Revise provisions related to the practice of physician assistants.
SB 102 revises South Dakota’s physician assistant practice act by replacing much of the current “supervision” framework with a “collaborative agreement” model. The bill updates definitions throughout chapter 36-4A, changing references from supervising physicians to collaborating physicians and from supervision to collaboration. It requires a written collaborative agreement between a physician assistant and physician, filed with and approved by the Board of Medical and Osteopathic Examiners before practice begins, and it bars physician assistants from practicing without an approved agreement.
The bill also updates the scope of services a physician assistant may provide under delegation, including initial diagnosis, prescribing and dispensing limited medications and samples, emergency treatment, restraint orders, completion of certain official documents, x-rays, and athletic physicals. It preserves the existing prohibition on abortion-related procedures and clarifies emergency/disaster practice and liability protections for physician assistants and physicians acting in those settings. The bill further revises board authority over discipline, rulemaking, and the number of physician assistants a physician may collaborate with, and it repeals a section that previously set physician eligibility requirements for supervising physician assistants.
SB 102 would substantially amend chapter 36-4A governing physician assistants by modernizing terminology, restructuring physician oversight, and changing the legal relationship between physicians and physician assistants from supervision to collaboration. It affects licensing, board approval of practice agreements, disciplinary standards, emergency practice exceptions, liability protections, and the board’s rulemaking authority. The bill would also repeal a standalone provision on physician qualifications for supervision, folding those requirements into the new collaborative-agreement framework.
The available voting history suggests the bill had mixed support and was not moving forward quickly, as it was deferred to the 41st legislative day on a 4-3 vote. With no committee transcript available, there is no recorded debate to show broad consensus or organized opposition, but the close vote indicates some members supported the modernization of physician assistant practice while others were not ready to advance it. Overall, the sentiment appears cautious and divided rather than strongly favorable or strongly opposed.
The main points of contention appear to be the shift from physician supervision to physician collaboration, the level of independence granted to physician assistants, and the board’s role in approving and regulating collaborative agreements. The bill also preserves and restates the abortion prohibition for physician assistants, which may be a separate policy point of concern for some lawmakers. In addition, the limits on how many physician assistants a physician may collaborate with, and the requirement that physicians be free of disciplinary restrictions to participate, could be debated by stakeholders concerned about access to care, oversight, and provider flexibility.