North Carolina SB 345: PA Team-Based Practice.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 2
SENATE BILL 345
Health Care Committee Substitute Adopted 4/30/25

Short Title: PA Team-Based Practice. (Public)
Sponsors:
Referred to:
March 20, 2025
*S345-v-2*
A BILL TO BE ENTITLED 1
AN ACT TO ADJUST THE SUPERVISION ARRANGEMENT OF PHYSICIAN 2
ASSISTANTS AND TO MAKE VARIOUS CHANGES TO THE LICENSURE OF 3
PHYSICIAN ASSISTANTS AND TO ALLOW NURSE PRACTITIONERS AND NURSE 4
MIDWIVES TO BE REGULATED BY THE BOARD OF NURSING. 5
The General Assembly of North Carolina enacts: 6
SECTION 1.(a) G.S. 90-1.1 is amended by adding a new subdivision to read: 7
"(4d) Team-based setting or team-based practice. – Any of the following: 8
a. A medical practice that meets all of the following requirements: 9
1. The majority of the practice is owned collectively by one or 10
more licensed physicians. 11
2. An owner who is a physician licensed under this Chapter has 12
consistent and meaningful participation in the design and 13
implementation of health services to patients, as defined by 14
rules adopted by the Board. 15
3. The physicians and team-based physician assistants who 16
provide services at the medical practice work in the same 17
clinical practice area. 18
b. Hospitals, clinics, nursing homes, and other health facilities with 19
active credentialing and quality programs where physicians have 20
consistent and meaningful participation in the design and 21
implementation of health services to patients, as defined by rules 22
adopted by the Board. 23
c. For the purposes of this Article, the term "team-based setting" or 24
"team-based practice" shall not include a medical practice that 25
specializes in pain management." 26
SECTION 1.(b) G.S. 90-9.3 reads as rewritten: 27
"§ 90-9.3. Requirements for licensure as a physician assistant. 28
(a) To be eligible for licensure as a physician assistant, an applicant shall submit proof 29
satisfactory to the Board that the applicant has met all of the following: 30
(1) The applicant has successfully completed an educational program for 31
physician assistants or surgeon assistants accredited by the Accreditation 32
Review Commission on Education for the Physician Assistant or its 33
predecessor or successor entities. 34
(2) The applicant has a current or previous certification issued by the National 35
Commission on Certification of Physician Assistants or its successor. 36

General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 345-Second Edition
(3) The applicant is of good moral character. 1
(b) Before initiating practice of medical acts, tasks, or functions as a physician assistant, 2
the physician assistant shall provide the Board the name, address, and telephone number of the 3
physician who will supervise the physician assistant in the relevant medical setting. This 4
subsection shall not apply to physician assistants who meet the requirements for team-based 5
practice under G.S. 90-9.3A. 6
(c) The Board may, by rule, require an applicant to comply with other requirements or 7
submit additional information the Board deems appropriate." 8
SECTION 1.(c) Article 1 of Chapter 90 of the General Statutes is amended by adding 9
a new section to read: 10
"§ 90-9.3A. Requirements for team-based practice as a physician assistant. 11
(a) In order to practice as a team-based physician assistant, a physician assistant shall 12
meet all of the following conditions: 13
(1) Practice in team-based settings, as defined in G.S. 90-1.1(4d). 14
(2) Have more than 4,000 hours of clinical practice experience as a licensed 15
physician assistant and more than 1,000 hours of clinical practice experience 16
within the specific medical specialty of practice with a physician in that 17
specialty. 18
(3) Submit proof as the Board may deem satisfactory by rule that the individual 19
meets the requirements of subdivisions (1) and (2) of this subsection. The 20
Board may, by rule, require the physician assistant to comply with other 21
requirements or submit additional information the Board deems appropriate. 22
(b) Team-based physician assistants shall collaborate and consult with or refer to the 23
appropriate members of the health care team as required by the patient's condition and as 24
indicated by the education, experience, and competencies of the physician assistant and the 25
standard of care. The degree of collaboration must be determined by the practice which may 26
include decisions by the employer, group, hospital service, and the credentialing and privileging 27
systems of a licensed facility. The Board may adopt rules to establish requirements for the 28
determination and enforcement of collaboration, consultation, and referral. Team-based 29
physician assistants are responsible for the care they provide. 30
(c) Notwithstanding any other provision of this Chapter, a team-based physician assistant 31
practicing in a perioperative setting, including the provision of surgical or anesthesia-related 32
services, shall be supervised by