A.R.S. tit. 32 ch. 25 — Arizona Revised Statutes Title 32 Chapter 25 — Physician Assistants

32-2501. Definitions In this chapter, unless the context otherwise requires: 1. "Active license" means a regular license issued pursuant to this chapter. 2. "Adequate records" means legible medical records containing, at a minimum, sufficient information to identify the patient, support the diagnosis, justify the treatment, accurately document the results, indicate advice and cautionary warnings provided to the patient and provide sufficient information for another practitioner to assume continuity of the patient's care at any point in the course of treatment. 3. "Advisory letter" means a nondisciplinary letter to notify a physician assistant that either: (a) While there is insufficient evidence to support disciplinary action, the board believes that continuation of the activities that led to the investigation may result in further board action against the licensee. (b) The violation is a minor or technical violation that is not of sufficient merit to warrant disciplinary action. (c) While the licensee has demonstrated substantial compliance through rehabilitation or remediation that has mitigated the need for disciplinary action, the board believes that repetition of the activities that led to the investigation may result in further board action against the licensee. 4. "Approved program" means a physician assistant educational program accredited by the accreditation review commission on education for physician assistants, or one of its predecessor agencies, the committee on allied health education and accreditation or the commission on the accreditation of allied health educational programs. 5. "Board" means the Arizona regulatory board of physician assistants. 6. "Collaborating physician or entity" means a physician, physician group practice, physician private practice or licensed health care institution that employs or collaborates with a physician assistant who has at least eight thousand hours of clinical practice as certified by the board pursuant to section 32-2536 and does not require a supervision agreement and that designates one or more physicians by name or position who is responsible for the oversight of the physician assistant. 7. "Completed application" means an application for which the applicant has supplied all required fees, information and correspondence requested by the board on forms and in a manner acceptable to the board. 8. "Immediate family" means the spouse, natural or adopted children, father, mother, brothers and sisters of the physician assistant and the natural or adopted children, father, mother, brothers and sisters of the physician assistant's spouse. 9. "Letter of reprimand" means a disciplinary letter that is issued by the board and that informs the physician assistant that the physician assistant's conduct violates state or federal law and may require the board to monitor the physician assistant. 10. "Limit" means a nondisciplinary action that is taken by the board and that alters a physician assistant's practice or medical activities if there is evidence that the physician assistant is or may be mentally or physically unable to safely engage in health care tasks. 11. "Medically incompetent" means that a physician assistant lacks sufficient medical knowledge or skills, or both, in performing delegated health care tasks to a degree likely to endanger the health or safety of patients. 12. "Minor surgery": (a) Means those invasive procedures that may be performed by a physician assistant, that are consistent with the training and experience of the physician assistant, that are normally taught in courses of training approved by the board, that have been approved by the board as falling within the scope of practice of a physician assistant and that are consistent with the practice setting requirements of the physician assistant. (b) Does not include a surgical abortion. 13. "Physician" means a physician who is licensed pursuant to chapter 13 or 17 of this title. 14. "Physician assistant" means a person who is licensed pursuant to this chapter. 15. "Regular license" means a valid and existing license that is issued pursuant to section 32-2521 to perform health care tasks. 16. "Restrict" means a disciplinary action that is taken by the board and that alters a physician assistant's practice or medical activities if there is evidence that the physician assistant is or may be medically incompetent or guilty of unprofessional conduct. 17. "Supervising physician" means a physician who holds a current unrestricted license, who supervises a physician assistant who has less than eight thousand hours of clinical practice and who assumes legal responsibility for health care tasks performed by the physician assistant. 18. "Supervision" means a physician's opportunity or ability to provide or exercise direction and control over the services of a physician assistant. Supervision does not require a physician's constant physical presence if the supervising physician is or can be easily in contact with the physician assistant by telecommunication. 19. "Supervision agreement" means a written or electronic signed agreement that both: (a) Describes the scope of practice for a physician assistant who has less than eight thousand hours of clinical practice. (b) Is between the physician assistant and a physician or the physician assistant's employer that employs or has on medical staff at least one physician who may provide oversight, as applicable, and who holds a current unrestricted license. For the purposes of this subdivision, "employer" means a physician, physician group practice, physician private practice or licensed health care institution. 20. "Unprofessional conduct" includes the following acts by a physician assistant that occur in this state or elsewhere: (a) Violating any federal or state law or rule that applies to the performance of health care tasks as a physician assistant. Conviction in any court of competent jurisdiction is conclusive evidence of a violation. (b) Claiming to be a physician or knowingly allowing another person to represent that person as a physician. (c) Performing health care tasks that do not meet the supervision or collaboration requirements, as applicable, pursuant to section 32-2531. (d) Exhibiting a pattern of using or being under the influence of alcohol or drugs or a similar substance while performing health care tasks or to the extent that judgment may be impaired and the ability to perform health care tasks detrimentally affected. (e) Signing a blank, undated or predated prescription form. (f) Committing gross malpractice, repeated malpractice or any malpractice resulting in the death of a patient. (g) Representing that a manifestly incurable disease or infirmity can be permanently cured or that a disease, ailment or infirmity can be cured by a secret method, procedure, treatment, medicine or device, if this is not true. (h) Refusing to divulge to the board on demand the means, method, procedure, modality of treatment or medicine used in treating a disease, injury, ailment or infirmity. (i) Prescribing or dispensing controlled substances or prescription-only drugs for which the physician assistant is not approved or in excess of the amount authorized pursuant to this chapter. (j) Committing any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public. (k) Violating a formal order, probation or stipulation issued by the board. (l) Failing to clearly disclose the person's identity as a physician assistant in the course of the physician assistant's employment. (m) Failing to use and affix the initials "P.A." or "P.A.