Ala. Admin. Code ch. 540-X-7 | Alabama Administrative Code Chapter 540-X-7 — Assistants to Physicians

540 Alabama Board of Medical Examiners

Ala. Admin. Code r. 540-X-7-.01 Definitions

The following definitions shall apply to these rules:

(1) APPROVED PROGRAM: A program for the education and training of assistants to physicians which has been formally approved in writing by the Board.

(2) ASSISTANT TO PHYSICIAN. A person who is a graduate of an approved program, is licensed by the Board, and is registered by the Board to perform medical services under the supervision of a physician approved by the Board to supervise the assistant.

(3) BOARD. The Board of Medical Examiners of the State of Alabama.

(4) CONTINUAL. Repeated regularly and frequently in steady rapid succession.

(5) DIRECT MEDICAL INTERVENTION. Physical presence of a physician to attend the patient as defined in the registration agreement protocol.

(6) FCVS, Federation Credentials Verification Service. A credentials verification service provided by the Federation of State Medical Boards that assistants to physicians may use to verify core credentials in connection with applications for licensure. The Board of Medical Examiners will accept those verified primary source records of credentials provided by FCVS in lieu of equivalent documentation required to be submitted with an application for licensure where designated in these rules. Applicants are responsible for payment of all fees charged by FCVS. Use of FCVS by an applicant is optional.

(7) GUIDELINES. The written guidelines established by the Board pursuant to Act 94-261 in the most current version which concern the prescribing practices of assistants to physicians and which do not require publication in accordance with the Alabama Administrative Procedures Act.

(8) LEGEND DRUG. Any drug, medicine, chemical or poison, bearing on the label the words, "Caution, Federal Law prohibits dispensing without prescription" or similar words indicating that the drug, medicine, chemical or poison may be sold or dispensed only upon the prescription of a licensed medical practitioner, except that the term legend drug shall not include any drug, substance or compound which is listed in Schedules I through V of the Alabama Uniform Controlled Substances Act.

(9) PHYSICIAN. A person who is licensed to practice medicine in this state and is approved by the Board to supervise assistants to physicians.

(10) PHYSICIAN SUPERVISION. A formal relationship between a licensed assistant to a physician and a licensed physician under which the assistant to the physician is authorized to practice as evidenced by a written job description approved by the Board. Physician supervision requires that there shall be at all times a direct, continuing and close supervisory relationship between the assistant to the physician and the physician to whom that assistant is registered. The term supervision does not require direct on-site supervision of the assistant to the physician; however, supervision does include the professional oversight and direction required by these rules and by the written guidelines established by the Board concerning prescribing practices.

(11) PRESCRIBE OR PRESCRIBING. The act of issuing a written prescription for a legend drug.

(12) PRESCRIPTION. An order for a legend drug which is written and signed by an assistant to a physician authorized to prescribe and administer the drug and which is intended to be filled, compounded, or dispensed by a pharmacist. The term "prescription" does not include an order for medication which is dispensed for immediate administration to the ultimate user. (e.g., an order to dispense a drug to a bed patient for immediate administration in a hospital is not a prescription.)

(13) READILY AVAILABLE. Response by the supervising or covering physician by telephone or telecommunication for consultation, referral or direct medical intervention for a patient as indicated by the needs of the patient and based on usual and customary standards of medical practice.

(14) REMOTE PRACTICE SITE. An approved site for a registration agreement without a supervising or covering physician on-site. The supervising physician’s principal practice site, acute care hospitals, skilled nursing facilities, licensed, special-care assisted living facilities and licensed assisted living facilities are not remote practice sites for the purpose of these rules.

(15) TRAINEE. A person who is currently enrolled in an approved program in this state.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed October 17, 2002; effective November 21, 2002. Amended: Filed December 16, 2015; effective January 30, 2016. Amended: Published November 30, 2020; effective February 14, 2021. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.02 Categories Of Assistants To Physicians

The two categories of assistants to physicians which are recognized for licensure and registration by the Board are the following:

(1) Physician assistant (P.A.) (Rules 540-X-7-.03 through 540-X-7-.36 apply);

(2) Anesthesiologist Assistant (A. A.) (Code of Ala. 1975, Rules 540-X-7-.37 through 540-X-7-.68).

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: October 15, 2008; effective November 19, 2008.

Ala. Admin. Code r. 540-X-7-.03 Requirements To Practice As A Physician Assistant

(P.A.) {#sec-540-x-7-.03 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.03}

(1) To practice or offer to practice as a physician assistant, each person shall be licensed by and registered by the Board in accordance with Chapter 7 of these rules.

(2) Effective January 1, 2024, physician assistants shall obtain continuing education prescribed by the Board of Medical Examiners regarding the rules and statutes governing supervised practice in Alabama, not more than forty-eight (48) months prior to or within twelve (12) months of registration to a physician.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.04 Requirements For The Issuance Of A License To Practice As A Physician Assistant (P.A.)

(1) To qualify for a license to practice as a physician assistant an individual must meet the following requirements:

(a) Provide evidence, satisfactory to the Board, of successful completion of a training program accredited by the Committee on Allied Health Education and Accreditation (CAHEA), the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), or their successor agencies;

(b) Provide evidence, satisfactory to the Board, of successful completion of the Physician Assistant National Certification Examination (PANCE) as administered by the National Commission on Certification of Physician Assistants (NCCPA);

(d) Pay the required license application fee as determined by the Board.

(e) Beginning October 1, 2008, submit to a criminal history background check which includes the following:

Provide fingerprints and execute a criminal history information release using forms provided by the Board; and
Pay a criminal history background check fee in an amount established in Rule 540-X-3-.09(2). Fingerprints provided by an applicant shall be submitted to the Alabama State Bureau of Investigation (SBI), which is responsible for forwarding the fingerprints to the Federal Bureau of Investigation (FBI) for a national criminal history record check. Information received by the Board pursuant to a criminal history background check shall be confidential and shall not be a public record, except that such information received and relied upon in denying the issuance of a license to practice as a physician assistant in this state may be disclosed as may be necessary to support the denial.

(2) Documentation submitted through the Federation Credentials Verification Service (FCVS) may be accepted to demonstrate compliance with the credentialing requirements of this rule.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed October 17, 2002; effective November 21, 2002. Amended: October 15, 2008; effective November 19, 2008. Amended: Filed November 16, 2018; effective December 31, 2018. Amended: Published January 31, 2022; effective March 7, 2022.

Ala. Admin. Code r. 540-X-7-.05 Issuance Of License To Practice As A Physician Assistant (P.A.)

(1) The Board shall issue a license to practice as a physician assistant when all requirements for licensure have been met.

(2) Every license issued shall be dated, shall be numbered in the order of issuance, and shall be signed by the chair of the Board or the chair’s designee.

(3) The size and design of the license shall be determined by the Board.

History

Author: Patricia E. Shaner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002.

Ala. Admin. Code r. 540-X-7-.06 License Fee - Physician Assistant (P.A.)

(1) All applicants for a license to practice as a physician assistant shall submit to the Board an application fee in the amount of $200.00.

(2) The initial license fee in paragraph (1) shall be waived for any person who was certified as a physician assistant or surgeon assistant on the effective date of these rules.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.07 License Renewal-Physician Assistant (P.A.)

(1) A license to practice as a physician assistant shall be renewed annually on or before January 1st of each year. Application for annual renewal shall be received by the Board on or before December 31st and shall be accompanied by a renewal fee in the amount of $100.00.

(2) The Board shall not renew the license to practice of any physician assistant against whom an administrative fine has been assessed by the Board until such fine is paid in full. In the event that the fine is subsequently reduced or set aside on judicial review as provided in the Alabama Administrative Procedure Act, the physician assistant shall be entitled to a prompt refund of the amount of the fine, but shall not be entitled to interest thereon.

(3) If a physician assistant fails to renew his license before January 1, he may subsequently renew his license as follows:

(a) Between January 1 and January 31, submit a completed renewal application, pay the renewal fee of $100, and certify completion of the continuing medical education hours required by this Chapter.

(b) February 1 and thereafter, submit a completed renewal application, pay the renewal fee of $100, and submit proof of completion of the continuing medical education hours required by this Chapter.

History

Author: Alabama Board of Medical Examiners; Patricia E. Shaner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed May 21, 2004; effective June 25, 2004. Amended: Filed November 16, 2018; effective December 31, 2018.

Ala. Admin. Code r. 540-X-7-.08 Grandfather Clause - Physician Assistant (P.A.)

(1) Any person who was certified by the board as a physician assistant or surgeon assistant to a licensed physician on December 21, 1994, shall be eligible for the issuance of a license and a registration to practice as a physician assistant.

(2) To qualify for a license under this section, an applicant must submit an application for licensure and the required fee on or before May 7, 1999. After May 7, 1999, an applicant must meet all of the requirements of Rule 540-X-7-.04 concerning licensure.

(3) A person who holds a degree of doctor of medicine but who is not licensed to practice medicine in the State of Alabama shall not be eligible for a license and a registration as a physician assistant unless paragraph (1) of this Rule applies or unless the applicant meets all statutory requirements for a license to practice as a physician assistant in Alabama.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Published October 29, 2021; effective December 13, 2021. Amended: Published October 31, 2024; effective December 15, 2024.

Ala. Admin. Code r. 540-X-7-.09 Temporary License - Physician Assistant (P.A.)

(1) The Board may, in its discretion, grant a temporary license to an applicant who meets the qualifications for licensure as a physician assistant, except that the applicant has not taken the Physician Assistant National Certification Examination (PANCE) for the first time or the applicant has taken the PANCE for the first time and is awaiting the results.

(2) A temporary license is valid:

(a) For one year from the date issued, or

(b) Until the results of an applicant’s examination are available, or

(c) Until the Board makes a final decision on the applicant’s request for licensure as a physician assistant, whichever comes first.

(3) Physician assistants granted a temporary license will not be granted prescriptive privileges, be allowed to practice without direct, on-site physician supervision, be allowed to practice in a remote practice site, or be approved for additional duties in the Job Description.

(4) The Board, in its discretion, may waive the requirement(s) in paragraph (3) of this Rule.

(5) A physician assistant who is granted a temporary license shall not practice or offer to practice unless he or she is registered by the Board to a licensed physician in accordance with these rules and applicable statutes.

(6) There shall be no independent unsupervised practice by a physician assistant who is granted a temporary license.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed May 16, 2013; effective June 20, 2013.

Ala. Admin. Code r. 540-X-7-.10 Grounds For Denial Of License - Physician Assistant (P. A.)

The commission by a physician assistant of any act, offense or condition set forth in Rule 540-X-7-.12 shall be grounds, within the discretion of the board, to deny an application for a license to practice as a physician assistant.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002.

Ala. Admin. Code r. 540-X-7-.11 Denial Of Application For License To Practice As A Physician Assistant (P.A.) - Hearing

(1) If, after examination of the application for a license to practice as a physician assistant and after consideration of any information developed by the Board pursuant to an investigation into the qualifications of the physician assistant for licensure, the Board determines that there is probable cause to believe there exist grounds upon which the application for licensure may be denied, the Board shall take the following actions:

(a) Defer final decision on the application for licensure; and

(b) Notify the physician assistant of the grounds for possible denial of the application for licensure and the procedure for obtaining a hearing before the Board.

(2) The failure to request a hearing within the time specified in the notice shall be deemed a waiver of such hearing.

(3) If requested by the physician assistant, a hearing shall be set before the full Board of Medical Examiners on the application for licensure.

(4) In the event that a hearing is not requested, the Board shall take action to approve or deny the application for licensure.

(5) All hearings under this rule shall be conducted in accordance with the Alabama Administrative Procedure Act, §§41-22-1 et seq., Code of Ala. 1975 and Chapter 6 of the Rules and Regulations of the Board of Medical Examiners. A decision rendered by the Board at the conclusion of the hearing shall constitute final administrative action of the Board of Medical Examiners for the purposes of judicial review under §§41-22-20. The physician assistant applicant shall have the burden of demonstrating to the reasonable satisfaction of the Board that he or she meets all qualifications and requirements for licensure as a physician assistant.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002.

Ala. Admin. Code r. 540-X-7-.12 Discipline Of License - Physician Assistant

(P.A.) - Grounds {#sec-540-x-7-.12 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.12}

After notice and hearing, the Board, within its discretion, shall suspend, revoke, restrict, place on probation or otherwise discipline the license of a physician assistant who is found guilty on the basis of substantial evidence of any of the following acts or offenses:

(1) Conviction of a felony;

(2) Conviction of any crime or other offense, felony or misdemeanor, reflecting on the ability of the individual to render patient care in a safe manner;

(3) Conviction of any violation of state or federal laws relating to controlled substances;

(4) Termination, restriction, suspension, revocation, or curtailment of licensure, registration or certification by another state or other licensing jurisdiction on grounds similar to those stated in these rules;

(5) The denial of a registration, a certification, or a license to practice by another state or other licensing jurisdiction;

(6) Being unable to render patient care with reasonable skill and safety by reason of illness, inebriation, addiction to or excessive use of alcohol, narcotics, chemicals, drugs or any other substance or by reason of a mental or physical condition or disability;

(7) Revocation, termination, suspension or restriction of hospital privileges;

(8) Knowingly submitting or causing to be submitted any false, fraudulent, deceptive or misleading information to the Board of Medical Examiners in connection with an application for licensure or registration;

(9) That the physician assistant has represented himself or herself or permitted another to represent him or her as a physician;

(10) That the physician assistant has performed otherwise than at the direction and under the supervision of a physician approved by the Board;

(11) That the physician assistant has been delegated and/or has performed or attempted to perform tasks and functions beyond his or her competence;

(12) That the physician assistant has performed or attempted to perform tasks beyond those authorized in the approved job description;

(13) Practicing or permitting another to practice as a physician assistant without the required license and registration from the Board of Medical Examiners;

(14) Prescribing in violation of statutory authority and/or Board rules and/or Board guidelines;

(15) Intentional falsification of a certification of compliance with the continuing medical education requirement for physician assistants established in these rules; and

(16) Unprofessional conduct for failing to maintain or provide to the Board records documenting compliance with the minimum continuing medical education requirement.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed May 21, 2004; effective June 25, 2004. Amended: Filed October 15, 2008; effective November 19, 2008.

