295 Physician Assistant Scope of Practice 2015
practice medicine in collaboration with their physician partners, and second,
the physician and PA should determine the PA’s scope of practice.83 Although the latter concept has always been a part of the Model State Legislation, state laws had to undergo decades of revisions before culminating in a
movement toward a more PA and physician-determined scope of practice.84
This occurred as medical boards discovered that it was both absurd and futile to itemize every task that a physician could conceivably and properly
delegate to a PA.85 By 1999, forty-six states and the District of Columbia
had passed laws to allow physician-delegated prescriptive authority to
PAs.86 In more than three-quarters of those states, that authority included
the ability to prescribe controlled medications.87 Indiana, Louisiana, and
Ohio were the only outlier states that authorized PA practice but continued
to prohibit prescribing by PAs.88
In 2000, Mississippi became the fiftieth state to formally authorize PA
practice, and in 2007, Indiana became the fiftieth state to grant PAs prescriptive authority.89 Upon enactment of legislation to authorize PA practice
in Mississippi, the medical board immediately adopted regulations to authorize PA prescribing.90 As of the end of 2014, PAs are authorized to prescribe controlled medications in all but two states.91
83. Id. at 1.
84. Ann Davis & Michael L. Powe, Physician Assistants: Scope of Practice, Regulation
and Reimbursement, 18 J. MED. PRAC. MGMT. 81, 81 (2002) (indicating that the role of PAs
in the United States has “undergone rapid evolution since the profession’s inception 34 years
ago” and that the “most recent trend has been a return to a more physician-determined scope
85. Id. at 82.
86. AM.ACAD. OFPHYSICIANASSISTANTS,PHYSICIANASSISTANTSSTATELAWS AND
REGULATIONS i (8th ed. 2000).
87. Davis & Powe, supra note 84 at 83.
89. See H. B. 846, 2000 Reg. Sess. (Miss. 2000). See also H. B. 1241, 115th Gen. As-
semb.,1st Reg. Sess. (Ind. 2007). See also Ann Davis, PA-C, Mississippi Enacts PA Licensing Act, All 50 States Now Authorize PA Practice, AAPA NEWS, May 30, 2000, at 1 (stating
that Mississippi was the last state to recognize PA practice). See generally RODERICK S.
HOOKER ET AL., PHYSICIAN ASSISTANTS POLICY AND PRACTICE 408 (2010) (stating that by
2007 all states had permitted PA prescribing authority).
90. Davis, supra note 89, at 1 (indicating that on April 24, 2000, at 3:30 p.m. Mississippi Gov. Ronnie Musgrove signed H. B. 846, legislation to license and authorize the practice
of physician assistants). See also ADVANCE HEALTHCARE NETWORK, In the News: State PA
News, Mississippi Board of Medical Licensure Adopts PA Rules, 10 (Sept. 1, 2000), available at http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/In-the-
News-2.aspx (asserting that the Mississippi State Board of Medical Licensure unanimously
adopted regulations governing PA practice in the state on July 27, 2000 and that the rules
went into effect on August 28, 2000).
91. DRUG ENFORCEMENT ADMINISTRATION, MID-LEVEL PRACTITIONERS AUTHORIZATION
BY STATE 1, 1-7 (OCT. 29, 2014), available at http://www.deadiversion.usdoj.gov/drugreg/
practioners/mlp_by_state.pdf (the only two states that indicate “NO” for PAs are Florida and
Kentucky). See FLA. STAT. ANN. § 458.347(4)(f) (West, WestlawNext through Ch. 255 of 4