-C." after the physician assistant's name or signature on charts, prescriptions or professional correspondence. (n) Procuring or attempting to procure a physician assistant license by fraud, misrepresentation or knowingly taking advantage of the mistake of another. (o) Having professional connection with or lending the physician assistant's name to an illegal practitioner of any of the healing arts. (p) Failing or refusing to maintain adequate records for a patient. (q) Using controlled substances that have not been prescribed by a physician, physician assistant, dentist or nurse practitioner for use during a prescribed course of treatment. (r) Prescribing or dispensing controlled substances to members of the physician assistant's immediate family. (s) Prescribing, dispensing or administering any controlled substance or prescription-only drug for other than accepted therapeutic purposes. (t) Dispensing a schedule II controlled substance that is an opioid, except as provided in section 32-2532. (u) Knowingly making any written or oral false or fraudulent statement in connection with the performance of health care tasks or when applying for privileges or renewing an application for privileges at a health care institution. (v) Committing a felony, whether or not involving moral turpitude, or a misdemeanor involving moral turpitude. In either case, conviction by a court of competent jurisdiction or a plea of no contest is conclusive evidence of the commission. (w) Having a certification or license refused, revoked, suspended, limited or restricted by any other licensing jurisdiction for the inability to safely and skillfully perform health care tasks or for unprofessional conduct as defined by that jurisdiction that directly or indirectly corresponds to any act of unprofessional conduct as prescribed by this paragraph. (x) Having sanctions including restriction, suspension or removal from practice imposed by an agency of the federal government. (y) Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate a provision of this chapter. (z) Using the term "doctor" or the abbreviation "Dr." on a name tag or in a way that leads the public to believe that the physician assistant is licensed to practice as an allopathic or osteopathic physician in this state. (aa) Failing to furnish legally requested information to the board or its investigator in a timely manner. (bb) Failing to allow properly authorized board personnel to examine on demand documents, reports and records of any kind relating to the physician assistant's performance of health care tasks. (cc) Knowingly making a false or misleading statement on a form required by the board or in written correspondence or attachments furnished to the board. (dd) Failing to submit to a body fluid examination and other examinations known to detect the presence of alcohol or other drugs pursuant to an agreement with the board or an order of the board. (ee) Violating a formal order, probation agreement or stipulation issued or entered into by the board or its executive director. (ff) Except as otherwise required by law, intentionally betraying a professional secret or intentionally violating a privileged communication. (gg) Allowing the use of the licensee's name in any way to enhance or allow the continuance of the activities of, or maintaining a professional connection with, an illegal practitioner of medicine or the performance of health care tasks by a person who is not licensed pursuant to this chapter. (hh) Committing false, fraudulent, deceptive or misleading advertising by a physician assistant or the physician assistant's staff or representative. (ii) Knowingly failing to disclose to a patient on a form that is prescribed by the board and that is dated and signed by the patient or guardian acknowledging that the patient or guardian has read and understands that the licensee has a direct financial interest in a separate diagnostic or treatment agency or in nonroutine goods or services that the patient is being prescribed and whether the prescribed treatment, goods or services are available on a competitive basis. This subdivision does not apply to a referral by one physician assistant to another physician assistant or to a doctor of medicine or a doctor of osteopathic medicine within a group working together. (jj) With the exception of heavy metal poisoning, using chelation therapy in the treatment of arteriosclerosis or as any other form of therapy without adequate informed patient consent or without conforming to generally accepted experimental criteria, including protocols, detailed records, periodic analysis of results and periodic review by a medical peer review committee, or without approval by the United States food and drug administration or its successor agency. (kk) Prescribing, dispensing or administering anabolic or androgenic steroids for other than therapeutic purposes. (ll) Prescribing, dispensing or furnishing a prescription medication or a prescription-only device as defined in section 32-1901 to a person unless the licensee first conducts a physical examination of that person or has previously established a professional relationship with the person. This subdivision does not apply to: (i) A physician assistant who provides temporary patient care on behalf of the patient's regular treating licensed health care professional. (ii) Emergency medical situations as defined in section 41-1831. (iii) Prescriptions written to prepare a patient for a medical examination. (iv) Prescriptions written or antimicrobials dispensed to a contact as defined in section 36-661 who is believed to have had significant exposure risk as defined in section 36-661 with another person who has been diagnosed with a communicable disease as defined in section 36-661 by the prescribing or dispensing physician assistant. (mm) Engaging in sexual conduct with a current patient or with a former patient within six months after the last medical consultation unless the patient was the licensee's spouse at the time of the contact or, immediately preceding the professional relationship, was in a dating or engagement relationship with the licensee. For the purposes of this subdivision, "sexual conduct" includes: (i) Engaging in or soliciting sexual relationships, whether consensual or nonconsensual. (ii) Making sexual advances, requesting sexual favors or engaging in other verbal conduct or physical contact of a sexual nature with a patient. (iii) Intentionally viewing a completely or partially disrobed patient in the course of treatment if the viewing is not related to patient diagnosis or treatment under current practice standards. (nn) Performing health care tasks under a false or assumed name in this state. 32-2502. Arizona regulatory board of physician assistants; membership; appointment; terms; immunity A. The Arizona regulatory board of physician assistants is established consisting of the following members: 1. Five physician assistants who hold a current regular license pursuant to this chapter. The governor may appoint these members from a list of qualified candidates submitted by the Arizona state association of physician assistants. The governor may seek additional input and nominations before the governor makes the physician assistant appointments. 