Ala. Admin. Code r. 540-X-7-.13 Administrative Fines - Physician Assistant (P.A.)

In addition to any other penalty authorized by Code of Ala. 1975, §34-24-302, the Board may in its discretion assess administrative fines not to exceed ten thousand dollars ($10,000.00) for each violation of the provisions of §34-24-302, Board Rule 540-X-7-.12 or any of the Board rules concerning physician assistants.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002.

Ala. Admin. Code r. 540-X-7-.14 Discipline Of License - Physician Assistant

(P.A.) - Hearings {#sec-540-x-7-.14 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.14}

Before revoking, suspending, restricting, placing on probation, assessing administrative fines against, or otherwise disciplining the license of a physician assistant on any of the grounds specified in Rule 540-X-7-.12, the Board shall conduct a hearing pursuant to the provisions of the Alabama Administrative Procedure Act, §§41-22-1 et seq. Code of Ala. 1975, and Chapter 6 of the Rules of the Board.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed October 15, 2008; effective November 19, 2008.

Ala. Admin. Code r. 540-X-7-.15 Registration - Physician Assistant (P.A.)

(1) Registration of a physician assistant by the Board to perform medical services under the supervision of a physician approved by the Board to supervise the assistant shall be accomplished in the following manner:

(a) A completed application for registration in the form specified in Appendix A to Chapter 7 shall be submitted to the Board and shall include a list of each practice site, including the address and phone number where the registration and core duties shall be utilized, and shall list the name and designated working hours of the physician assistant at each practice site;

(b) A non-refundable, non-transferable registration fee in the amount of $100.00 shall accompany the application; and

(c) A detailed job description signed by the physician and physician assistant shall accompany the application. The job description shall set forth those functions and procedures for which the physician assistant qualified by formal education, clinical training, area of certification, and experience, and which sets forth the anticipated functions and activities of the physician assistant. The job description shall include the formulary for prescribing non-controlled drugs that are authorized by the supervising physician to be prescribed by the physician assistant and shall include the authorized dosages, quantities, and number of refills for each drug type to be prescribed.

(2) If the physician assistant intends to practice under a limited protocol, a limited protocol form must be completed and accompany the application.

(3) The physician and the physician assistant may be personally interviewed, at the discretion of the Board, prior to final action on the application for registration.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Published October 29, 2021; effective December 13, 2021. Amended: Published December 29, 2023; effective February 12, 2024.

Ala. Admin. Code r. 540-X-7-.15.01 Exemption From Registration Requirement (P.A.)

(1) A P. A. may request in writing an exemption from the requirement of being registered to perform medical services under the supervision of a physician under the limited circumstances designated in this rule.

(2) Requirements necessary to request and obtain an exemption from registration are the following:

(a) The P. A. holds a current Alabama license.

(b) The P. A. is employed as an instructor at a university or college.

(c) The P. A. will be functioning as attending faculty at a school sponsored student-run free clinic which is not a free clinic within the definition of Code of Ala. 1975, §§6-5-660 through 6-5-663, the Volunteer Medical Professional Act.

(d) The attending faculty P. A. will not be performing those medical services contemplated by Code of Ala. 1975, §34-24-292 and Board Rule 540-X-7-.25.

(e) The attending faculty P. A. will have no prescriptive privileges at the student-run free clinic.

(f) The attending faculty P. A. will not diagnose or treat patients at the student-run free clinic.

(g) The student-run free clinic functions as a wellness only clinic which provides health screenings and health education.

(3) Upon review of information provided, the Board may grant an exemption from registration when it determines that the requirements for exemption have been met.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §34-24-293(a).
New Rule: February 27, 2018; effective April 14, 2018.

Ala. Admin. Code r. 540-X-7-.16 Qualifications For Registration - Physician Assistant (P.A.)

To qualify for registration as a physician assistant an individual must meet the following requirements:

(1) Be employed by:

(a) A physician qualified under these rules or by a partnership, medical professional corporation, medical professional association or physician practice foundation that also employs a supervising physician qualified under these rules; or

(b) An entity approved by the Board under Rule 540-X-7-.22;

(2) Be of good moral character;

(3) Submit an application on forms approved by the Board;

(4) Pay the appropriate fee as determined by the Board;

(5) Submit to the Board any other information which the Board deems necessary to evaluate the applicant's qualifications; and

(6) Effective January 1, 2024, obtain continuing education prescribed by the Board of Medical Examiners regarding the rules and statutes governing supervised practice in Alabama, not more than forty-eight (48) months prior to or within twelve (12) months of registration to a physician.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed August 2, 2018; effective September 16, 2018. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.17 Qualifications Of The Supervising Physician – Physician Assistants (P.A.)

The physician to whom a physician assistant is registered shall:

(1) Possess a current, unrestricted license to practice medicine in the State of Alabama;

(2) On the date of the application:

(a) Have satisfied one of the following experience requirements:

Practiced medicine for at least three years; or
Practiced medicine for at least one year and certified by one or more of the specialty boards recognized by the American Board of Medical Specialties or the American Osteopathic Association; or
Practiced medicine for at least one year and the registration’s practice site is limited solely to a general acute care hospital, a critical access hospital, or a specialized hospital licensed as such by the Alabama Department of Public Health.

(3) Effective January 1, 2024, have obtained continuing medical education prescribed by the Board of Medical Examiners regarding the rules and statutes governing supervised practice in Alabama, not more than forty-eight (48) months prior to or within twelve (12) months of registration to a physician assistant.

(4) The Board, in its discretion, may waive the practice requirements in (2)(a).

(5) Effective January 1, 2024, all supervising physicians shall obtain continuing medical education prescribed by the Board of Medical Examiners regarding the rules and statutes governing supervised practice in Alabama every forty-eight months (48) following registration to a physician assistant.

(6) The Board of Medical Examiners may decline to consider an application where the physician is under investigation for a potential violation of the Code of Ala. 1975, Section 34-24-360 or any rule of the Alabama Board of Medical Examiners of Medical Licensure Commission of Alabama.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Published October 29, 2021; effective December 13, 2021. Amended: Published March 31, 2022; effective May 15, 2022.

Ala. Admin. Code r. 540-X-7-.18 Grounds For Denial Of Registration - Physician Assistant (P.A.) And Supervising Physician

Grounds, within the discretion of the Board, to deny an application for registration as a physician assistant shall be the following:

(1) The commission by a physician assistant of any act, offense or condition stated in Rule 540-X-7-.12

(2) The physician to whom the physician assistant is registered has permitted or required the physician assistant to perform or to attempt to perform tasks which are beyond the assistant’s competence or which are not authorized in the job description approved by the Board.

(3) The supervising physician’s license to practice medicine has been revoked, suspended, restricted or disciplined in any manner.

(4) Refusal by the physician assistant or supervising physician to appear before the Board after having been formally requested to do so in writing by the Executive Director of the Board.

(5) Failure by the physician assistant or physician to notify the Board in writing of termination of previous employment as required by Rule 540-X-7-.20.

(6) The signing by a physician assistant of any form which is to be authenticated by the supervising physician’s signature if the supervising physician has not authorized signing by the assistant or if signing by the assistant is prohibited by Federal or state statutes or regulations or if signing by the assistant is prohibited by the agency governing the form.

(7) Prescribing by a physician or physician assistant in violation of Code of Ala. 1975, §20-2-60, et seq., or the rules of the Alabama Board of Medical Examiners.

(8) Failure of a physician to maintain current or unrestricted licensure with the Medical Licensure Commission of Alabama.

(9) Failure of a supervising physician to comply with any statute or rule governing supervised practice.

(10) The commission or any act by a physician which would constitute a violation of Code of Ala. 1975, §34-24-360 or any rule of the Alabama Board of Medical Examiners or Medical Licensure Commission of Alabama.

(11) Failure of a supervising physician to maintain or produce for inspection upon request by the Alabama Board of Medical Examiners any documentation required to be maintained by the supervising physician.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.19 Denial Of Registration - Physician Assistant

(P.A.) - Hearing {#sec-540-x-7-.19 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.19}

(1) If after examination of the application for registration and after consideration of any information developed by the Board pursuant to an investigation into the qualifications of the physician or of the physician assistant for registration, the Board determines that there is probable cause to believe there exist grounds upon which the application for registration may be denied, the Board shall take the following actions:

(a) Defer final decision on the application for registration; and

(b) Notify the physician and the physician assistant of the grounds for possible denial of the application for registration and the procedure for obtaining a hearing before the Board.

(2) The failure to request a hearing within the time specified in the notice shall be deemed a waiver of such hearing.

(3) If requested by the physician or the physician assistant, a hearing shall be set before the full Board of Medical Examiners on the application for registration.

(4) In the event that a hearing is not requested, the Board shall take action to approve or deny the application for registration.

(5) All hearings under this rule shall be conducted in accordance with the Alabama Administrative Procedure Act, §§41-22-1 et seq., Code of Ala. 1975, and Chapter 6 of the Rules and Regulations of the Board of Medical Examiners. A decision rendered by the Board at the conclusion of the hearing shall constitute final administrative action of the Board of Medical Examiners for the purposes of judicial review under §§41-22-20. The physician assistant applicant shall have the burden of demonstrating to the reasonable satisfaction of the Board that he or she meets all qualifications and requirements for registration as a physician assistant. The physician applying for registration of a physician assistant shall have the burden of demonstrating to the reasonable satisfaction of the Board that he or she meets all the requirements of these regulations.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002.

Ala. Admin. Code r. 540-X-7-.20 Termination Of Registration - Voluntary - Physician Assistants (P.A.)

When for any reason a physician assistant shall discontinue his or her employment with the employer designated in the application for registration, then registration of such physician assistant to the supervising physician designated in the application is automatically terminated. The physician assistant or the physician shall inform the Board in writing of the effective date of the termination of employment and the reasons for such termination. Failure to notify the Board of termination may be considered by the Board as a violation of these rules and regulations for the purpose of approval of future applications for registration.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.21 Interim Approval-Physician Assistant (P.A.)

(1) A physician assistant may obtain interim approval of a supervised practice with an interim supervising physician after confirmed receipt by the Board of Medical Examiners of a registration application and may continue in interim practice until such time as the pending application for registration is approved or denied, provided the interim supervising physician meets the qualifications established in these rules. A physician assistant who has been granted a temporary license may not obtain interim approval.

(2) An applicant for approval to practice as a physician assistant may obtain interim approval when either the supervising physician or the physician assistant is under investigation by a state or federal authority. The interim approval shall remain in force until the application for registration has been approved, denied, or withdrawn. However, the Board of Medical Examiners may decline to approve the application until the investigation has been concluded. The Board of Medical Examiners may withdraw interim approval in accordance with this Chapter.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed August 2, 2018; effective September 16, 2018. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.22 Physician Assistants (P.A) Not Employed By Supervising Physician/Physician Not In Full-Time Practice.

(1) Under the circumstances where a physician assistant is seeking registration to a physician not regularly engaged in the full-time practice of medicine and/or in the circumstance where the physician and the physician assistant seeking registration are each employees of a legal entity other than a professional partnership, medical professional corporation, medical professional association or physician practice foundation, the applicant shall have the burden of satisfying the Board that there exists the supervisory relationship between the physician and the physician assistant contemplated by these rules.

(2) Factors to be used by the Board in determining the nature of the relationship shall include but are not limited to the following:

(a) The physician's authority to terminate the employment of the physician assistant;

(b) The physician's authority to determine or recommend levels of compensation for the physician assistant;

(c) The physician's authority to enforce compliance with orders and directives and to initiate suitable disciplinary action for violation of such orders and directives;

(d) The extent to which the physician assistant may be subject to the direction and control in matters relating to patient care of a person other than the physician to whom the assistant is registered;

(e) The extent to which the physician assistant is subject to the supervisory authority of a non-physician.

(3) In considering applications of the type described above, the Board may require that the applicant submit certificates in the form set forth in Appendix A to Chapter 7 from the Chairman, President, Chief Executive Officer or other acceptable authority of any corporation, business firm or other legal entity which employs the physician assistant and the physician to whom the assistant is to be registered.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.23 Requirements For Supervised Practice - Physician Assistants (P.A.)

(1) Physician supervision requires, at all times, a direct, continuing and close supervisory relationship between a physician assistant and the physician to whom the assistant is registered.

(2) There shall be no independent, unsupervised practice by physician assistants.

(3) The supervising physician shall be readily available for direct communication or by telephone or telecommunication.

(4) The supervising physician shall be available for consultation or referrals of patients from the physician assistant.

