An Act to amend and reenact §§ 54.1-2951.1, 54.1-2952, and 54.1-2952.1 of the Code of Virginia and to amend the Code of Virginia by adding a section numbered 54.1-2952.01, relating to physician assistants; authorization to practice without a practice agreement.
HB746 revises Virginia’s physician assistant practice laws to allow certain physician assistants to practice without a separate written or electronic practice agreement in limited settings. Under the bill, physician assistants generally remain part of a patient care team and continue to work in collaboration and consultation with a patient care team physician or podiatrist, but an exception is created for physician assistants employed by hospitals, state facilities operated by the Department of Behavioral Health and Developmental Services, and federally qualified health centers, so long as the facility’s credentialing and privileging requirements include the same core elements that would otherwise appear in a practice agreement.
The bill also preserves and updates existing licensure and endorsement rules for physician assistants, including requirements for education, national certification, and good standing in other jurisdictions. It continues to define the role of the patient care team physician or podiatrist, limits collaboration to no more than six physician assistants at one time, and clarifies that participation on a patient care team does not by itself create vicarious liability for the actions of other team members.
HB746 amends §§ 54.1-2951.1, 54.1-2952, and 54.1-2952.1 and adds § 54.1-2952.01 to the Code of Virginia, changing the regulatory framework for physician assistant practice. The main legal effect is to remove the universal requirement for a separate practice agreement in specified institutional settings while keeping patient care team oversight, collaboration, and consultation requirements in place through facility credentialing and privileging processes. The bill affects physician assistants, supervising physicians or podiatrists, hospitals, state behavioral health facilities, federally qualified health centers, and the Board of Medicine’s licensure and enforcement practices.
The available record shows no committee transcripts or recorded votes, so there is no documented floor or committee debate to indicate partisan or stakeholder opposition. The enacted chapter text suggests the bill advanced successfully and was approved, which is consistent with a generally favorable or at least noncontroversial reception. Based on the substance of the measure, the likely support comes from efforts to reduce administrative barriers and expand practice flexibility for physician assistants in institutional settings while maintaining oversight.
The main policy issue is the balance between reducing paperwork and preserving physician oversight. Supporters would likely favor eliminating separate practice agreements for physician assistants in hospitals, state facilities, and federally qualified health centers because it can streamline staffing and credentialing. Potential concerns would come from those worried that loosening agreement requirements could weaken supervision, though the bill addresses that by requiring collaboration, consultation, and facility-based practice arrangements that mirror the key elements of a practice agreement. Another point of interest is the cap of six physician assistants per patient care team physician or podiatrist, which preserves a limit on team size and may reflect an effort to reassure opponents about oversight.