2. Two public members who are appointed by the governor. 3. Two physicians who are actively engaged in the practice of medicine and who are licensed pursuant to chapter 17 of this title, one of whom supervises or collaborates with a physician assistant at the time of appointment, and who are appointed by the governor. 4. Two physicians who are actively engaged in the practice of medicine and who are licensed pursuant to chapter 13 of this title, one of whom supervises or collaborates with a physician assistant at the time of appointment, and who are appointed by the governor. B. Before appointment by the governor, a prospective member of the board shall submit a full set of fingerprints to the governor for the purpose of obtaining a state and federal criminal records check pursuant to section 41-1750 and Public Law 92-544. The department of public safety may exchange this fingerprint data with the federal bureau of investigation. C. The term of office of members of the board is four years to begin and end on July 1. D. Each board member is eligible for appointment to not more than two full terms, except that the term of office for a member appointed to fill a vacancy that is not caused by the expiration of a full term is for the unexpired portion of that term and the governor may reappoint that member to not more than two additional full terms. Each board member may continue to hold office until the appointment and qualification of that member's successor. The governor may remove a member after notice and a hearing on a finding of continued neglect of duty, incompetence or unprofessional or dishonorable conduct. That member's term ends when the finding is made. E. A board member's term automatically ends: 1. On written resignation submitted to the board chairperson or to the governor. 2. If the member is absent from this state for more than six months during a one-year period. 3. If the member fails to attend three consecutive regular board meetings. 4. Five years after retirement from active practice. F. Board members are immune from civil liability for all good faith actions they take pursuant to this chapter. 32-2503. Organization; meetings; payment for service A. The board shall annually elect a chairperson and vice chairperson from among its members. B. The board shall hold a regular meeting at least quarterly on a date and at a time and place it designates. The board shall hold special meetings, including meetings using communications equipment that allows all members participating in the meeting to hear each other, as the chairperson determines are necessary to carry out the functions of the board. The board shall hold a special meeting on any day that the chairperson determines is necessary to carry out the functions of the board. The vice chairperson may call regular meetings and special meetings if the chairperson is not available. C. Members of the board are eligible to receive up to $200 for each day of service in the business of the board and for all expenses necessarily and properly incurred in attending board meetings. 32-2504. Powers and duties; delegation of authority; rules; subcommittees; immunity A. The board shall: 1. As its primary duty, protect the public from unlawful, incompetent, unqualified, impaired or unprofessional physician assistants. 2. License and regulate physician assistants pursuant to this chapter. 3. Order and evaluate physical, psychological, psychiatric and competency testing of licensees and applicants the board determines is necessary to enforce this chapter. 4. Review the credentials and the abilities of applicants for licensure whose professional records or physical or mental capabilities may not meet the requirements of this chapter. 5. Initiate investigations and determine on its own motion whether a licensee has engaged in unprofessional conduct or is or may be incompetent or mentally or physically unable to safely perform health care tasks. 6. Establish fees and penalties pursuant to section 32-2526. 7. Develop and recommend standards governing the profession. 8. Engage in the full exchange of information with the licensing and disciplinary boards and professional associations of other states and jurisdictions of the United States and foreign countries and a statewide association for physician assistants. 9. Direct the preparation and circulation of educational material the board determines is helpful and proper for its licensees. 10. Discipline and rehabilitate physician assistants pursuant to this chapter. 11. Certify physician assistants for thirty-day prescription privileges for schedule II, schedule III, schedule IV and schedule V controlled substances that are opioids or benzodiazepine and ninety-day prescription privileges for schedule II, schedule III, schedule IV and schedule V controlled substances that are not opioids or benzodiazepine if the physician assistant either: (a) Within the preceding three years of application, completed forty-five hours in pharmacology or clinical management of drug therapy or at the time of application is certified by a national commission on the certification of physician assistants or its successor. (b) Met any other requirement established by board rule. B. The board may delegate to the executive director the board's authority pursuant to this section or section 32-2551. The board shall adopt a substantive policy statement pursuant to section 41-1091 for each specific licensing and regulatory authority the board delegates to the executive director. C. The board may make and adopt rules necessary or proper for the administration of this chapter. D. The chairperson may establish subcommittees consisting of board members and define their duties as the chairperson deems necessary to carry out the functions of the board. E. Board employees, including the executive director, temporary personnel and professional medical investigators, are immune from civil liability for good faith actions they take to enforce this chapter. F. In performing its duties pursuant to subsection A of this section, the board may receive and review staff reports on complaints, malpractice cases and all investigations. G. The chairperson and vice chairperson of the Arizona regulatory board of physician assistants are members of the committee on executive director selection and retention established by section 32-1403, subsection G, which is responsible for the appointment of the executive director pursuant to section 32-1405. 32-2505. Personnel; consultants; compensation A. The executive director employed by the Arizona medical board is the executive director of the Arizona regulatory board of physician assistants. The staff of the Arizona medical board shall carry out the administrative responsibilities of the Arizona regulatory board of physician assistants. B. The executive director is eligible to receive compensation set by the board within the range determined under section 38-611. C. The executive director or the executive director's designee shall: 1. Employ, evaluate, dismiss, discipline and direct professional, clerical, technical, investigative and administrative personnel necessary to carry on the work of the board. 2. Set compensation for board employees within the range determined under section 38-611. 