(5) In the event the physician to whom the physician assistant is registered is not readily available, provisions must be made for professional medical oversight and direction by a covering physician who is readily available, who is preapproved by the Board of Medical Examiners, and who is familiar with these rules.

(6) In the event of an unanticipated, permanent absence of a supervising physician, a previously approved covering physician may be designated as a temporary supervising physician for a period of up to sixty (60) days. During the sixty (60) day time period, a new registration agreement designating a new supervising physician should be submitted for approval.

(7) If the physician assistant is to perform duties at a remote site, the application for registration must clearly specify the circumstances and provide written verification of physician availability for consultation and/or referral, and direct medical intervention in emergencies and after hours, if indicated. The Board, at its discretion, may waive the requirement of written verification upon documentation of exceptional circumstances. Employees of state and county health departments and facilities certified by the Alabama Department of Mental Health are exempt from the requirement of written verification of physician availability.

(8) The supervising physician and the physician assistant shall adhere to any written guidelines established by the Board to govern the prescription practices of physician assistants.

(9) If the physician assistant is to perform duties at a remote site physician supervision requires the following:

(a) The supervising physician receives a daily status report to be made in person, by telephone, or by telecommunications from the assistant on any complications or unusual problems encountered;

(b) The supervising physician will be present ten percent (10%) of the P. A.’s scheduled work hours in an approved remote practice site if:

The P. A. has less than two (2) years (4,000 hours) in a registration agreement.
The P. A. has entered into a new registration agreement and the new supervising physician has a dissimilar primary specialty than the previous supervising physician.

Visit the remote site no less than twice a year.
Meet with the P. A. no less than quarterly.

(d) A pre-approved covering physician is allowed to be present in lieu of the supervising physician.

(e) The supervising physician, during office visits, if applicable, reviews with the assistant case histories of patients with unusual problems or complications.

(f) An appropriate physician personally diagnoses or treats patients requiring physician follow-up.

(10) The supervising physician must complete quarterly quality assurance with each physician assistant. Documentation of any quality assurance review required by this chapter shall be maintained by the supervising physician for the duration of the registration agreement and for three years following the termination of the supervised practice agreement.

(a) The mechanism for quarterly quality assurance shall be as follows:

Specify a plan for quarterly quality assurance management with defined quality outcome measures for evaluation of the clinical practice of the physician assistant and include review of a meaningful sample of medical records plus all adverse outcomes. The term “medical records” includes, but is not limited to, electronic medical records. Documentation of quality assurance review shall be readily retrievable, identify records that were selected for review, include a summary of findings conclusions, and, if indicated, recommendations for change.
Countersignature by supervising physician must be pursuant to established policy and/or applicable legal regulations and accreditation standards.

(11) The supervising physician must maintain documentation of the physician assistant’s two (2) years (4,000 hours) of supervised practice experience for the duration of the supervised practice and for three (3) years following the termination of the registration agreement.

(12) The physician shall at all times maintain independent medical judgment related to the practice of medicine, irrespective of employment structure or business model.

(13) Irrespective of the location of the principal practice site and any remote site(s) of the supervised practice, all services provided to patients and actions incident to services provided to patients of the supervised practice shall be deemed to have occurred in the state where the patient is located at the time of service or action incident to the service. The supervising physician, covering physician, and physician assistant shall comply with all applicable Alabama laws, rules, and regulations pertaining to services and actions incident to services provided to Alabama patients of the supervised practice. Actions incident to services include, but are not limited to, professional medical oversight and direction to the physician assistant regarding Alabama patients, consultation, or referral of Alabama patients from the physician assistant, quality assurance review of the medical records of Alabama patients, and maintenance of documentation pursuant to this chapter. The supervising physician shall maintain all documentation required pursuant to this chapter for the duration of the supervised practice and for three years following the termination of the supervised practice agreement.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed October 21, 2010; effective November 25, 2010. Amended: Filed December 11, 2014; effective January 15, 2015. Amended: Filed December 16, 2015; effective January 30, 2016. Amended: Filed October 19, 2017; effective December 3, 2017. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.24 Covering Physicians For Physician Assistants

(P.A.) {#sec-540-x-7-.24 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.24}

(1) When the primary supervising physician is not readily available to respond to patients’ medical needs, the physician assistant is not authorized to perform any act or render any treatments unless another qualified physician in the same medical practice, practice group, or multidisciplinary medical team, or of the same or similar specialty as the supervising physician is immediately available to supervise the physician assistant who has previously filed with the Board a letter stating that he or she assumes all responsibility for the actions of the physician assistant during the temporary absence of the primary supervising physician.

(2) The covering physician providing the supervision shall also affirm in the letter that he or she is familiar with the current rules regarding physician assistants and the job description filed by the supervising physician and the physician assistant, that he or she is accountable for adequately supervising the medical care rendered pursuant to the job description, and that he or she approves the drug type, dosage, quantity and number of refills of legend drugs which the physician assistant is authorized to prescribe in the job description. The covering physician must meet the same qualifications as the supervising physician as established in Rule 540-X-7-.17.

(3) The supervising physician shall certify to the Board of Medical Examiners at least annually that any approved covering physician continues to agree to serve in that capacity and shall inform the Board of Medical Examiners of the termination of a covering physician within ten (10) days of the termination.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed December 16, 2015; effective January 30, 2016. Amended: Filed August 2, 2018; effective September 16, 2018. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.25 Functions And Activities Of A Physician Assistant

(P.A.) {#sec-540-x-7-.25 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.25}

(1) There shall be at all times a direct continuing and close supervisory relationship between the physician assistant and the physician to whom that assistant is registered. The supervising physician shall at all times be responsible for the activities of the physician assistant.

(2) The physician assistant shall provide medical services within the education, training, and experience of the physician assistant that are delegated by the supervising physician. These services include, but are not limited to:

(a) Obtaining patient histories and performing physical examinations;

(b) Ordering and/or performing diagnostic and therapeutic procedures;

(d) Developing and implementing a treatment plan;

(e) Monitoring the effectiveness of therapeutic interventions;

(f) Assisting at surgery;

(g) Offering counseling and education to meet patient needs; and

(h) Making appropriate referrals.

(3) The job description in the form specified in Appendix B to Chapter 7 is approved by the Board as a model job description which shall be acceptable to the Board if submitted by a qualified applicant for registration in compliance with these Rules.

(4) Requests for changes in the job description of the assistant, including addition of specialized duties and tasks, shall be submitted, in writing, by the supervising physician to the Board for prior approval.

(5) Should the supervising physician contemplate a request for additional duties for the assistant for addition to the assistant’s Job Description, a written request shall be submitted to and approved by the Board prior to any additional duty or procedure being performed by the assistant.

(6) When any addition of a duty or procedure to the assistant’s Job Description is contemplated, a written request for training of the assistant in the duty or procedure shall be submitted to and approved by the Board prior to the assistant actually receiving any training in the duty or procedure.

(7) In the event of a national emergency duly declared by Federal officials or in the event of a natural disaster or state emergency duly declared by the Governor, a physician assistant may provide emergency medical treatment without immediate physician supervision or direction to patients within the affected areas of the state, provided that the treatment is within the scope of the assistant’s education, training and approved job description. The physician assistant in such circumstance shall make reasonable efforts to inform his supervising physician of the location and type of emergency medical services being provided and shall act in conformance with the direction of local medical supervisors. The authority granted under this paragraph shall extend only for the duration of the declared national emergency or state emergency or natural disaster.

(8) A physician assistant may write admission orders for inpatients and nursing home patients as directed by the supervising physician and subsequent orders in accordance with established guidelines and institutional policies.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed November 19, 2004; effective December 24, 2004. Amended: Filed November 20, 2008; effective December 25, 2008. Amended: Filed June 20, 2018; effective August 4, 2018.

Ala. Admin. Code r. 540-X-7-.26 Limitations Upon Utilization Of Physician Assistants (P.A.)

(1) A supervising physician must be present in the operating room or be immediately available to that operating room whenever a physician assistant is involved in the care of a patient in the operating room. Whenever a physician assistant performs or assists in performing invasive procedures with involvement deeper than the complete dermis, the supervising physician must be present in the operating room, unless otherwise specifically approved by the Board.

(2) The cumulative work time for all physician assistants being supervised by an individual primary supervising physician shall not exceed three hundred and sixty (360) hours (nine FTEs) per week. The physician shall not supervise or collaborate with any combination of assistants to physicians, certified registered nurse practitioners, and/or certified nurse midwives exceeding three hundred and sixty (360) hours per week (nine full-time equivalent positions). “One full-time equivalent” (FTE) is herein described as a person/persons collectively working forty hours a week, excluding time on call.

(3) A physician collaborating with or supervising more than four FTEs per week shall engage in documented quality assurance review with each physician assistant every month for six (6) months following registration with a new physician assistant.

(4) A physician shall disclose to the Board of Medical Examiners the existence of all collaborative and supervisory agreements to which the physician is party, including collaborative and supervisory agreements in other states, and shall not be eligible to collaborate with or supervise any combination of certified registered nurse practitioners, certified nurse midwives and/or assistants to physicians exceeding three hundred and sixty (360) hours per week (nine full-time equivalent positions), inclusive of collaborative and supervisory agreements existing in other states. Agreements with an individual certified registered nurse practitioner, certified nurse midwife, and/or assistant to physician in multiple states shall only be counted once for purposes of calculating the total number of full-time equivalent positions.

(5) A physician assistant may be registered to more than one supervising physician at any one time. The number of supervising physicians to whom a physician assistant may be registered shall be restricted by the Board if the Board, in its discretion, determines that such restriction is appropriate to maintain the quality of medical services being provided or to otherwise protect the public health, safety and welfare.

(6) A physician in a registration agreement/ collaboration with a Physician Assistant, Certified Registered Nurse Practitioner or Certified Nurse Midwife totaling three hundred and sixty (360) hours per week (nine (9) full-time equivalents (FTEs)) may request a transitional allowance increasing the total weekly hours for the purpose of orientation of the incoming Physician Assistant. The transitional allowance shall not exceed forty-five (45) days. The physician shall request the transitional allowance in writing and specify the starting date of this FTE allowance.

(7) Employees of the State Health Department or of a county board of health are specifically exempt from the requirements of paragraph (2) of this rule. The Board of Medical Examiners, in its discretion, may determine how many physician assistants may be registered to and/or supervised by a physician employed by the State Health Department or by a county board of health.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed July 22, 2005; effective August 26, 2005. Amended: Filed March 20, 2008; effective April 24, 2008. Amended: Filed October 22, 2015; effective November 26, 2015. Amended: Published August 31, 2021; effective October 15, 2021.

Ala. Admin. Code r. 540-X-7-.27 Prohibited Activities And Functions - Physician Assistants (P.A.)

(1) Notwithstanding any other provision of law, a physician assistant may perform medical service when such services are rendered under the supervision of a licensed physician or physicians approved by the Board; except, that no medical services may be performed except under the supervision of an ophthalmologist in the office in which such physician normally actually practices his profession and nowhere else in any of the following areas:

(a) The measurement of the powers or range of human vision or the determination of the accommodation and refractive state of the human eye or the scope of its functions in general or the fitting or adaptation of lenses or frames for the aid thereof.

(b) The prescribing or directing the use of or using any optical device in connection with ocular exercises, visual training or orthoptics.

(c) The prescribing of contact lenses for or the fitting or adaptation of contact lenses to the human eye. Nothing in this section shall preclude the performance of routine visual screening.

(2) There shall be no practice by a Physician Assistant who is not licensed and registered by the Board.

(3) There shall be no independent practice by a physician assistant who is licensed and/or registered by the Board.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed June 20, 2018; effective August 4, 2018.

Ala. Admin. Code r. 540-X-7-.28 Prescriptions And Medication Orders - Physician Assistants (P.A.)

(1) A physician assistant may prescribe a legend drug to a patient subject to both of the following conditions being met:

(a) The drug type, dosage, quantity prescribed, and number of refills are authorized in the job description which is signed by the supervising physician to whom the physician assistant is currently registered and which is approved by the Board; and

(b) The drug is included in the formulary approved by the Board for governing the prescription practices of physician assistants.

(2) Subject to any limitations stated in protocols and medical regimens adopted by the Board and subject to any limitations by the supervising physician in the approved formulary, a physician assistant may prescribe any drug, substance or compound which is listed in Schedules III through V of the Alabama Uniform Controlled Substances Act upon being granted a Qualified Alabama Controlled Substances Certificate (QACSC) and upon submission of an approved QACSC formulary.

(3) The supervising physician and the physician assistant shall adhere to and follow all requirements and procedures stated in written guidelines established by the Board to govern the prescribing practices of physician assistants.

(4) A physician assistant who is registered to a physician with prescriptive privileges shall not engage in prescribing for:

(a) Self.

(b) Immediate family members.

(5) A physician assistant may not initiate a call-in prescription in the name of the supervising physician for any drug which the assistant is not authorized to prescribe unless the drug is specifically ordered for the patient by the supervising physician either in writing or by a verbal order reduced to writing and signed within seven (7) working days of the date of the prescription.

(6) For any drug which the physician assistant is authorized to prescribe, a written prescription signed by the physician assistant and entered into the patient's chart may be called-in to a pharmacy.

(7) Whenever a physician assistant calls in a prescription to a pharmacy, the physician assistant shall identify his or her supervising physician.

(8) A physician assistant may administer any legend drug or controlled drug which the assistant is authorized to prescribe.

