House Bill 67 was signed into law on July 1, 2025. This bill represents significant progress for patients, physicians, PAs, and health care as it conforms the regulatory structure for PAs to specifically address increasingly important team-based care settings.
The team-based care model outlined in this law is the product of the work from the NCMS Medical Team Task Force (MTTF), created in 2017. For two years, the MTTF met several times with key stakeholders and were charged with:
1. Reviewing the different forms, effectiveness, and status of physician supervision of advanced practice nurses and physician assistants.
2. Determining whether changes occurring in health care delivery and payment systems warrant a modernization of the current regulatory scheme.
Here’s what this law means for our members and patients:
Reduced Administrative Paperwork for Experienced PAs. PAs with 4,000+ hours of clinical experience as a licensed PA and 1,000+ hours in their specialty may practice without a specific physician supervisory agreement, but only if they work in a team-based setting that meets specific clinically-oriented standards.
Collaborative Care Standards Remain. Team-based PAs must still “collaborate and consult with or refer to appropriate health care team members as required by the patient’s condition.”
Physician Oversight Protected in Critical Areas. The law requires physician supervision for PAs in perioperative settings and prohibits PAs from performing final interpretations of advanced imaging like CT, MRI, PET, mammography, and ultrasounds.
Appropriate Delegation Continues. PAs under physician supervision may conduct final interpretation of plain film radiographs.
PA Scope of Practice. Under this new law, PA scope of practice in supervised settings is unchanged and can be found in the supervisory agreement with their physician. The definition of a team-based setting places guardrails for PA Scope. The NC Medical Board will adopt rules prior to implementation. PA scope of practice continues to be based on the individual licensee’s education, training, and experience.
Our advocacy for our members and patients is working, and we are being seen as reliable thought leaders with the current state administration and our legislators.
For more information, contact John Thompson, Chief Strategy Officer, [email protected].
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Latest Legislative News
The Role of the NCMS Medical Team Task Force (MTTF)
In light of our evolving health care system and practice, the MTTF was formed in 2016 to review the existing requirements for physician supervision and to determine if a modernization of those requirements was warranted.
An Insider’s View of the Medical Team Task Force Webinar – May 5, 2021
This webinar shares more about the work of the NCMS’ MTTF and its charge, the key issues it has addressed and its recommendations to the NCMS Board of Directors on PA team-based care.
If you prefer to watch this webinar in segments, we have separated it into three parts and loaded them on YouTube:
Part 1: About the MTTF and a Review of SB 345 (20 mins.)
Part 2: Point/Counterpoint on MTTF and SB 345 (23 mins.)
Part 3: Group Discussion (40 mins.)
Full webinar video is below.