3. As directed by the board, prepare and submit recommendations for amendments to the physician assistant practice act for consideration by the legislature. 4. Appoint and employ medical consultants and agents necessary to conduct investigations, gather information and perform those duties the executive director determines are necessary and appropriate to enforce this chapter. 5. Issue licenses, registrations and permits to applicants who meet the requirements of this chapter. 6. Manage the board's offices. 7. Prepare minutes, records, reports, registries, directories, books and newsletters and record all board transactions and orders. 8. Collect all monies due and payable to the board. 9. Pay all bills for authorized expenditures of the board and its staff. 10. Prepare an annual budget. 11. Submit a copy of the budget each year to the governor, the speaker of the house of representatives and the president of the senate. 12. Initiate an investigation if evidence appears to demonstrate that a physician assistant may be engaged in unprofessional conduct or may be medically incompetent or mentally or physically unable to safely practice as a physician assistant. 13. Issue subpoenas if necessary to compel the attendance and testimony of witnesses and the production of books, records, documents and other evidence. 14. Provide assistance to the attorney general in preparing and sign and execute disciplinary orders, rehabilitative orders and notices of hearings as directed by the board. 15. Enter into contracts to procure goods and services pursuant to title 41, chapter 23 that are necessary to carry out board policies and directives. 16. Execute board directives. 17. Represent the board in matters with the federal government, other states or jurisdictions of the United States, this state, political subdivisions of this state, the news media and the public. 18. Enter into stipulated agreements on behalf of the board with persons under the jurisdiction of the board for the treatment, rehabilitation or monitoring of chemical substance abuse or misuse. 19. Review all complaints filed pursuant to section 32-2551. If delegated by the board, the executive director may also dismiss a complaint if the complaint is without merit. 20. If delegated by the board, directly refer cases to a formal hearing. 21. If delegated by the board, close cases resolved through mediation. 22. If delegated by the board, issue advisory letters. 23. If delegated by the board, enter into a consent agreement if there is evidence of danger to the public health and safety. 24. If delegated by the board, grant uncontested requests for inactive status and cancellation of a license pursuant to this chapter. 25. If delegated by the board, refer cases to the board for a formal interview. 26. Perform all other administrative, licensing or regulatory duties required by the board. D. Medical consultants and agents appointed pursuant to subsection C, paragraph 4 of this section are eligible to receive compensation determined by the executive director in an amount not to exceed two hundred dollars for each day of service. E. A person who is aggrieved by an action taken by the executive director may request the board to review that action by filing with the board a written request within thirty days after that person is notified of the executive director's action by personal delivery, or if mailed to that person's last known residence or place of business, within thirty-five days after the date on the notification. At the next regular board meeting, the board shall review the executive director's action. On review, the board shall approve, modify or reject the executive director's action. 32-2506. Arizona medical board fund (L24, Ch. 222, sec. 35. Eff. until 7/1/28) A. Pursuant to sections 35-146 and 35-147, the board shall deposit fifteen percent of all monies collected pursuant to this chapter in the state general fund and deposit the remaining eighty-five percent in the Arizona medical board fund. B. Monies deposited in the fund pursuant to this section are subject to section 35-143.01. 32-2506. Arizona medical board fund (L24, Ch. 222, sec. 36. Eff. 7/1/28) A. Pursuant to sections 35-146 and 35-147, the board shall deposit ten percent of all monies collected pursuant to this chapter in the state general fund and deposit the remaining ninety percent in the Arizona medical board fund. B. Monies deposited in the fund pursuant to this section are subject to section 35-143.01. 32-2507. Licensee profiles; civil penalty A. The board shall make available to the public a profile of each licensee. The board shall make this information available through an internet website and, if requested, in writing. The profile shall contain the following information: 1. A description of any conviction of a felony or a misdemeanor involving moral turpitude within the last five years. For the purposes of this paragraph, a licensee is deemed to be convicted of a crime if the licensee pled guilty or was found guilty by a court of competent jurisdiction. 2. A description of any felony charges or misdemeanor charges involving moral turpitude within the last five years to which the licensee pled no contest. 3. The number of pending complaints and final board disciplinary and nondisciplinary actions within the last five years. Information concerning pending complaints shall contain the following statement: Pending complaints represent unproven allegations. On investigation, many complaints are found to be without merit and are dismissed. 4. All medical malpractice court judgments and all medical malpractice awards or settlements in which a payment is made to a complaining party within the last five years. Information concerning malpractice actions shall contain the following statement: The settlement of a medical malpractice action may occur for a variety of reasons that do not necessarily reflect negatively on the professional competence or conduct of the physician assistant. A payment in settlement of a medical malpractice action does not create a presumption that medical malpractice occurred. 5. The name and location of the licensee's training and the date of graduation. 6. The licensee's primary practice location. B. Each licensee shall submit the information required pursuant to subsection A of this section as directed by the board. An applicant for licensure shall submit this information at the time of application. The applicant and licensee shall submit the information on a form prescribed by the board. A licensee shall submit immediately any changes in information required pursuant to subsection A, paragraphs 1, 2 and 4 of this section. The board shall update immediately its internet website to reflect changes in information relating to subsection A, paragraphs 1, 2, 3 and 4 of this section. The board shall update the internet website information after receipt of the renewal application pursuant to section 32-2523. C. The board shall provide each licensee with a copy of the licensee's profile and give the licensee reasonable time to correct the profile before it is available to the public. D. It is an act of unprofessional conduct for a licensee to provide erroneous information pursuant to this section. In addition to other disciplinary action, the board may impose a civil penalty of not more than one thousand dollars for each erroneous statement. 