(9) When prescribing legend drugs or controlled drugs a physician assistant shall use a prescription form which includes all of the following:

(a) The name, medical practice site address and telephone number of the physician supervising the physician assistant;

(b) The medical practice site address and telephone number of the physician assistant, if different from the address of the supervising physician;

(c) The physician assistant's license number assigned by the Board and the QACSC registration number, when a controlled substance is prescribed;

(d) The words "Product Selection Permitted" printed on one side of the prescription form directly underneath a signature line; and

(e) The words "Dispense as written" printed on one side of the prescription form directly underneath a signature line.

(10) For inpatients and nursing home patients, a physician assistant may enter a verbal order from the supervising physician for controlled substances or other medications which the assistant is not authorized to prescribe, provided that the order is co-signed by the supervising physician in accordance with established guidelines and institutional policies.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008. Amended: Filed November 20, 2008; effective December 25, 2008. Amended: Filed February 17, 2010; effective March 24, 2010. Amended: Filed December 16, 2015; effective January 30, 2016. Amended: Filed April 15, 2016; effective May 30, 2016. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published October 29, 2021; effective December 13, 2021.

Ala. Admin. Code r. 540-X-7-.29 Continuing Medical Education - Physician Assistant

(1) Effective January 1, 2025, every two calendar years, each physician assistant licensed by the Board must earn not less than fifty (50) hours of AMA PRA Category 1 Credits™ or the equivalent as defined in this rule of continuing medical education as a condition precedent to receiving his or her annual renewal of license, unless he or she is exempt from the minimum continuing medical education requirement.

(a) Effective January 1, 2025, each new applicant issued a license to practice as a physician assistant shall complete a Board-designated course in the area of professional boundaries within twelve (12) months of the license issue date. This requirement must be met regardless of any existing exemption provided in these rules.

(b) Effective January 1, 2025, all actively licensed physician assistants shall complete a Board-designated course in the area of professional boundaries by December 31, 2025. There are no exemptions to this requirement.

(2) For the purposes of this chapter, AMA PRA Category 1 Credit™ continuing medical education shall mean those programs of continuing medical education designated as AMA PRA Category 1 Credit™ which are sponsored or conducted by those organizations or entities accredited by the Council on Medical Education of the Medical Association of the State of Alabama or by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor or conduct Category 1 continuing medical education programs.

(3) The following courses and continuing medical education courses shall be deemed, for the purposes of this Chapter, to be the equivalent of AMA PRA Category 1 Credit™ continuing medical education:

(a) Programs of continuing medical education designated as Category 1-A which are sponsored or conducted by organizations or entities accredited by the American Osteopathic Association to sponsor or conduct Category 1-A continuing medical education for osteopathic physicians.

(b) Programs of continuing medical education designated to confer "Prescribed credits" which are sponsored or conducted by organizations or entities accredited by the American Academy of Family Physicians to sponsor or conduct "Prescribed credit" continuing medical education activities.

(d) Programs of continuing medical education designated to confer "ACOG Cognate Credits" which are sponsored or conducted by organizations or entities which are accredited by the American College of Obstetrics and Gynecology to sponsor or conduct approved ACOG Cognate Credit activities on obstetrical and gynecologic related subjects.

(e) Programs of continuing medical education designated as AAPA Category I CME Credits which are sponsored or conducted by those organizations or entities accredited by the Education Council of the American Academy of Physician Assistants to sponsor or conduct AAPA Category I continuing medical education programs.

(f) Effective January 1, 2014, nationally recognized advanced life support/resuscitation certification courses, not otherwise accredited for AMA PRA Category 1 Credit™, for a maximum of two (2) Category 1 credits for each course. Basic life support courses are excluded and are not deemed to be the equivalent of Category 1 continuing medical education.

(4) Every physician assistant subject to the minimum continuing medical education requirement established in these rules shall maintain records of attendance or certificates of completion demonstrating compliance with the minimum continuing medical education requirement. Documentation adequate to demonstrate compliance with the minimum continuing medical education requirements of these rules shall consist of certificates of attendance, completion certificates, proof of registration, or similar documentation issued by the organization or entity sponsoring or conducting the continuing medical education program. The records shall be maintained by the physician assistant for a period of three (3) years following the year in which the continuing medical education credits were earned and shall be subject to examination by representatives of the State Board of Medical Examiners upon request. Every physician assistant subject to the continuing medical education requirements of these rules must, upon request, submit a copy of such records to the State Board of Medical Examiners for verification. Failure to maintain records documenting that a physician assistant has met the minimum continuing medical education requirement, and/or failure to provide such records upon request to the Board is hereby declared to be unprofessional conduct and may constitute grounds for discipline of the physician assistant’s license to practice as a physician assistant, in accordance with the statutes and regulations governing the disciplining of a physician assistant’s license.

(5) Every physician assistant shall certify annually that he or she has met the minimum annual continuing medical education requirement established pursuant to these rules or that he or she is exempt. This certification will be made on a form provided on the annual renewal of license application required to be submitted by every physician assistant on or before December 31st of each year. The Board shall not issue a renewed license to any physician assistant who has not certified that he or she has met the minimum continuing medical education requirement unless the physician assistant is exempt from the requirement.

(6) A physician assistant who is unable to meet the minimum continuing medical education requirement by reason of illness, disability or other circumstances beyond his or her control may apply to the Board for a waiver of the requirement for the calendar year in which such illness, disability or other hardship condition existed. A waiver may be granted or denied within the sole discretion of the Board, and the decision of the Board shall not be considered a contested case and shall not be subject to judicial review under the Alabama Administrative Procedure Act. If a waiver is granted, the physician assistant shall be exempt from the continuing medical education requirement for the calendar year in which the illness, disability or other hardship condition existed.

(7) A physician assistant receiving his or her initial license to practice medicine in Alabama is exempt from the minimum continuing medical education requirement for the calendar year in which he or she receives his or her initial license.

(8) A physician assistant who is a member of any branch of the armed forces of the United States and who is deployed for military service is exempt from the continuing medical education requirement for the calendar year in which he or she is deployed.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed May 21, 2004; effective June 25, 2004. Amended: Filed November 18, 2009; effective December 23, 2009. Amended: Filed March 11, 2010; effective April 15, 2010. Amended: Filed April 12, 2013; effective May 17, 2013. Amended: Filed December 12, 2013; effective January 16, 2014. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published January 31, 2024; effective March 16, 2024. Amended: Published August 30, 2024; effective October 14, 2024.

Ala. Admin. Code r. 540-X-7-.30 Physician Assistants' Advisory Committee

(1) The Physician Assistants' Advisory Committee is established for the purpose of enabling a mechanism for the exchange of information between the Alabama Board of Medical Examiners and the physician assistants through their representative organization on issues related to physician assistant practice.

(2) The Physician Assistants' Advisory Committee shall consist of the following:

(a) Four physicians licensed to practice medicine in the state of Alabama, two of whom shall be current members of the Alabama Board of Medical Examiners. All physician members shall be appointed by the Chairman of the Board; and

(b) Four physician assistants appointed by the Alabama Society of Physician Assistants.

(3) The members of the Physician Assistants' Advisory Committee shall serve for a term of three years and may be reappointed to two additional terms of three years.

(4) The Physician Assistants' Advisory Committee may exercise the following functions and responsibilities:

(a) Review and/or recommend changes to the current rules and regulations for physician assistant practice;

(b) Discuss and/or make recommendations regarding changes to the scope of practice privileges of the physician assistant;

(c) Serve in an advisory role regarding issues related to applications for licensure, practice agreements, disciplinary proceedings and renewal requirements;

(d) Discuss issues of mutual concern regarding the education, utilization and scope of practice of the physician assistant.

(5) The Physician Assistant Advisory Committee shall meet on a quarterly basis at the discretion and call of the Chairman of the Board of Medical Examiners. An Advisory Committee meeting may be called upon reasonable notice by a petition of three Board members to the Chairman.

History

Author: State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed August 16, 2007; effective September 20, 2007. Amended: Published April 29, 2022; effective June 13, 2022. Amended: Published July 31, 2024; effective September 14, 2024.

Ala. Admin. Code r. 540-X-7-.31 Forms Requiring A Physician’s Signature - Physician Assistant (P.A.)

Unless prohibited by Federal or state statutes or regulations or by the agency governing a specific form, a physician assistant may sign any form which can be authenticated by the supervising physician’s signature, if signing by the physician assistant is authorized by the supervising physician.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed August 2, 2018; effective September 16, 2018.

Ala. Admin. Code r. 540-X-7-.32 Grounds For Termination Of Registration – Involuntary – Physician Assistant (P.A.)

The commission by a physician assistant or physician of any act, offense or condition set forth in Rule 540-X-7-.12 or Rule 540-X-7-.18 shall be grounds, within the discretion of the Board, to terminate the registration of a physician assistant to perform medical services under the supervision of a physician.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed August 2, 2018; effective September 16, 2018.

Ala. Admin. Code r. 540-X-7-.33 Termination Of Registration - Involuntary – Physician Assistant (P.A.) - Hearings

Before terminating the registration of a physician assistant on any of the grounds specified in Rule 540-X-7-.32, the Board shall conduct a hearing under the provisions of the Alabama Administrative Procedure Act, §§34-22-1, et seq., Code of Ala. 1975, and Chapter 6 of the Rules of the Board.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002.

Ala. Admin. Code r. 540-X-7-.34 Investigations - Physician Assistant (P.A.)

(1) During the course of an investigation, the Board may require that a physician assistant submit to a criminal history background check to include the following:

(a) The provision of fingerprints using forms provided by the Board;

(b) The execution and provision of a criminal history information release using forms provided by the Board; and

(2) The fingerprints shall be submitted to the Alabama Bureau of Investigation (ABI), which is responsible for forwarding the fingerprints to the Federal Bureau of Investigation (FBI) for a national criminal history record check.

(3) Information received by the Board pursuant to a criminal history background check shall be confidential and shall not be a public record, except that such information received and relied upon in an investigation by the Board may be disclosed to the Physician Assistant (P.A.).

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§ 34-24-290, et. seq. and Act No. 08-378.
New Rule: Filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.35 Examinations/Evaluations - Physician Assistant

(P.A.) {#sec-540-x-7-.35 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.35}

(1) When the issue is whether a physician assistant is physically or mentally capable of practicing as a physician assistant with reasonable skill and safety to patients, then, upon a showing of probable cause to the Board that the physician assistant is not capable of practicing with reasonable skill and safety to patients, the Board may order and direct the physician assistant in question to submit to a physical, mental, or laboratory examination or any combination of such examinations to be performed by a physician designated by the Board. The expense of such examination shall be borne by the physician assistant who is so examined.

(2) Every physician assistant licensed to practice as a physician assistant in the state of Alabama who accepts the privilege of practicing by actually practicing or by the making and filing of an annual registration to practice shall be deemed to have given consent to submit to a mental, physical, or laboratory examination or to any combination of such examinations and to waive all objections to the admissibility of the examining physician’s testimony or examination reports on the ground that they constitute privileged doctor-patient communications.

(3) Upon receipt of credible information that a physician assistant has been evaluated or has received inpatient or outpatient treatment for any physical, psychiatric, or psychological illness or for chemical dependency, drug addiction, or alcohol abuse, the Board may order that the physician assistant execute and deliver to the Board an authorization and release form directed to each and every facility or treatment provider authorizing and directing the release to the Board of any reports of evaluation, mental, or physical, or examination, including psychiatric, psychological, and neuropsychiatric examinations, hospital and treatment provider medical records, reports of laboratory tests for the presence of alcohol or drugs, rehabilitation records, and mental competency evaluations. Any and all expenses incurred in the furnishing of the reports, records, or documents which are the subject of an order issued by the Board shall be borne by the physician assistant who is the subject of the order.

(4) Failure or refusal by the physician assistant to comply with an order of the Board directing the execution and delivery to the Board of an authorization and release form as provided in paragraph (3) herein shall constitute grounds for the summary suspension of the physician assistant’s license to practice. The suspension shall continue in effect until such time as the physician assistant complies with the order of the Board or the order is withdrawn by the Board.

(5) All reports, records, and documents released to the Board under the provisions of paragraph (3) herein are privileged and confidential and shall not be public records nor available for court subpoena or for discovery proceedings, but may be used by the Board in the course of its investigation and may be introduced as evidence in administrative hearings conducted by the Board.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq. and Act No. 08-378.
New Rule: Filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.36 Voluntary Surrender, Voluntary Restrictions, Reinstatements - Physician Assistant (P.A.)

(1) A physician assistant may surrender his or her license to practice or request in writing to the Board that a restriction be placed upon the license. The Board may accept a surrender or grant such a request for restriction and shall have the authority, if it deems appropriate, to attach such restrictions to the license.

(2) Removal of a voluntary restriction on the license shall be done only by order of the Board.

(3) If the Board accepts the surrender of a license, any current registration of the physician assistant shall be automatically terminated, and the physician assistant shall not be authorized to practice within the state of Alabama.

(4) Requests for modification or termination of restrictions on a license or for reinstatement of a revoked or surrendered license which are filed with the Board within 24 months of the effective date of the restriction, revocation or surrender may, within the discretion of the Board, be dismissed by the Board as prematurely filed. A request as described above which is filed with the Board more than 24 months following the effective date of the restriction, revocation or surrender may be granted or may be set for a hearing before the Board, and such hearing shall be conducted as a contested case under the Alabama Administrative Procedure Act.

