Resources you need for collaborative agreements with physician assistants

Important changes have occurred to the scope of practice for physician assistants (PA). After two years of fiercely fought and failed legislative attempts, SB23-83 passed the legislature and was signed into law by Governor Polis earlier this spring. CO ACEP in collaboration with CMS secured important amendments to the bill. The new law changes how PAs practice. Instead of practicing medicine under the direct supervision of a physician, a physician assistant must now enter a “collaborative agreement” with a physician.

In addition, the legislature included the requirement for a “supervisory agreement in the following circumstances:

  • All PAs practicing in Level I & II trauma designated emergency departments.
  • New PAs for their first 5,000 hours regardless of practice area (specialty).
  • PAs changing practice area (specialty) must complete an additional 3,000 hours in that new practice area.

The Colorado Board of Medicine (CMB) recently finalized regulations to operationalize the law (changing what was Rule 400 to the new Rule 1.15 [starting on page 21]). If you work with PAs, then CO ACEP encourages you to review COPIC’s excellent analysis that explains exactly how the new agreements work. CO ACEP also encourages you to utilize the collaborative practice agreement template and the performance evaluation form template that COPIC developed and is supported by both CO ACEP and CMS.

While the CMB rules failed to address the extent and manner a PA may practice in a “supervisory agreement”, CO ACEP continues to encourage the CMB to further define the responsibilities of both physicians and PAs in those required circumstances. CO ACEP will alert you to all developments on that front.

Chapter Administration

External Links

Residency Corner

2023 Documentation and Coding Guidelines

Discussion and Q & A with Dr. David Friedenson

Colorado ACEP 2017 Opioid Prescribing & Treatment Guidelines

Confronting The Opioid Epidemic In Colorado’s Emergency Departments

Emergency providers across Colorado and our nation are facing one of the greatest public health crises of our generation. Opioids, both prescription and illicit, have become the leading cause of accidental death in the United States. View or download the Guidelines (PDF).