree of collaboration required based on their specific needs, rather than relying on a rigid state mandate.
  • Expands the size of a government regulatory board, increasing the bureaucracy and the number of state appointees rather than shrinking the administrative state.
  • Undermines the traditional medical hierarchy by reducing physician oversight, potentially devaluing the extensive training, authority, and leadership role of licensed Medical Doctors.
  • Facilitates direct government payments to a new class of providers under state entitlement programs, which could potentially lead to increased utilization and higher public spending on Medicaid.

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.