(5) The Board shall be without jurisdiction to reinstate a revoked or voluntarily surrendered license if the request for reinstatement is received by the Board more than five years after the effective date of the revocation or surrender.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq. and Act No. 08-378.
New Rule: Filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.37 Requirements To Practice As An Anesthesiologist Assistant (A.A.)

(1) To practice or offer to practice as an anesthesiologist assistant, each person shall be licensed by and registered by the Board in accordance with Chapter 7 of these rules.

(2) Effective January 1, 2024, anesthesiologist assistants shall obtain continuing education prescribed by the Board of Medical Examiners regarding the rules and statutes governing supervised practice in Alabama not more than forty-eight (48) months prior to or within twelve (12) months of registration to a physician.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Published November 30, 2021; effective January 14, 2022.
Editor's note: Previous Rule 540-X-7-.34 was renumbered to .37 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.38 Requirements For The Issuance Of A License To Practice As An Anesthesiologist Assistant (A.A.)

To qualify for a license to practice as an anesthesiologist assistant an individual shall meet the following requirements:

(1) Provide evidence, satisfactory to the Board, of successful completion of a training program accredited by the Committee on Allied Health Education and Accreditation (CAHEA), the Commission on Accreditation of Allied Health Education Programs (CAAHEP), or the Accreditation Review Committee for the Anesthesiologist Assistant (ARC-AA), or their successor agencies;

(2) Provide evidence, satisfactory to the Board, of successful completion of the National Certifying Examination for Anesthesiologist Assistants (NCEAA) as administered by the National Commission for Certification of Anesthesiologist Assistants (NCCAA);

(3) Submit an application on forms approved by the Board; and

(4) Pay the required license application fee as determined by the Board.

(5) Beginning October 1, 2008, submit to a criminal history background check which includes the following:

(a) Provide fingerprints and execute a criminal history information release using forms provided by the Board; and

(b) Pay a criminal history background check fee in an amount established in Rule 540-X-3-.09(2).

Fingerprints provided by an applicant shall be submitted to the Alabama State Bureau of Investigation (ASBI), which is responsible for forwarding the fingerprints to the Federal Bureau of Investigation (FBI) for a national criminal history record check. Information received by the Board pursuant to a criminal history background check shall be confidential and shall not be a public record, except that such information received and relied upon in denying the issuance of a license to practice as an anesthesiologist assistant in this state may be disclosed as may be necessary to support the denial.

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008. Amended: Published March 31, 2022; effective May 15, 2022.
Editor's note: Previous Rule 540-X-7-.35 was renumbered to .38 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.39 Issuance Of License To Practice As An Anesthesiologist Assistant (A.A.)

(1) The Board shall issue a license to practice as an anesthesiologist assistant when all requirements for licensure have been met.

(2) Every license issued shall be dated, shall be numbered in the order of issuance, and shall be signed by the chair of the Board or the chair’s designee.

(3) The size and design of the license shall be determined by the Board.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.36 was renumbered to .39 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.40 License Fee - Anesthesiologist Assistant (A.A.)

(1) All applicants for a license to practice as an anesthesiologist assistant shall submit to the Board an application fee in the amount of $200.00.

(2) The initial license fee in paragraph (1) shall be waived for any person who was certified as an anesthesiologist assistant on the effective date of these rules.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.37 was renumbered to .40 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.41 License Renewal - Anesthesiologist Assistant (A.A.)

(1) A license to practice as an anesthesiologist assistant shall be renewed annually on or before January 1st of each year. Application for annual renewal shall be received by the Board on or before December 31st and shall be accompanied by a renewal fee in the amount of $100.00.

(2) The Board shall not renew the license to practice of any anesthesiologist assistant against whom an administrative fine has been assessed by the Board until such fine is paid in full. In the event that the fine is subsequently reduced or set aside on judicial review as provided in the Alabama Administrative Procedure Act, the anesthesiologist assistant shall be entitled to a prompt refund of the amount of the fine, but shall not be entitled to interest thereon.

(3) If an anesthesiologist assistant fails to renew his license before January 1, he may subsequently renew his license as follows:

(a) Between January 1 and January 31, submit a completed renewal application, pay the renewal fee of $100, and certify completion of the continuing medical education hours required by this Chapter.

(b) February 1 and thereafter, submit a completed renewal application, pay the renewal fee of $100, and submit proof of completion of the continuing medical education hours required by this Chapter.

History

Author: Alabama Board of Medical Examiners; Patricia E. Shaner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290 thru 34-24-303.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed May 21, 2004; effective June 25, 2004. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Filed November 16, 2018; effective December 31, 2018.
Editor's note: Previous Rule 540-X-7-.38 was renumbered to .41 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.42 Temporary License - Anesthesiologist Assistant

(A.A.) {#sec-540-x-7-.42 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.42}

(1) The Board may, in its discretion, grant a temporary license to an applicant who meets the qualifications for licensure as an anesthesiologist assistant, except that the applicant has not yet taken the Certifying Examination for Anesthesiologist Assistants (CEAA) for the first time or the applicant has taken the NCEAA for the first time and is awaiting the results.

(2) A temporary license is valid:

(a) For one year from the date issued, or

(b) Until the results of an applicant’s examination are available, or

(c) Until the Board makes a final decision on the applicant’s request for licensure as an anesthesiologist assistant, whichever comes first.

(3) Anesthesiologist assistants granted a temporary license will not be allowed to practice without direct, on-site physician supervision and will not be approved for additional duties in the Job Description.

(4) An anesthesiologist assistant who is granted a temporary license shall not practice or offer to practice unless he or she is registered by the Board to a licensed physician in accordance with these rules and applicable statutes.

(5) There shall be no independent unsupervised practice by an anesthesiologist assistant who is granted a temporary license.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Filed May 16, 2013; effective June 20, 2013.
Editor's note: Previous Rule 540-X-7-.39 was renumbered to .41 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.43 Grounds For Denial Of License - Anesthesiologist Assistant (A.A.)

The commission by an anesthesiologist assistant of any act, offense or condition set forth in Rule 540-X-7-.44 shall be grounds, within the discretion of the board, to deny an application for a license to practice as an anesthesiologist assistant.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.40 was renumbered to .43 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.44 Denial Of Application For License To Practice As An Anesthesiologist Assistant (A.A.) - Hearing

(1) If, after examination of the application for a license to practice as an anesthesiologist assistant and after consideration of any information developed by the Board pursuant to an investigation into the qualifications of the anesthesiologist assistant for licensure, the Board determines that there is probable cause to believe there exist grounds upon which the application for licensure may be denied, the Board shall take the following actions:

(a) Defer final decision on the application for licensure; and

(b) Notify the anesthesiologist assistant of the grounds for possible denial of the application for licensure and the procedure for obtaining a hearing before the Board.

(2) The failure to request a hearing within the time specified in the notice shall be deemed a waiver of such hearing.

(3) If requested by the anesthesiologist assistant, a hearing shall be set before the full Board of Medical Examiners on the application for licensure.

(4) In the event that a hearing is not requested, the Board shall take action to approve or deny the application for licensure.

(5) All hearings under this rule shall be conducted in accordance with the Alabama Administrative Procedure Act, §§41-22-1, et seq., Code of Ala. 1975, and Chapter 6 of the Rules and Regulations of the Board of Medical Examiners. A decision rendered by the Board at the conclusion of the hearing shall constitute final administrative action of the Board of Medical Examiners for the purposes of judicial review under §§41-22-20. The anesthesiologist assistant applicant shall have the burden of demonstrating to the reasonable satisfaction of the Board that he or she meets all qualifications and requirements for licensure as an anesthesiologist assistant.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290 thru 34-24-303.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.41 was renumbered to .44 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.45 Discipline Of License - Anesthesiologist Assistant (A.A.) - Grounds

After notice and hearing, the Board, within its discretion, shall suspend, revoke, place on probation or otherwise discipline the license of an anesthesiologist assistant who is found guilty on the basis of substantial evidence of any of the following acts or offenses:

(1) Conviction of a felony;

(2) Conviction of any crime or other offense, felony or misdemeanor, reflecting on the ability of the individual to render patient care in a safe manner;

(3) Conviction of any violation of state or federal laws relating to controlled substances;

(5) The denial of a registration, a certification, or a license to practice by another state or other licensing jurisdiction;

(7) Revocation, termination, suspension or restriction of hospital privileges;

(9) That the anesthesiologist assistant has represented himself or herself or permitted another to represent him or her as a physician;

(10) That the anesthesiologist assistant has performed otherwise than at the direction and under the supervision of an anesthesiologist approved by the Board;

(11) That the anesthesiologist assistant has been delegated and/or has performed or attempted to perform tasks and functions beyond his or her competence;

(12) That the anesthesiologist assistant has performed or attempted to perform tasks beyond those authorized in the approved job description;

(13) Practicing or permitting another to practice as an anesthesiologist assistant without the required license and registration by the Board of Medical Examiners;

(14) Prescribing in violation of statutory authority and/or Board rules and/or Board guidelines;

(15) Intentional falsification of a certification of compliance with the continuing medical education requirement for anesthesiologist assistants established in these rules; and

(16) Unprofessional conduct for failing to maintain or provide to the Board records documenting compliance with the minimum continuing medical education requirement.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed May 21, 2004; effective June 25, 2004. Amended: Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.42 was renumbered to .45 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.46 Administrative Fines-Anesthesiologist Assistant

(A.A.) {#sec-540-x-7-.46 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.46}

In addition to any other penalty authorized by Code of Ala. 1975, §34-24-302, the Board may in its discretion assess administrative fines not to exceed ten thousand dollars ($10,000) for each violation of the provisions of §34-24-302, Board Rule 540-X-7-.45 or any of the Board rules concerning anesthesiologist assistants.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.43 was renumbered to .46 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.47 Discipline Of License - Anesthesiologist Assistant

(A.A.) - Hearings {#sec-540-x-7-.47 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.47}

Before revoking, suspending, placing on probation, assessing administrative fines against, or otherwise disciplining the license of an anesthesiologist assistant on any of the grounds specified in Rule 540-X-7-.45, the Board shall conduct a hearing pursuant to the provisions of the Alabama Administrative Procedure Act, §§41-22-1, et seq., Code of Ala. 1975, and Chapter 6 of the Rules of the Board.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.44 was renumbered to .47 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.48 Registration - Anesthesiologist Assistant (A.A.)

Registration of an anesthesiologist assistant by the Board to perform medical services under the supervision of an anesthesiologist approved by the Board to supervise the assistant shall be accomplished in the following manner:

(1) A completed application for registration in the form specified in Appendix E to Chapter 7 shall be submitted to the Board;

(2) A registration fee in the amount of $100.00 shall accompany the application;

(3) A detailed job description in the form specified in Appendix F which sets forth the anticipated functions and activities of the anesthesiologist assistant and is signed by the anesthesiologist and the anesthesiologist assistant shall accompany the application. The job description shall list each practice site, including address and phone number, where the job description shall be utilized;

(4) The anesthesiologist and the anesthesiologist assistant may be personally interviewed, at the discretion of the Board, prior to final action on the application for registration.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.45 was renumbered to .48 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.49 Qualifications For Registration - Anesthesiologist Assistant (A.A.)

To qualify for registration as an anesthesiologist assistant an individual must meet the following requirements:

(1) Be employed by:

(a) An anesthesiologist who practices in the medical specialty of anesthesiology and who is qualified under these rules or by a partnership, medical professional corporation, medical professional association or anesthesiologist practice foundation that also employs a supervising anesthesiologist who practices in the medical specialty of anesthesiology and who is qualified under these rules; or

(b) An entity approved by the Board under Rule 540-X-7-.54;

(2) Be of good moral character;

(3) Submit an application on forms approved by the Board;

(4) Pay the appropriate fee as determined by the Board; and

(5) Submit to the Board any other information which the Board deems necessary to evaluate the applicant's qualifications.

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008. Amended: Published November 30, 2021; effective January 14, 2022.
Editor's note: Previous Rule 540-X-7-.46 was renumbered to .49 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.50 Qualifications Of The Supervising Anesthesiologist – Anesthesiologist Assistants (A.A.)

The anesthesiologist to whom an anesthesiologist assistant is registered shall:

(1) Possess a current, unrestricted license to practice medicine in the State of Alabama and practice in the medical specialty of anesthesiology;

(2) On the date of the application, have satisfied one of the following experience requirements:

(a) Practice medicine for at least three years, including any practice as a licensed physician while enrolled in an internship, residency, or fellowship;

(b) Practice medicine as a licensed physician for at least one year, including any practice while enrolled in an internship, residency, or fellowship, and certified by the American Board of Anesthesiology (ABA) or by the American Osteopathic Board of Anesthesiology; or

(c) Practice medicine as a licensed physician for at least one year, including any practice while enrolled in an internship, residency, or fellowship, and the registration’s practice site is limited solely to a general acute care hospital, a critical access hospital, or a specialized hospital licensed as such by the Alabama Department of Public Health.

(3) Effective January 1, 2025, have obtained continuing medical education prescribed by the Board of Medical Examiners regarding the rules and statutes governing supervised practice in Alabama, not more than forty-eight (48) months prior to or within twelve (12) months of registration to an anesthesiologist assistant.

(4) The Board, in its discretion, may waive the practice requirements in (2).

History

Author: Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Published January 31, 2022; effective March 17, 2022. Amended: Published January 31, 2023; effective March 17, 2023. Amended: Published January 31, 2024; effective March 16, 2024.
Editor's note: Previous Rule 540-X-7-.47 was renumbered to .50 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.51 Grounds For Denial Of Registration - Anesthesiologist Assistant (A.A) And Supervising Anesthesiologist.