32-2508. Preceptorship awareness campaign; definitions A. The board shall develop a preceptorship awareness campaign that educates medical professionals who are licensed pursuant to this chapter on how to become and the benefits of being a medical preceptor for students. B. For the purposes of this section: 1. "Medical preceptor" means a medical professional who is licensed pursuant to this chapter and who maintains an active practice in this state. 2. "Preceptorship": (a) Means a mentoring experience in which a medical preceptor provides a program of personalized instruction, training and supervision to a student to enable the student to obtain a medical professional degree to become licensed pursuant to this chapter. (b) Does not include mentoring for medical services that are prescribed in section 36-2301.01, subsection C, paragraph 1. 3. "Student" means an individual who is matriculating at the graduate level at an accredited institution of higher education in this state and who is seeking a medical professional degree to become licensed pursuant to this chapter. 32-2521. Qualifications A. An applicant for licensure shall: 1. Have graduated from a physician assistants educational program approved by the board. 2. Pass a certifying examination approved by the board. 3. Be physically and mentally able to safely perform health care tasks as a physician assistant. 4. Have a professional record that indicates that the applicant has not committed any act or engaged in any conduct that constitutes grounds for disciplinary action against a licensee pursuant to this chapter. This paragraph does not prevent the board from considering the application of an applicant who was the subject of disciplinary action in another jurisdiction if the applicant's act or conduct was subsequently corrected, monitored and resolved to the satisfaction of that jurisdiction's regulatory board. 5. Not have had a license to practice revoked by a regulatory board in another jurisdiction in the United States for an act that occurred in that jurisdiction that constitutes unprofessional conduct pursuant to this chapter. 6. Not be currently under investigation, suspension or restriction by a regulatory board in another jurisdiction in the United States for an act that occurred in that jurisdiction that constitutes unprofessional conduct pursuant to this chapter. If the applicant is under investigation by a regulatory board in another jurisdiction, the board shall suspend the application process and may not issue or deny a license to the applicant until the investigation is resolved. 7. Not have surrendered, relinquished or given up a license in lieu of disciplinary action by a regulatory board in another jurisdiction in the United States for an act that occurred in that jurisdiction that constitutes unprofessional conduct pursuant to this chapter. This paragraph does not prevent the board from considering the application of an applicant who surrendered, relinquished or gave up a license in lieu of disciplinary action by a regulatory board in another jurisdiction if that regulatory board subsequently reinstated the applicant's license. 8. Have submitted verification of all hospital affiliations and employment for the five years preceding application. Each hospital must verify the applicant's affiliation or employment on the hospital's official letterhead or the electronic equivalent. B. The board shall require an applicant to have all credentials submitted from the primary source where the document originated, either electronically or by hard copy, except that the board may accept primary-source verified credentials from a credentials verification service approved by the board. C. The board may make investigations it deems necessary to advise itself with respect to the qualifications of the applicant, including physical examinations, mental evaluations, written competency examinations or any combination of these examinations and evaluations. D. If the board finds that the applicant committed an act or engaged in conduct that would constitute grounds for disciplinary action in this state, before issuing a license the board must determine to its satisfaction that the act or conduct has been corrected, monitored and resolved. If the act or conduct has not been resolved, before issuing a license the board must determine to its satisfaction that mitigating circumstances exist that prevent its resolution. E. If another jurisdiction has taken disciplinary action against an applicant, before issuing a license the board must determine to its satisfaction that the cause for the action was corrected and the matter was resolved. If the other jurisdiction has not resolved the matter, before issuing a license the board must determine to its satisfaction that mitigating circumstances exist that prevent its resolution. F. The board may delegate to the executive director the authority to deny licenses to applicants who do not meet the requirements of this section. 32-2522. Applications; interview; withdrawal A. Each applicant shall file a verified completed application in the form required and supplied by the board that is accompanied by the prescribed application fee. B. The application shall be designed to require the submission of evidence, credentials and other proof necessary to satisfy the board that the applicant qualifies for licensure. C. The application shall contain the oath of the applicant that: 1. All information contained in the application and evidence submitted with it are true and correct. 2. The credentials submitted were not procured by fraud or misrepresentation or any mistake of which the applicant is aware. 3. The applicant is the lawful holder of the credentials. D. All applications submitted to the board and any attendant evidence, credentials or other proof submitted with an application are the property of the board and part of the permanent record of the board and shall not be returned to an applicant. E. After the board has received a completed application the board either shall grant or deny a license to the applicant. If an applicant has submitted an incomplete application, the board shall promptly notify an applicant, in writing, of the deficiencies, if any, in the application that prevent it from being a completed application. F. The board or its representatives may interview an applicant to determine whether the application is sufficient. G. Applications are considered withdrawn on any of the following conditions: 1. Written request of the applicant. 2. Failure of the applicant to appear for an interview with the board unless good cause is shown. 3. Failure to submit a completed application within one year from the date of the mailing by the board of a statement to the applicant of the deficiencies in the application pursuant to subsection E of this section. H. On request of an applicant who disagrees with the statement of deficiency, the board shall grant a hearing before the board at its next regular meeting if there is time at that meeting to hear the matter. The board shall not delay this hearing beyond one regularly scheduled meeting. At any hearing granted pursuant to this subsection, the burden of proof is on the applicant to demonstrate that the alleged deficiencies do not exist. I. The board may deny a license to an applicant who does not meet the requirements of this article. J. If an applicant does not meet the requirements of section 32-2521, subsection A, paragraph 3, the board may issue a license subject to any of the following probationary conditions: 1. Restrict the licensee's practice. 