From WA State:
In Washington, “a physician is not required to countersign orders written in a patient’s clinical record or an official form by a physician assistant with whom the physician has a practice agreement,” per RCW 18.71A.090. Physician assistants are still required to register and update their designated supervisory physician with the Washington Medical Commission.
https://app.leg.wa.gov/rcw/default.aspx?cite=18.71A.090
This change will not impact CMS, as CMS does not require co-signature of notes for APCs if state statutes and hospital bylaws are congruent.
To make this alignment, we have updated the PA/ARNP (PCH) and Providence Extender Level II (PSPH) privilege request forms to remove the requirement for co-signatures, unless on a training plan. The no co-signature requirement automatically applied to all PAs at PCH & PSPH, effective immediately. Sponsors/departments/clinics may still co-sign at their discretion, but it is no longer required at the facility level. Health Information Management is aware of and supportive of this change. The PCH & PSPH Delinquent Medical Records policies have also been updated to remove the sponsor co-signature requirements for PA-Cs unless the PA-C is on a training plan. To request an updated copy of the delinquent medical records policy, please reach out to Heather McClellan, Credentialing Supervisor, at heather.mcclellan@providence.org.
Additionally, PA-Cs now have the option to request performance of admission History & Physicals and admit patients as part of their core privileges, at both facilities, in alignment with their department/clinic’s practice. Supervision level remains that the sponsor/supervising provider is to be immediately available via phone. As performance of admission H&Ps and admitting patients are new privileges, any PA that would like these privileges needs to send a request to Heather McClellan via email at heather.mcclellan@providence.org.