Grounds, within the discretion of the Board, to deny an application for registration as an anesthesiologist assistant shall be the following:

(1) The commission by an anesthesiologist assistant of any act, offense or condition stated in Rule 540-X-7-.45.

(2) The anesthesiologist to whom the anesthesiologist assistant is registered has permitted or required the anesthesiologist assistant to perform or to attempt to perform tasks which are beyond the assistant’s competence or which are not authorized in the job description approved by the Board.

(3) The supervising anesthesiologist’s license to practice medicine has been revoked, suspended, restricted or disciplined in any manner.

(4) Refusal by the anesthesiologist assistant or supervising anesthesiologist to appear before the Board after having been formally requested to do so in writing by the Executive Director of the Board.

(5) Failure by the anesthesiologist assistant or anesthesiologist to notify the Board in writing of termination of previous employment as required by Rule 540-X-7-.53.

(6) The signing by an anesthesiologist assistant of any form which is to be authenticated by the supervising anesthesiologist’s signature if the supervising anesthesiologist has not authorized signing by the assistant or if signing by the assistant is prohibited by Federal or state statutes or regulations or if signing by the assistant is prohibited by the agency governing the form.

(7) Failure of an anesthesiologist to maintain current or unrestricted licensure with the Medical Licensure Commission of Alabama.

(8) Failure of a supervising anesthesiologist to comply with any statute or rule governing supervised practice.

(9) The commission or any act by an anesthesiologist which would constitute a violation of Code of Ala. 1975, §34-24-360 or any rule of the Alabama Board of Medical Examiners or Medical Licensure Commission of Alabama.

(10) Failure of a supervising anesthesiologist to maintain or produce for inspection upon request by the Alabama Board of Medical Examiners any documentation required to be maintained by the supervising anesthesiologist.

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008. Amended: Published November 30, 2021; effective January 14, 2022.
Editor's note: Previous Rule 540-X-7-.48 was renumbered to .51 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.52 Denial Of Registration - Anesthesiologist Assistant (A.A.) - Hearing

(1) If after examination of the application for registration and after consideration of any information developed by the Board pursuant to an investigation into the qualifications of the anesthesiologist or of the anesthesiologist assistant for registration, the Board determines that there is probable cause to believe there exist grounds upon which the application for registration may be denied, the Board shall take the following actions:

(a) Defer final decision on the application for registration; and

(b) Notify the anesthesiologist and the anesthesiologist assistant of the grounds for possible denial of the application for registration and the procedure for obtaining a hearing before the Board.

(2) The failure to request a hearing within the time specified in the notice shall be deemed a waiver of such hearing.

(3) If requested by the anesthesiologist or the anesthesiologist assistant, a hearing shall be set before the full Board of Medical Examiners on the application for registration.

(4) In the event that a hearing is not requested, the Board shall take action to approve or deny the application for registration.

(5) All hearings under this rule shall be conducted in accordance with the Alabama Administrative Procedure Act, §§41-22-1, et seq., Code of Ala. 1975 and Chapter 6 of the Rules and Regulations of the Board of Medical Examiners. A decision rendered by the Board at the conclusion of the hearing shall constitute final administrative action of the Board of Medical Examiners for the purposes of judicial review under §§41-22-20. The anesthesiologist assistant applicant shall have the burden of demonstrating to the reasonable satisfaction of the Board that he or she meets all qualifications and requirements for registration as an anesthesiologist assistant. The anesthesiologist applying for registration of an anesthesiologist assistant shall have the burden of demonstrating to the reasonable satisfaction of the Board that he or she meets all the requirements of these regulations.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.49 was renumbered to .52 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.53 Termination Of Registration - Voluntary – Anesthesiologist Assistants (A.A.)

When for any reason an anesthesiologist assistant shall discontinue his or her employment with the employer designated in the application for registration, then registration of such anesthesiologist assistant to the supervising anesthesiologist designated in the application is automatically terminated. The anesthesiologist assistant or the anesthesiologist shall inform the Board in writing of the effective date of the termination of employment and the reasons for such termination. Failure to notify the Board of termination may be considered by the Board as a violation of these rules and regulations for the purpose of approval of future applications for registration.

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290 thru 34-24-303.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Published November 30, 2021; effective January 14, 2022.
Editor's note: Previous Rule 540-X-7-.50 was renumbered to .53 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.54 Interim Approval - Anesthesiologist Assistant

(A.A.) {#sec-540-x-7-.54 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.54}

(1) An anesthesiologist assistant may obtain interim approval of a supervised practice with an interim supervising anesthesiologist after confirmed receipt by the Board of Medical Examiners of a registration application and may continue in interim practice until such time as the pending application for registration is approved or denied, provided the interim supervising anesthesiologist meets the qualifications established in these rules. An anesthesiologist assistant who has been granted a temporary license does not qualify for interim approval.

(2) An applicant for approval to practice as an anesthesiologist assistant may obtain interim approval when either the supervising anesthesiologist or the anesthesiologist assistant is under investigation by a state or federal authority. The interim approval shall remain in force until the application for registration has been approved, denied, or withdrawn. However, the Board of Medical Examiners may decline to approve the application until the investigation has been concluded. The Board of Medical Examiners may withdraw interim approval in accordance with this Chapter.

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290 thru 34-24-303.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published November 30, 2021; effective January 14, 2022.
Editor's note: Previous Rule 540-X-7-.51 was renumbered to .54 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.55 Anesthesiologist Assistants (A. A) Not Employed By Supervising Anesthesiologist/Anesthesiologist Not In Full-Time Practice.

(1) Under the circumstances where an anesthesiologist assistant is seeking registration to an anesthesiologist not regularly engaged in the full-time practice of medicine and/or in the circumstance where the anesthesiologist and the anesthesiologist assistant seeking registration are each employees of a legal entity other than a professional partnership, medical professional corporation, medical professional association or physician practice foundation, the applicant shall have the burden of satisfying the Board that there exists the supervisory relationship between the anesthesiologist and the anesthesiologist assistant contemplated by these rules.

(2) Factors to be used by the Board in determining the nature of the relationship shall include but are not limited to the following:

(a) The anesthesiologist's authority to terminate the employment of the anesthesiologist assistant;

(b) The anesthesiologist's authority to determine or recommend levels of compensation for the anesthesiologist assistant;

(c) The anesthesiologist's authority to enforce compliance with orders and directives and to initiate suitable disciplinary action for violation of such orders and directives;

(d) The extent to which the anesthesiologist assistant may be subject to the direction and control in matters relating to patient care of a person other than the anesthesiologist to whom the assistant is registered;

(e) The extent to which the anesthesiologist assistant is subject to the supervisory authority of a non-physician.

(3) In considering applications of the type described above, the Board may require that the applicant submit certificates in the form set forth in Appendix C to Chapter 7 from the Chairman, President, Chief Executive Officer or other acceptable authority of any corporation, business firm or other legal entity which employs the anesthesiologist assistant and the anesthesiologist to whom the assistant is to be registered.

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Published November 30, 2021; effective January 14, 2022.
Editor's note: Previous Rule 540-X-7-.52 was renumbered to .55 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.56 Requirements For Supervised Practice - Anesthesiologist Assistants (A.A.)

(1) Anesthesiologist supervision requires, at all times, a direct, continuing and close supervisory relationship between an anesthesiologist assistant and the supervising anesthesiologist to whom the assistant is registered or an anesthesiologist who is acting in a Board-approved supervisory role to the anesthesiologist assistant.

(2) Supervision does not, necessarily, require the constant physical presence of the supervising anesthesiologist or an anesthesiologist who is acting in a Board-approved supervisory role to the anesthesiologist assistant; however, the anesthesiologist must remain readily available in the facility.

(3) Except in life-threatening situations, the supervising anesthesiologist shall be readily available for personal supervision and shall be responsible for pre-operative, intra-operative and post-operative care.

(4) The supervising anesthesiologist shall insure that, with respect to each patient, all activities, functions, services and treatment measures are immediately and properly documented in written form by the anesthesiologist assistant. All written entries shall be reviewed, countersigned, and dated by the supervising anesthesiologist. The supervising anesthesiologist’s signature on the anesthetic record will fulfill this requirement for all written entries on the anesthetic record.

(5) All of the above is to emphasize that there shall be no independent, unsupervised practice by anesthesiologist assistants.

(6) In the event of an unanticipated, permanent absence of a supervising anesthesiologist, a previously approved covering anesthesiologist may be designated as a temporary supervising anesthesiologist for a period of up to sixty (60) days. During the sixty (60) day time period, a new registration agreement designating a new supervising anesthesiologist should be submitted for approval.

(7) In the event of a national emergency duly declared by Federal officials or in the event of a natural disaster or state emergency duly declared by the Governor, an anesthesiologist assistant may provide emergency medical treatment without immediate physician supervision or direction to patients within the affected areas of the state, provided that the treatment is within the scope of assistant’s education, training and approved job description. In the administration of anesthetic agents during the course of surgery, the assistant shall be directed by a licensed physician. The anesthesiologist assistant in such circumstance shall make reasonable efforts to inform his supervising physician of the location and type of emergency medical services being provided and shall act in conformance with the direction of local medical supervisors. The authority granted under this paragraph shall extend only for the duration of the declared national emergency or state emergency or natural disaster.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Repealed and Replaced: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed November 19, 2004; effective December 24, 2004. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Filed October 19, 2017; effective December 3, 2017. Amended: Published November 30, 2020; effective January 14, 2021.
Editor's note: Previous Rule 540-X-7-.53 was renumbered to .56 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.57 Covering Anesthesiologists For Anesthesiologist Assistants (A.A.)

(1) When the primary supervising anesthesiologist is off duty, out of town, not on call, or not immediately available to respond to patients' medical needs, the anesthesiologist assistant is not authorized to perform any act or render any treatments unless another qualified anesthesiologist in the same partnership, group, medical professional corporation or anesthesiologist practice foundation or with whom the primary supervising anesthesiologist shares call is on call and is immediately available to supervise the anesthesiologist assistant and has previously filed with the Board a letter stating that he or she assumes all responsibility for the actions of the anesthesiologist assistant during the temporary absence of the primary supervising anesthesiologist.

(2) The covering anesthesiologist providing the supervision shall also affirm in the letter that he or she is familiar with the current rules regarding anesthesiologist assistants and the job description filed by the primary supervising anesthesiologist and the anesthesiologist assistant and that he or she is accountable for adequately supervising the medical care rendered pursuant to the job description. The covering anesthesiologist must meet the same qualifications as the supervising anesthesiologist as established in this Chapter.

(3) The supervising anesthesiologist shall certify to the Board of Medical Examiners at least annually that any approved covering anesthesiologist continues to agree to serve in that capacity and shall inform the Board of Medical Examiners of the termination of a covering anesthesiologist within ten (10) days of the termination.

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
New Rule: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Published November 30, 2021; effective January 14, 2022. Amended: Published January 31, 2022; effective March 7, 2022
Editor's note: Previous Rule 540-X-7-.54 was renumbered to .57 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.58 Functions And Activities Of An Anesthesiologist Assistant (A.A.)

(1) There shall be a direct, continuing and close supervisory relationship between the anesthesiologist assistant and the anesthesiologist to whom the assistant is registered. The supervising anesthesiologist shall, at all times, be responsible for the activities of the anesthesiologist assistant.

(2) The anesthesiologist assistant shall provide medical services within the education, training, and experience of the anesthesiologist assistant that are delegated by the supervising anesthesiologist. These services include, but are not limited to:

(a) Administers anesthesia under the supervision of an anesthesiologist.

(b) Performs initial acute cardio-pulmonary resuscitation in life-threatening situations as directed by a physician.

(c) Establishes multi-parameter monitoring of patients prior to, during and after anesthesia or in other acute care situations. This may include invasive/non-invasive monitoring under the direct supervision of an anesthesiologist. Also, other monitoring as may be developed for anesthesia and intensive care use may be incorporated.

(d) Manages perioperative anesthetic care, including ventilatory support and other respiratory care parameters as directed by an anesthesiologist.

(e) Assists in research projects as carried out by an anesthesiologist.

(f) Instructs others in principles and practices of anesthesia, respiratory care and cardiopulmonary resuscitation as directed by the anesthesiologist.

(g) Assists an anesthesiologist in gathering routine perioperative data.

(h) The choice of anesthesia and drugs to be employed are prescribed by anesthesiologist for each patient except:

where standard orders for the conduct of a specified anesthetic are prescribed; and
where life-threatening emergencies arise necessitating the utilization of standard therapeutic or resuscitation procedures. An anesthesiologist will be immediately available for consultation regarding changes from standard procedures.

(3) The job description in the form specified in Appendix F to Chapter 7 is approved by the Board as a model job description which shall be acceptable to the Board if submitted by a qualified applicant for registration in compliance with Rule 540-X-7-.48.

(4) An anesthesiologist assistant is prohibited from performing any medical service, procedure, function, or activity which is not listed in the job description approved by the Board.

(5) Requests for changes in the job description of the assistant, including addition of specialized duties and tasks, shall be submitted, in writing, by the supervising anesthesiologist to the Board for prior approval.

(6) Should the supervising anesthesiologist contemplate a request for additional duties for the assistant for addition to the assistant’s Job Description, a written request shall be submitted to and approved by the Board prior to any additional duty or procedure being performed by the assistant.