2. Require the licensee to continue medical or psychiatric treatment. 3. Require the licensee to participate in a specified rehabilitation program. 4. Require the licensee to abstain from alcohol and other drugs. K. If the board offers a probationary license to an applicant pursuant to subsection J of this section, it shall notify the applicant in writing of the following: 1. The applicant's specific deficiencies. 2. The probationary period. 3. The applicant's right to reject the terms of probation. 4. If the applicant rejects the terms of probation, the applicant's right to a hearing on the board's denial of the application. 32-2523. Licensure; renewal; continuing education; audit; penalty fee; expiration A. Except as provided in section 32-4301, each holder of a regular license shall renew the license every other year on or before the licensee's birthday by paying the prescribed renewal fee and supplying the board with information it deems necessary, including proof of having completed, before the renewal date, forty hours of category I continuing medical education approved by the American academy of physician assistants, the American medical association, the American osteopathic association or any other accrediting organization acceptable to the board. The board shall verify continuing medical education compliance and shall randomly audit at least ten percent of physician assistants who are renewing their license within the calendar year and who do not hold a current national certification from a national certification organization for physician assistants that is approved by the board. B. Except as provided in section 32-4301, a holder of a regular license who fails to renew the license within thirty days after the licensee's birthday shall pay a penalty fee as set forth in rule for late renewal. C. Except as provided in section 32-4301, if a holder of a regular license fails to renew the license within ninety days after the licensee's birthday, the license automatically expires. It is unlawful for a person to perform health care tasks of a physician assistant after the license expires. D. A person whose license expires may reapply for licensure pursuant to this chapter. E. If a licensee does not meet the requirements of subsection A of this section because of that person's illness, religious missionary activity or residence in a foreign country or any other extenuating circumstance, the board may grant an extension of the deadline if it receives a written request to do so from the licensee that details the reasons for this request. F. The continuing medical education requirement in subsection A of this section is deemed satisfied if, at the time of renewal, the licensee holds a certification in good standing from a certifying body approved by the board. 32-2524. Exemption from licensure This chapter does not require licensure of: 1. A student who is enrolled in a physician assistant education program approved by the board. 2. A physician assistant who is an employee of the United States government and who works on land or in facilities owned or operated by the United States government. 3. A physician assistant who is a member of the armed forces of the United States and who is on official orders or performing official duties as outlined in the appropriate regulation of that branch of military service. 32-2525. Cancellation of license A. A person who holds an active regular license as a physician assistant, who is not presently under investigation by the board as the result of a complaint or information received by it, and against whom the board has not commenced any disciplinary proceedings may request and the board shall grant cancellation of the license. B. The board may accept the request to cancel the active regular license of a physician assistant who has been charged with a violation of this chapter or rules adopted pursuant to this chapter if the physician assistant admits the charges and stipulates this admission for the record. 32-2526. Fees A. By a vote at its annual fall meeting, the board shall establish nonrefundable fees and penalties that do not exceed the following: 1. Processing an application for an active license, four hundred dollars. 2. Issuing an active license, four hundred dollars. 3. Annual renewal of a regular license, four hundred dollars. 4. Penalty fee for late renewal of a regular license, three hundred fifty dollars. 5. Issuance of a duplicate license, twenty-five dollars. 6. Verification of a license, ten dollars. 7. Copying records, documents, letters, minutes, applications and files, one dollar for the first three pages and twenty-five cents for each additional page. 8. The sale of computerized tapes or diskettes that do not require programming, one hundred dollars. 9. Services not required to be provided by this chapter, but that the board deems appropriate to carry out the intent and purpose of this chapter, a fee of not to exceed the actual cost of providing the services. Notwithstanding section 32-2506, the board shall deposit, pursuant to sections 35-146 and 35-147, all of the monies collected under this paragraph in the Arizona medical board fund established by section 32-1406. B. Notwithstanding subsection A of this section, on written request the board may return the license renewal fee for good cause shown. C. The board may collect from a drawer of a dishonored check, draft, order or note an amount allowed pursuant to section 44-6852. 32-2527. Change of address; penalty A. A person holding an active license as a physician assistant in this state shall inform the board in writing within thirty days of that person's current residence address, office address and telephone number and of each change in residence and office address or telephone number that occurs. A residential address is not available to the public unless it is the only address of record. B. The board may assess its costs incurred in locating a physician assistant who fails to comply with subsection A of this section within thirty days after the date of change. The board may also assess a penalty of not to exceed one hundred dollars against the physician assistant. Notwithstanding section 32-2506, monies collected pursuant to this subsection shall be deposited, pursuant to sections 35-146 and 35-147, in the Arizona medical board fund established by section 32-1406. 32-2528. Inactive license; application; prohibited activities A. A person who holds a regular license pursuant to this chapter may request an inactive license from the board if both of the following are true: 1. The licensee is not under investigation by the board. 2. The board has not begun disciplinary proceedings against the licensee. B. The board may grant an inactive license and shall waive the annual renewal fee and requirements for continuing medical education if the person certifies total retirement from the performance of health care tasks in this state, any jurisdiction of the United States and any foreign country and is current on all fees required by this chapter. C. An inactive licensee shall not perform health care tasks. D. The board may convert an inactive license to a regular license on payment of the annual renewal fee and presentation of evidence to the board that the holder possesses the medical knowledge and the physical and mental ability to safely engage in the performance of health care tasks. The board may require any combination of physical examination, psychiatric or psychological evaluation, oral competency examination or a board qualified written examination or interview it believes necessary to assist it in determining the ability of a physician assistant who holds an inactive license to return to regular licensure. 