SB 345 – PA Team-Based Practice

Primary Senate Sponsors: Sen. Jim Perry (R-Lenoir, Wayne); Sen. Michael Lee (R-New Hanover); Sen. Todd Johnson (R-Union)


This bill makes various adjustments to the licensure and supervision arrangement of physician assistants including the following modifications:

  • Requires a PA to execute and maintain a supervisory agreement with a physician unless the PA practices in a team-based setting and has more than 4,000 hours or practice experience as a licensed PA and more than 1,000 hours of practice within the specific medical specialty of practice with a physician in that specialty.
  • Defines “team-based setting” to include 1) a medical practice organized pursuant to G.S. 55B-14(c)(3); 2) a physician-owned medical practice where the physician owner has consistent and meaningful participation in the design and implementation of health services to patients; 3) licensed health facilities with active credentialing and quality programs where physicians have consistent and meaningful participation in the design and implementation of health services to patient.
  • Specifically excludes medical practices that specialize in pain management from the definition of “team-based setting.”
  • Requires PAs to collaborate and consult with or refer to appropriate team members as required.
  • Requires supervision of a PA practicing in a perioperative setting, including the provision of surgical or anesthesia-related services.
  • States that a PA is responsible for the care provided by the PA.
  • Specifies required content of the supervisory arrangement, including the terms of clinical oversight, the onboarding or orientation process, quality measures to be achieved, scope of delated duties, and plan for interval expansion, and requires the arrangement be made available to the Board immediately upon request.
  • Requires PAs with supervisory arrangements to submit an “Intent to Practice” to the Medical Board before initiating the practice of medical acts or functions of a PA.
  • Requires consultation with a physician (rather than the supervising physician) for the prescription of targeted controlled substances under certain conditions.
  • Requires PAs to clearly designate their credentials in all clinical settings.
  • Clarifies that a PA’s authority to order medications, tests and treatment in hospitals, clinics, nursing homes, and other health facilities requires review by a supervising physician only if the PA is subject to a supervisory agreement.
  • Authorizes PAs to prescribe, dispense, compound, order, administer, and procure drugs and medical services, and plan and initiate a therapeutic regimen that includes ordering and prescribing non-pharmacological interventions and diagnostic support services.
  • Authorizes PAs to authenticate any document, including death certificates, to the same extent as a physician.
  • Prohibits PAs from performing final interpretations of diagnostic imaging studies.
  • Expands current statute to allow a PA to conduct the required health assessment of a child prior to admission to a child care facility.


Filed – 3/24/2021