(7) When any addition of a duty or procedure to the assistant’s Job Description is contemplated, a written request for training of the assistant in the duty or procedure shall be submitted to and approved by the Board prior to the assistant actually receiving any training in the duty or procedure.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290 thru 34-24-303.
New Rule: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.55 was renumbered to .58 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.59 Limitations Upon Utilization Of Anesthesiologist Assistants (A.A.)

(1) An anesthesiologist may have registered to him or her not more than four (4) anesthesiologist assistants.

(2) An anesthesiologist assistant may be registered to more than one supervising anesthesiologist at any one time. The number of supervising anesthesiologists to whom an anesthesiologist assistant may be registered shall be restricted by the Board if the Board, in its discretion, determines that such restriction is appropriate to maintain the quality of medical services being provided or to otherwise protect the public health, safety and welfare.

(3) An anesthesiologist shall disclose to the Board of Medical Examiners the existence of all collaborative and supervisory agreements to which the physician is party, including collaborative and supervisory agreements in other states, and shall not be eligible to collaborate with or supervise any combination of certified registered nurse practitioners, certified nurse midwives, and\or assistants to physicians exceeding three hundred and sixty (360) hours per week (nine full-time equivalent positions), inclusive of collaborative and supervisory agreements existing in other states. Agreements with an individual certified registered nurse practitioner, certified nurse midwife, and/or assistant to physician in multiple states shall only be counted once for purposes of calculating the total number of full-time equivalent positions.

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290 thru 34-24-303.
New Rule: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Published November 30, 2021; effective January 14, 2022.
Editor's note: Previous Rule 540-X-7-.56 was renumbered to .59 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.60 Prohibited Activities And Functions - Anesthesiologist Assistants (A.A.)

Any medical service, procedure, activity or function not specifically enumerated in the job description approved by the Board is prohibited.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
New Rule: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.57 was renumbered to .60 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.61 Medication Orders - Anesthesiologist Assistants

(A.A.) {#sec-540-x-7-.61 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.61}

An anesthesiologist assistant may administer drugs commonly used in anesthesia practice, by protocol (i.e., routine or urgent/emergent) or as directed by the supervising anesthesiologist who formulates the anesthetic plan and maintains continual supervision.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners.
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
New Rule: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.58 was renumbered to .61 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.62 Continuing Medical Education - Anesthesiologist Assistant (A.A.)

(1) Effective January 1, 2025, every two calendar years, each anesthesiologist assistant licensed by the Board must earn not less than fifty (50) hours of AMA PRA Category 1 Credits™ or the equivalent as defined in this rule of continuing medical education as a condition precedent to receiving his or her annual renewal of license, unless he or she is exempt from the minimum continuing medical education requirement.

(a) Effective January 1, 2025, each new applicant issued a license to practice as an anesthesiologist assistant shall complete a Board-designated course in the area of professional boundaries within twelve (12) months of the license issue date. This requirement must be met regardless of any existing exemption provided in these rules.

(b) Effective January 1, 2025, all actively licensed anesthesiologist assistants shall complete a Board-designated course in the area of professional boundaries by December 31, 2025. There are no exemptions to this requirement.

(e) Effective January 1, 2014, nationally recognized advanced life support/resuscitation certification courses, not otherwise accredited for AMA PRA Category 1 Credit™, for a maximum of two (2) Category 1 credits for each course. Basic life support courses are excluded and are not deemed to be the equivalent of Category 1 continuing medical education.

(f) Programs accredited by the Federation for Advancement of Anesthesia Care Team (FAACT) are deemed to be equivalent of Category 1 credits only for Anesthesiologist Assistants.

(4) Every anesthesiologist assistant subject to the minimum continuing medical education requirement established in these rules shall maintain records of attendance or certificates of completion demonstrating compliance with the minimum continuing medical education requirement. Documentation adequate to demonstrate compliance with the minimum continuing medical education requirements of these rules shall consist of certificates of attendance, completion certificates, proof of registration, or similar documentation issued by the organization or entity sponsoring or conducting the continuing medical education program. The records shall be maintained by the anesthesiologist assistant for a period of three (3) years following the year in which the continuing medical education credits were earned and shall be subject to examination by representatives of the State Board of Medical Examiners upon request. Every anesthesiologist assistant subject to the continuing medical education requirements of these rules must, upon request, submit a copy of such records to the State Board of Medical Examiners for verification. Failure to maintain records documenting that an anesthesiologist assistant has met the minimum continuing medical education requirement, and/or failure to provide such records upon request to the Board is hereby declared to be unprofessional conduct and may constitute grounds for discipline of the anesthesiologist assistant’s license to practice as an anesthesiologist assistant, in accordance with the statutes and regulations governing the disciplining of an anesthesiologist assistant’s license.

(5) Every anesthesiologist assistant shall certify annually that he or she has met the minimum annual continuing medical education requirement established pursuant to these rules or that he or she is exempt. This certification will be made on a form provided on the annual renewal of license application required to be submitted by every anesthesiologist assistant on or before December 31st of each year. The Board shall not issue a renewed license to any anesthesiologist assistant who has not certified that he or she has met the minimum continuing medical education requirement unless the anesthesiologist assistant is exempt from the requirement.

(6) An anesthesiologist assistant who is unable to meet the minimum continuing medical education requirement by reason of illness, disability or other circumstances beyond his control may apply to the Board for a waiver of the requirement for the calendar year in which such illness, disability or other hardship condition existed. A waiver may be granted or denied within the sole discretion of the Board, and the decision of the Board shall not be considered a contested case and shall not be subject to judicial review under the Alabama Administrative Procedure Act. If a waiver is granted, the anesthesiologist assistant shall be exempt from the continuing medical education requirement for the calendar year in which the illness, disability or other hardship condition existed.

(7) An anesthesiologist assistant receiving his or her initial license to practice medicine in Alabama is exempt from the minimum continuing medical education requirement for the calendar year in which he or she receives his initial license.

(8) An anesthesiologist assistant who is a member of any branch of the armed forces of the United States and who is deployed for military service is exempt from the continuing medical education requirement for the calendar year in which he or she is deployed.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
New Rule: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed May 21, 2004; effective June 25, 2004. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008. Amended: Filed November 18, 2009; effective December 23, 2009. Amended: Filed March 11, 2010; effective April 15, 2010. Amended: Filed April 12, 2013; effective May 17, 2013. Amended: Filed December 12, 2013; effective January 16, 2014. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published January 31, 2024; effective March 16, 2024. Amended: Published August 30, 2024; effective October 14, 2024.
Editor's note: Previous Rule 540-X-7-.59 was renumbered to .62 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.63 Forms Requiring An Anesthesiologist’s Signature – Anesthesiologist Assistant (A.A.)

(1) Unless prohibited by Federal or state statutes or regulations or by the agency governing a specific form, an anesthesiologist assistant may sign any form which can be authenticated by the supervising anesthesiologist’s signature, if signing by the anesthesiologist assistant is authorized by the supervising anesthesiologist.

(2) Anesthesiologist assistants are prohibited from signing prescriptions for controlled substances.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners.
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
New Rule: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended (Rule Number Only): Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.60 was renumbered to .63 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.64 Grounds For Termination Of Registration Involuntary

– Anesthesiologist Assistant (A.A.) {#sec-540-x-7-.64 omnilex-key=us-al-regs-official--chapter-540-x-7--540-X-7-.64}

The commission by an anesthesiologist assistant or anesthesiologist of any act, offense or condition set forth in Rule 540-X-7-.45 or Rule 540-X-7-.51 shall be grounds, within the discretion of the Board, to terminate the registration of an anesthesiologist assistant to perform medical services under the supervision of an anesthesiologist.

History

Author: Patricia E. Shiner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
New Rule: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.61 was renumbered to .64 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.65 Termination Of Registration - Involuntary – Anesthesiologist Assistant (A.A.) - Hearings

Before terminating the registration of an anesthesiologist assistant on any of the grounds specified in Rule 540-X-7-.64, the Board shall conduct a hearing under the provisions of the Alabama Administrative Procedure Act, §§341-22-1, et seq., Code of Ala. 1975, and Chapter 6 of the Rules of the Board.

History

Author: Patricia E. Shaner, Attorney for the Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq.
New Rule: Filed July 23, 1999; effective August 27, 1999. Amended: Filed November 22, 1999; effective December 27, 1999. Repealed and New Rule: Filed August 22, 2002; effective September 26, 2002. Repealed and New Rule: Filed September 19, 2002; effective October 24, 2002. Amended: Filed September 11, 2008; effective October 16, 2008.
Editor's note: Previous Rule 540-X-7-.39 was renumbered to .41 as per certification filed September 11, 2008; effective October 16, 2008.

Ala. Admin. Code r. 540-X-7-.66 Investigations - Anesthesiologist Assistant (A.A.)

(1) During the course of an investigation, the Board may require that an anesthesiologist assistant submit to a criminal history background check to include the following:

(a) The provision of fingerprints using forms provided by the Board;

(b) The execution and provision of a criminal history information release using forms provided by the Board;

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq. and Act No. 08-378.
New Rule: Filed October 15, 2008; effective November 19, 2008.

Ala. Admin. Code r. 540-X-7-.67 Examinations/Evaluations - Anesthesiologist Assistant (A.A.)

(1) When the issue is whether an anesthesiologist assistant is physically or mentally capable of practicing as an anesthesiologist assistant with reasonable skill and safety to patients, then, upon a showing of probable cause to the Board that the anesthesiologist assistant is not capable of practicing with reasonable skill and safety to patients, the Board may order and direct the anesthesiologist assistant in question to submit to a physical, mental or laboratory examination or any combination of such examinations to be performed by a physician designated by the Board. The expense of such examination shall be borne by the anesthesiologist assistant who is so examined.

(2) Every anesthesiologist assistant licensed to practice as an anesthesiologist assistant in the state of Alabama who accepts the privilege of practicing by actually practicing or by the making and filing of an annual registration to practice shall be deemed to have given consent to submit to a mental, physical or laboratory examination or to any combination of such examinations and to waive all objections to the admissibility of the examining physician’s testimony or examination reports on the ground that they constitute privileged doctor-patient communications.

(3) Upon receipt of credible information that an anesthesiologist assistant has been evaluated or has received inpatient or outpatient treatment for any physical, psychiatric or psychological illness or for chemical dependency, drug addiction or alcohol abuse, the Board may order that the anesthesiologist assistant execute and deliver to the Board an authorization and release form directed to each and every facility or treatment provider authorizing and directing the release to the Board of any reports of evaluation, mental or physical, or examination, including psychiatric, psychological, and neuropsychiatric examinations, hospital and treatment provider medical records, reports of laboratory tests for the presence of alcohol or drugs, rehabilitation records and mental competency evaluations. Any and all expenses incurred in the furnishing of the reports, records, or documents which are the subject of an order issued by the Board shall be borne by the anesthesiologist assistant who is the subject of the order.

(4) Failure or refusal by the anesthesiologist assistant to comply with an order of the Board directing the execution and delivery to the Board of an authorization and release form as provided in paragraph (3) herein shall constitute grounds for the summary suspension of the anesthesiologist assistant’s license to practice. The suspension shall continue in effect until such time as the anesthesiologist assistant complies with the order of the Board or the order is withdrawn by the Board.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq. and Act No. 08-378.
New Rule: Filed October 15, 2008; effective November 19, 2008.

Ala. Admin. Code r. 540-X-7-.68 Voluntary Surrender, Voluntary Restrictions, Reinstatements - Anesthesiologist Assistant (A.A.)

(1) An anesthesiologist assistant may surrender his or her license to practice or request in writing to the Board that a restriction be placed upon the license. The Board may accept a surrender or grant such a request for restriction and shall have the authority, if it deems appropriate, to attach such restrictions to the license.

(2) Removal of a voluntary restriction on the license shall be done only by order of the Board.

(3) If the Board accepts the surrender of a license, any current registration of the anesthesiologist assistant shall be automatically terminated, and the anesthesiologist assistant shall not be authorized to practice within the state of Alabama.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-290, et. seq. and Act No. 08-378.
New Rule: Filed October 15, 2008; effective November 19, 2008.

Ala. Admin. Code r. 540-X-7-.69 Expedited License For Military Members And Spouses

(1) The intent of this rule is to provide for the expedited issuance of a license to military service members and the spouses of military service members who are relocated to and stationed in Alabama and who are also qualified assistants to physicians.

(2) The board, at its discretion and pursuant to this rule, may issue a temporary license to an assistant to physician applicant who is relocated to or stationed in this state under official military orders and who satisfies any of the following:

(a) Is an active duty, reserve, or transitioning member of the United States Armed Forces, including the National Guard;

(b) Is the spouse of an active duty, reserve, or transitioning member of the United States Armed Forces, including the National Guard; or

(3) For the purposes of this rule, a transitioning service member is a member of the United States Armed Forces, including the National Guard, on active duty status or on separation leave who is within 24 months of retirement or 12 months of separation.

(4) An assistant to physician must satisfy the requirements of paragraph (2) by providing one of the following:

(a) The active or reserve service member’s official military orders;

(b) The transitioning service member’s DD Form 214 or NGB Form 22; or

(c) The deceased service member’s DD Form 214 or NGB Form 22 and death certificate if the assistant to physician is the spouse of a service member; and

(d) A marriage certificate substantiating marriage to the service member if the assistant to physician is the spouse of a service member.