32-2531. Physician assistant scope of practice; health care tasks; supervision agreements; supervising physician duties; civil penalty A. Except as prohibited in subsection E of this section, a physician assistant may provide any legal medical service for which the physician assistant has been prepared by education, training and experience and that the physician assistant is competent to perform, including: 1. Obtaining comprehensive health histories and performing physical examinations. 2. Evaluating and diagnosing patients and managing and providing medical treatment and therapeutic interventions. 3. Ordering, performing and interpreting diagnostic studies and therapeutic procedures. 4. Educating patients on health promotion and disease prevention and providing counseling and education to meet patient needs. 5. Providing consultation on request. 6. Writing medical orders. 7. Obtaining informed consent. 8. Assisting in surgery. 9. Delegating and assigning therapeutic and diagnostic measures to and supervising licensed or unlicensed personnel. 10. Making appropriate referrals. 11. Ordering, prescribing, dispensing and administering drugs and medical devices. 12. Prescribing prescription-only medications. 13. Prescribing schedule IV or schedule V controlled substances as defined in the controlled substances act (P.L. 91-513; 84 Stat. 1242; 21 United States Code section 802). 14. Prescribing schedule II and schedule III controlled substances as defined in the controlled substances act. 15. Performing minor surgery. 16. Performing nonsurgical health care tasks that are normally taught in courses of training approved by the board and that are consistent with the physician assistant's education, training and experience. 17. Certifying the health or disability of a patient as required by any local, state or federal program. 18. Ordering home health services. B. Pursuant to the requirements of this chapter and the standard of care, a physician assistant who has at least eight thousand hours of clinical practice certified by the board pursuant to section 32-2536 is not required to practice pursuant to a supervision agreement but shall continue to collaborate with, consult with or refer to the appropriate health care professional as indicated by the patient's condition and by the physician assistant's education, experience and competencies. The level of collaboration required by this subsection is determined by the policies of the practice setting at which the physician assistant is employed, including a physician employer, physician group practice or health care institution. Collaboration, consultation or a referral pursuant to this subsection may occur through electronic means and does not require the physical presence of the appropriate health care professional at the time or place the physician assistant provides medical services. This subsection does not prohibit a physician assistant who has at least eight thousand hours of clinical practice certified by the board pursuant to section 32-2536 from practicing pursuant to a supervision agreement. C. A physician assistant who has less than eight thousand hours of clinical practice certified by the board shall work in accordance with a supervision agreement that describes the physician assistant's scope of practice. A physician assistant may not perform health care tasks until the physician assistant has completed and signed a supervision agreement. Under a supervision agreement, supervision may occur through electronic means and does not require the physical presence of the supervising physician at the time or place the physician assistant provides medical services. The supervision agreement must be kept on file at the main location of the physician assistant's practice and, on request, be made available to the board or the board's representative. On receipt of board certification of the physician assistant's completion of at least eight thousand hours of clinical practice, a physician assistant is no longer subject to the requirements of this subsection. The board may count practice hours earned in another jurisdiction toward the hours of clinical practice required by this subsection. D. A physician assistant who does not practice pursuant to a supervision agreement is legally responsible for the health care services performed by the physician assistant. E. A physician assistant shall not perform surgical abortions as defined in section 36-2151. F. A physician assistant may pronounce death and may authenticate, by the physician assistant's signature, certification, stamp, verification, affidavit or endorsement, any form that may be authenticated by a physician's signature, certification, stamp, verification, affidavit or endorsement. G. The board by rule may prescribe a civil penalty for a violation of this article. The penalty shall not exceed $50 for each violation. The board shall deposit, pursuant to sections 35-146 and 35-147, all monies it receives from this penalty in the state general fund. A physician assistant and the supervising physician or collaborating physician or entity may contest the imposition of this penalty pursuant to board rule. The imposition of a civil penalty is public information, and the board may use this information in any future disciplinary actions. 32-2532. Prescribing, administering and dispensing drugs; limits and requirements; notice A. Except as provided in subsection G of this section, a physician assistant shall not prescribe, dispense or administer: 1. A schedule II or schedule III controlled substance as defined in the controlled substances act (P.L. 91-513; 84 Stat. 1242; 21 United States Code section 802) without board approval and United States drug enforcement administration registration. If the physician assistant has less than eight thousand clinical practice hours, the supervision agreement shall specify the physician assistant's ability to prescribe, dispense or administer a schedule II or schedule III controlled substance. 2. A schedule IV or schedule V controlled substance as defined in the controlled substances act without United States drug enforcement administration registration. If the physician assistant has less than eight thousand clinical practice hours, the supervision agreement shall specify the physician assistant's ability to prescribe, dispense or administer a schedule IV or schedule V controlled substance. 