43-17-02.1. Physician assistant - Scope of practice
1. An individual providing the services of a physician assistant under this chapter to a
patient located in this state shall possess an active North Dakota license for physician
assistant practice or be privileged to practice in this state under chapter 43-17.5. The
board shall adopt rules governing the conduct, licensure, fees for licensure and
privilege, qualifications, and discipline of physician assistants. Physician assistants are
not authorized to perform any services that must be performed by individuals licensed
under chapters 43-12.1, 43-13, 43-15, and 43-28 or services otherwise regulated by
licensing laws, notwithstanding medical doctors are not required to be licensed
specifically to perform the services contemplated under such chapters or licensing
laws.
2. A physician assistant may:
a. Provide a legal medical service for which a physician assistant is prepared by
education, training, and experience and is competent to perform, including:
(1) Obtaining and performing a comprehensive health history and physical
examination;
(2) Evaluating, diagnosing, managing, and providing medical treatment;
(3) Ordering and evaluating a diagnostic study and therapeutic procedure;
(4) Performing a diagnostic study or therapeutic procedure not involving the use
of medical imaging as defined in section 43-62-01 or radiation therapy as
defined in section 43-62-01;
(5) Performing limited sonography on a focused imaging target to assess
specific and limited information about a patient's medical condition or to
provide real-time visual guidance for another procedure;
(6) Educating a patient on health promotion and disease prevention;
(7) Providing consultation upon request; and
(8) Writing a medical order;
b. Obtain informed consent;
c. Supervise, delegate, and assign therapeutic and diagnostic measures not
involving the use of medical imaging as defined in section 43-62-01 or radiation
therapy as defined in section 43-62-01 to licensed or unlicensed personnel;
d. Certify the health or disability of a patient as required by any local, state, or
federal program;
e. Authenticate any document with the signature, certification, stamp, verification,
affidavit, or endorsement of the physician assistant if the document may be
authenticated by the signature, certification, stamp, verification, affidavit, or
endorsement of a physician; and
f. Pronounce death.
3. A physician assistant shall collaborate with, consult with, or refer to the appropriate
member of the health care team as indicated by the condition of the patient, the
education, experience, and competence of the physician assistant, and the standard of
care. The degree of collaboration must be determined at the practice which may
include decisions made by the employer, group, hospital service, and the credentialing
and privileging systems of a licensed facility. A physician assistant is responsible for
the care provided by that physician assistant and a written agreement relating to the
items in this chapter is not required.
4. A physician assistant:
a. May prescribe, dispense, administer, and procure drugs and medical devices;
b. May plan and initiate a therapeutic regimen that includes ordering and prescribing
nonpharmacological interventions, including durable medical equipment, nutrition,
blood and blood products, and diagnostic support services, including home health
care, hospice, and physical and occupational therapy;
c. May prescribe and dispense schedule II through V substances as designated by
the federal drug enforcement agency and all legend drugs;
d. May not dispense a drug, unless pharmacy services are not reasonably available,
dispensing is in the best interest of the patient, or an emergency exists;
e. May request, receive, and sign for a professional sample, and may distribute a
professional sample to a patient; and
f. If prescribing or dispensing a controlled substance, shall register with the federal
drug enforcement administration and shall comply with appropriate state and
federal laws.
5. A physician assistant shall practice at a licensed health care facility, facility with a
credentialing and privileging system, physician-owned facility or practice, or facility or
practice approved by the board.
6. Notwithstanding subsections 3 and 5, a physician assistant with less than four
thousand hours of practice approved by the board under subsection 5 shall execute a
written collaborative agreement that:
a. Is between a physician and a physician assistant with less than four thousand
hours practice;
b. Describes how collaboration required under subsection 3 must occur; and
c. Is available to the board on request.
7. A physician assistant shall comply with any privileging and credentialing systems at
the facility at which the physician assistant practices.
