For more than 15 years the right of Arkansas physicians to delegate to medical assistants has been hotly contested.  On March 5, 2009, the Arkansas Medical Practices Act (the Act) was amended to establish a statutory basis for physician delegation to medical assistants. The following is the language added to the Act by the Arkansas General Assembly:

17-95-208.  Rules on physician’s authority to delegate.

(a)  The Arkansas State Medical Board shall adopt rules that establish standards to be met and procedures to be followed by a physician with respect to the physician’s delegation of the performance of medical practices to a qualified and properly trained employee who is not licensed or otherwise specifically authorized by the Arkansas Code to perform the practice.

(b)  The rules adopted under subsection (a) of this section shall provide that:

(1)  The delegating physician remains responsible for the acts of the employee performing the delegated practice;

(2)  The employee performing the delegated practice shall not be represented to the public as a licensed physician, licensed nurse, licensed physician’s assistant, or other licensed healthcare provider; and

(3)  Medical practices delegated under this section shall be performed under the physician’s supervision.

(c)  Delegation of medical practices under this section may include administration of drugs that do not require substantial specialized judgment and skill based on knowledge and application of the principles of biological, physical, and social sciences as determined by the board.

(d)  Rules adopted regarding the delegation of the administration of drugs shall provide for:

(1)  The delegated administration of drugs only within the physical boundaries of the delegating physician’s offices;

(2)  Evaluation of whether delegation is appropriate according to the acuity of the patient involved;

(3)  Training and competency requirements that shall be met by the person administering the drugs; and

(4)  Other standards and procedures the board considers relevant.

(e)  The board shall not adopt rules that:

(1)  Authorize a physician to transfer to a health professional other than another physician the physician’s responsibility for supervising a delegated medical practice;

(2)  Authorize an individual to whom a medical practice is delegated to delegate the performance of the practice to another individual;

(3)  Authorize a physician to delegate the administration of anesthesia; or

(4)  Conflict with a provision of the Arkansas Code that specifically authorizes an individual to perform a particular practice.

It is significant that this new law requires the Arkansas State Medical Board to “adopt rules that establish standards to be met and procedures to be followed by a physician with respect to the physician’s delegation of the performance of medical practices to a qualified and properly trained employee.” Both the Arkansas Society of Medical Assistants and the American Association of Medical Assistants will be involved in the rule-making process.

Questions? Contact Donald A. Balasa, JD, MBA, at dbalasa@aama-ntl.org or 800/228-2262.