3. Prescription medication intended to perform or induce an abortion. B. If the physician assistant has less than eight thousand clinical practice hours, the supervision agreement shall specify the physician assistant's ability to prescribe, dispense or administer prescription-only medication. C. All prescription orders issued by a physician assistant shall contain the name, address and telephone number of the physician assistant. A physician assistant shall issue prescription orders for controlled substances under the physician assistant's own United States drug enforcement administration registration number. D. If the physician assistant is certified for prescription privileges pursuant to section 32-2504, subsection A, initial prescriptions by the physician assistant for schedule II controlled substances that are opioids are subject to the limits prescribed in sections 32-3248 and 32-3248.01. For each schedule IV or schedule V controlled substance, the physician assistant may not prescribe the controlled substance more than five times in a six-month period for each patient. E. A prescription by a physician assistant for a schedule III controlled substance that is an opioid or benzodiazepine is not refillable without the written consent of a physician. F. A physician assistant may not dispense, prescribe or refill prescription-only drugs for a period exceeding one year for each patient. G. Except in an emergency, a physician assistant may dispense schedule II or schedule III controlled substances for a period of use of not to exceed seventy-two hours with board approval or any other controlled substance for a period of use of not to exceed ninety days and may administer controlled substances without board approval if it is medically indicated in an emergency dealing with potential loss of life or limb or major acute traumatic pain. Notwithstanding the authority granted in this subsection, a physician assistant may not dispense a schedule II controlled substance that is an opioid, except for an implantable device or an opioid that is for medication-assisted treatment for substance use disorders or as provided in section 32-3248.03. H. Except for samples provided by manufacturers, all drugs dispensed by a physician assistant shall be labeled to show the name of the physician assistant. I. A physician assistant shall not obtain a drug from any source other than a physician or a pharmacist. A physician assistant may receive manufacturers' samples. J. If a physician assistant is approved by the board to prescribe, administer or dispense schedule II and schedule III controlled substances, the physician assistant shall maintain an up-to-date and complete log of all schedule II and schedule III controlled substances the physician assistant administers or dispenses. The board may not grant a physician assistant the authority to dispense schedule II controlled substances that are opioids, except for implantable devices or opioids that are for medication-assisted treatment for substance use disorders. K. The Arizona regulatory board of physician assistants shall advise the Arizona state board of pharmacy and the United States drug enforcement administration of all physician assistants who are authorized to prescribe or dispense drugs and any modification of their authority. L. The Arizona state board of pharmacy shall notify all pharmacies at least quarterly of physician assistants who are authorized to prescribe or dispense drugs. 32-2533. Supervising physicians; responsibilities A. A supervising physician is responsible for all aspects of the performance of a physician assistant who has less than eight thousand hours of clinical practice, whether or not the supervising physician actually pays the physician assistant a salary. The supervising physician is responsible for supervising the physician assistant and ensuring that the health care tasks performed by a physician assistant are within the physician assistant's scope of training and experience and have been properly delegated by the supervising physician. B. Each physician-physician assistant team must ensure that: 1. The physician assistant's scope of practice is identified. 2. The delegation of medical tasks is appropriate to the physician assistant's level of competence. 3. The relationship of, and access to, the supervising physician is defined. 4. A process for evaluating the physician assistant's performance is established. C. A supervising physician shall not supervise more than six physician assistants who work at the same time. D. A supervising physician shall develop a system for recording and reviewing all instances in which the physician assistant prescribes schedule II or schedule III controlled substances. 32-2534. Billing; direct payment A physician assistant may bill and receive direct payment for the professional services provided by the physician assistant. 32-2535. Emergency medical care A. Notwithstanding the requirements of this article, in response to a natural disaster, accident or other emergency, a physician assistant who is licensed pursuant to this chapter, licensed or certified by another regulatory jurisdiction in the United States or credentialed as a physician assistant by a federal employer may provide medical care at any location, and the physician assistant is not required to have completed eight thousand clinical practice hours pursuant to section 32-2531. B. A physician who supervises a physician assistant who is providing medical care pursuant to this section is not required to comply with the requirements of this article relating to supervising physicians. 32-2536. Physician assistants; documentation; certification; rules A. A physician assistant who is licensed pursuant to this chapter, who is in good standing, who has graduated from an accredited physician assistant program in the United States and who has at least eight thousand clinical practice hours within the previous five years in this state or another jurisdiction shall provide the board with documentation of having completed at least eight thousand hours of clinical practice in order to meet the requirements of section 32-2531, subsection B. The board shall develop: 1. A policy that sets forth the process of attestation or documentation required as proof of completion of at least eight thousand clinical practice hours and issuance of certification of completion of the eight thousand clinical practice hours. 2. An alternative comparable standard for certification of eight thousand hours of clinical practice for physician assistants who have been actively practicing for more than five years. B. The board shall adopt rules establishing additional certification standards or requirements for physician assistants who previously completed eight thousand clinical practice hours certified by the board and who are seeking employment with a collaborating physician or entity for a position that is not substantially similar to the practice setting or specialty in which the physician assistant was previously certified. The certification standards or requirements shall ensure appropriate training and oversight, including a supervision agreement if warranted, for the physician assistant's new practice setting or specialty. 32-2551. Grounds for disciplinary action; duty to report; immunity; proceedings; board action; notice; civil penalty A. The board on its own motion may investigate any evidence that appears to show that a physician assistant is or may be medically incompetent, is or may be guilty of unprofessional conduct or is or may be mentally or physically unable to carry out approved health care tasks. Any physician, physician assistant or health care institution as defined in section 36-401 shall, and any other person may, report to the board any information the physician, physician assistant, health care institution or other person has that appears to show that a physician assistant is or may be medically incompetent, is or may be guilty of unprofessional conduct or is or may be menta