The Wisconsin Medical Examining Board (MEB) recently finalized changes to Wisconsin’s physician assistant (PA) supervision requirements. The changes, effective March 1, 2014, include the following:

1. Clarification that one or more physicians may supervise a PA;

2. Requirement that a supervising physician to sign and make available to the MEB the supervising physician’s review of the PA’s prescriptive practices;

3. Requirement that the supervising physician to be readily identifiable by the PA; and,

4. Clarification that a physician may supervise no more than four on-duty PAs at any time unless approved by the MEB; that a physician is not limited in the number of PAs he or she can supervise over time; and, that a PA may be supervised by more than one physician while on duty.

Also, under the new rules, supervising physicians no longer have to make monthly site visits or enter into substitution agreements to temporarily serve as a supervising physician for a PA.

Overall, the MEB’s rules align with customary PA supervision practice in Wisconsin. Providers commonly read the supervision rules to cover on-duty supervision and not on-going supervision between a PA and a particular physician. The MEB’s changes to supervision requirements are aligned with this reasoning and appear to allow a physician to supervise numerous PAs, in general, and four PAs on duty at any specific period of time.

However, as a result of the new rule, the MEB will also be able to obtain PA prescriptive practice documents and now requires the PA to “readily identify” his or her supervising physician.

Providers should determine if internal processes should be modified to comply with the new rule.