(5) An assistant to physician may receive a temporary license issued under paragraph (2) if he or she satisfies the requirements of paragraph (2) to the satisfaction of the board, and presents evidence satisfactory to the board of all of the following:

(a) Possession of a full and unrestricted license to practice as an assistant to physician issued by the appropriate licensing board of another state, the District of Columbia, a territory of the United States, or a province of Canada;

(b) Completion of a training program accredited by the Committee on Allied Health Education and Accreditation (CAHEA), the Commission on Accreditation of Allied Health Education Programs (CAAHEP), the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), or the Accreditation Review Committee for the Anesthesiologist Assistant (ARC-AA), or their successor agencies;

(c) Completion of the Physician Assistant National Certification Examination (PANCE) as administered by the National Commission on Certification of Physician Assistants (NCCPA) or the National Certifying Examination for Anesthesiologist Assistants (NCEAA) as administered by the National Commission for Certification of Anesthesiologist Assistants (NCCAA);

(d) Has never been convicted, received adjudication, community supervision, or deferred disposition of any felony offense or any crime related to fraud, violence, sexual violations, or health care;

(e) Has never had his or her license to practice as an assistant to physician subjected to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to the non-payment of fees related to a license;

(f) Has never had a controlled substance license or permit suspended or revoked by a state or the United States Drug Enforcement Administration;

(g) Is not currently under investigation by a licensing agency or law enforcement authority in any state, federal, or foreign jurisdiction; and

(h) Is a United States citizen, a national of the United States, or an alien lawfully present in the United States.

(6) An assistant to physician who is issued a temporary license under this rule shall apply for a license to practice as an assistant to physician under this chapter within 12 months after the issuance of a temporary license.

(a) A temporary license issued under these rules shall expire 12 months after the date of issuance if an application for a license to practice as an assistant to physician pursuant to this chapter is not received by the board.

(b) An assistant to physician who is issued a temporary license under this rule must apply for registration to a supervising physician under Chapter 540-X-7 of these rules in order to practice as an assistant to physician in Alabama.

(d) A temporary license may be issued by the Executive Director of the State Board of Medical Examiners, or his or her designee, upon his or her satisfaction and certification of the requirements set forth in this rule.

(e) The temporary license shall clearly indicate that it is a temporary license for military service members or their spouses.

(f) Any assistant to physician issued a temporary license under this rule shall be subject to having his or her license suspended or revoked by the board for the same causes or reasons, and in the same manner, as provided by law and these rules for other assistants to physician licensed pursuant to this chapter.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Alabama 1975, §§34-24-53, 34-24-297, 34-24-301.1; Alabama Acts No. 2021-100.
New Rule: Published August 31, 2021; effective October 15, 2021.
Editor's note: Due to the agency making such drastic changes (moving rules around, changing titles, repealing and adding new rules) in this chapter, it was difficult to accurately post the history. The changes that were made to the complete chapter prior to the July 23, 1999, are: Existing Chapter 540-X-7 Physician’s Assistants and Surgeon’s Assistants was repealed and new Chapter 540-X-7, Assistants to Physicians was filed November 16, 1995; effective December 16, 2004. Rules 540-7-1-.01 and .02 were amended and New Rules 540-X-7-.43 - .60 were added filed September 22, 1995; effective October 27, 1995. Chapter 540-X-7 and Appendices C, D, and L were amended filed December 20, 1996; effective January 24, 1997.

Ala. Admin. Code r. 540-X-7-Appendix-A Application For Registration Of Physician Assistant

ALABAMA BOARD OF MEDICAL EXAMINERS

Appendix A

ALABAMA BOARD OF MEDICAL EXAMINERS

P.O. Box 946/Montgomery, AL 36101-0946/(334) 242-4116

APPLICATION FOR REGISTRATION OF PHYSICIAN ASSISTANT

PHYSICIAN:

Supervising Physician Name in Full

AL Medical License Number

Medical Specialty

Board Certified

Residency Completion Date

If applicable, name of program and completion date of any fellowship, or other supervised training program.

Practice Address

County

Street

Apt/Suite

State

Zip

Telephone Number

Is the physician assistant for whom registration is sought employed by you or by your group, partnership or professional corporation?

You answered No, a Supplemental Certificate must be submitted.

PHYSICIAN ASSISTANT

Physician Assistant Name in Full

AL P. A. License Number

Covering Physicians

If you would like to add covering physicians to this registration agreement, please submit covering physician agreements.

Limited Protocols

If the P.A. intends to practice under a limited protocol, please submit the applicable limited protocol form.

Core Duties and Scope Of Practice

Please submit the core duties and scope of practice form.

List each practice site where the core duties and scope of practice will be utilized and the number of hours this P.A. will be working weekly in each site. Must include name, address, and phone number of each site:

Remote site: Yes* No

Practice Name

Address

Phone

Hours Per Week

*If yes, provide a plan describing the practice location, facilities, and arrangements for appropriate communication, consultation, and review.

Specify a plan for quarterly quality assurance management with defined quality outcome measures for evaluation of the clinical practice of the physician assistant and include review of a meaningful sample of medical records plus all adverse outcomes. The term “medical records” includes, but is not limited to, electronic medical records.

Documentation of quality assurance review shall be readily retrievable, identify records that were selected for review, include a summary of findings conclusions, and, if indicated, recommendations for change.

Supervising Physician Initials

Physician Assistant Initials

Will this P. A. be authorized to have prescriptive privileges?

You answered Yes, comlete the Formulary which is a list of the legend drugs which are authorized by the Physician to be prescribed by the P. A. The formulary approved under the rules of the Board of Medical Examiners should be utilized and attached as the authorized legend drugs to be prescribed. The medication categories chosen should reflect the needs of the supervising physician’s medical practice.

Will this P. A. be authorized to have prescriptive privileges to prescribe controlled substances as allowed under Alabama Code Section 20-2-60, et seq.? (Prerequisites for controlled substances prescribing by P.A.s are stated in Board Rules, Chapter 540-X-12)

If yes, the application for a Qualified Alabama Control Substance Certificate can be found at our web site, www.albme.gov.

We hereby certify under penalty of law of the State of Alabama that the foregoing information in this Physician Assistant Job Description is correct to the best of our knowledge and belief. We certify that we have reviewed the current rules of the Alabama Board of Medical Examiners pertaining to assistants to physicians and understand our responsibilities. We understand that we are equally responsible for the actions of the Assistant to the Physician.

Under Alabama law, this document is a public record and will be provided upon request

I understand and agree that by typing my name, I am providing an electronic signature that has the same legal effect as a written signature pursuant to Ala. Code §§ 8-1A-2 and 8-1A-7. I attest that the foregoing information has been provided by me and is true and correct to the best of my knowledge, information and belief.

Knowingly providing false information to the Alabama Board of Medical Examiners or Medical Licensure Commission of Alabama could result in disciplinary action.

SUPPLEMENTAL CERTIFICATE TO APPLICATION

FOR REGISTRATION AS A PHYSICIAN ASSISTANT

To: (Name and Address of Hospital or Corporate Employer)

The State Board of Medical Examiners has been presented with an application from , P. A., for certification as a physician assistant to

, M.D. Information available to the Board indicates that ________________________________, M.D., is an employee of (legal entity), and that , Physician Assistant, is an employee of (legal entity).

To assist the Board in evaluating this application, it is requested that this questionnaire be filled out and executed by the President, Chairman, Chief Executive Officer or Chief Administrative Officer of the corporation or other legal entity that employs the physician and/or the physician assistant. These questions relate directly to the supervisory relationship contemplated by Board Rules, Chapter 540-X-7. When an additional explanation is to be provided, please attach additional information on separate pages.

Is the physician whose name appears above, employed by you to engage in the full-time practice of medicine? If the answer to this question is no, please provide the Board with details of the employment agreement between your corporation and the physician.
Does the physician whose name is stated above have the unqualified authority to terminate the employment of the physician assistant registered to him/her? If the answer to this question is no, please set out in detail the steps required to terminate the employment of the physician assistant and identify the officer or officers of the corporation authorized to make that decision.
Does the physician whose name is stated above, have the unqualified authority to determine the levels of compensation to be paid to the physician assistant registered to him/her? If the answer to this question is no, please set forth in detail the manner in which the compensation of the physician assistant is established and the identification of the officer or officers of the corporation who are authorized to establish, increase or reduce the compensation of the physician assistant.
Does the physician whose name appears above have the unqualified authority in matters relating to patient care to enforce compliance with orders and directives issued to the physician assistant? Please describe in detail the manner in which such orders and directives may be enforced.
Is the physician assistant whose name appears above subject to the supervision, direction or control of any officer, director, supervisor or employee of the corporation other than the physician to whom he/she is registered? If the answer to this question is yes, please explain in detail, identifying the individual exercising the supervision, direction or control and the circumstances in which such supervision, direction and control would be exercised.
In matters relating to patient care, is the physician assistant whose name appears above subject to the immediate supervision, direction or control of any non-physician? If yes, explain the relationship.
Will the physician assistant whose name appears above be expected or required to perform any part of his/her duties at any time when the physician to whom he/she is registered is not on duty and physically present on the premises of the hospital, clinic, or facility where the physician’s assistant services will be rendered? If the answer to this question is yes, please explain in detail all such circumstances.

I understand that the information submitted herein is to be used by the Board of Medical Examiners as the basis for registration of a physician assistant and that the furnishing of false or misleading information or the future occurrence of substantial departures from or violations of the standards and procedures outlined in this response may be considered by the Board as grounds for termination of the registration of the physician assistant.

The undersigned hereby certifies that the foregoing information is true and correct to the best of my knowledge, information and belief.

Name of the Corporation Title of Officer Signing Certificate

Printed Name of the Officer Signing Certificate Signature

This form may be sent to the Board via facsimile or email (see instructions)

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §34-24-290, et. seq.
Repealed and Replaced: Filed September 21, 1998; effective October 26, 1998. Amended: Filed July 23, 1999; effective August 27, 1999. Repealed and New Appendix: Filed September 19, 2002; effective October 24, 2002. Amended: April 17, 2008; effective May 22, 2008. Amended: Filed February 17, 2012; effective March 23, 2012. Amended: Filed February 27, 2018; effective April 14, 2018. Amended: Filed August 22, 2018; effective October 6, 2018. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published October 29, 2021; effective December 13, 2021. Amended: Published December 29, 2023; effective February 12, 2024.

Ala. Admin. Code r. 540-X-7-Appendix-B Application For Licensure Of Physician Assistant

ALABAMA BOARD OF MEDICAL EXAMINERS

Appendix B

Application for Licensure of Physician Assistant

Under Alabama law, this document is a public record and will be provided upon request.

Required demographic information:

Name in full (First, Middle, Last, M.D./D.O.)

Alternate name(s) used

Address (Street, City, State, Zip)

Email address

Place of Birth

Date of Birth

Social Security Number (Pursuant to Ala. Code §30-3-194, it is mandatory that we request and that you provide your social security number (SSN) on this application. The uses of your SSN are limited to the purpose of administering the state child support program and intra-agency for identification purposes. If your SSN is not provided, your application is not complete and no license will be issued)

Sex

Telephone (H or C)

Telephone (W)

Required background information:

If your answer is “yes,” please provide a detailed explanation in the space provided.

Legal:

Have you ever been arrested for, cited for, charged with, or convicted of any crime, offense, or violation of any law, felony, or misdemeanor, including, but not limited to, offenses related to the practice of medicine or state or federal controlled substances laws, or driving under the influence (DUI)?

*This question excludes minor traffic violations such as speeding and parking tickets but includes felony and misdemeanor criminal matters that have been dismissed, expunged, sealed, subject to a diversion or deferred prosecution program, or otherwise set aside.

Have you ever been arrested, cited for, charged with, or convicted of any sex offender laws or required to register as a sex offender for any reason?
Have you ever had a judgment rendered against you or action settled relating to an action for injury, damages, or wrongful death for breach of the standard of care in the performance of your professional service (“malpractice”)?
To your knowledge, as of the date of this application, are you the subject of an investigation or proposed action by any law enforcement agency?

Administrative/Regulatory:

Have you ever had any Drug Enforcement Administration registration and/or state controlled substances registration denied, voluntarily surrendered while under investigation, or subject to any discipline, including, but not limited to revocation, suspension, probation, restriction, conditions, reprimand, or fine?
Have you ever been denied prescription privileges for non-controlled or legend drugs by any state or federal authority?
Have you ever been denied a license to practice as an assistant to physicians in any state or jurisdiction or has your application for a license to practice as an assistant to physicians been withdrawn under threat of denial?
Has your certification or license to practice as an assistant to physicians in any state or jurisdiction ever been subject to any discipline, including but not limited to revocation, suspension, probation, restrictions, conditions, reprimand, or fine?
Have your staff privileges at any hospital or health care facility ever been revoked, suspended, curtailed, limited, placed under conditions restricting your practice?
To your knowledge, as of the date of this application, are you the subject of an investigation or proposed action by any federal agency, any licensing board/agency, or any hospital or heath care facility?

Fitness to Practice:

Are you currently suffering from any condition that impairs your judgment or that would otherwise adversely affect your ability to practice medicine in a competent, ethical, and professional manner?
Within the past five years, have you raised the issue of any physical or psychiatric health disorder as a defense, mitigation, or explanation for your actions during any administrative or judicial proceeding or investigation; any injury or other proceeding; or any proposed termination by an educational institution; employer; government agency; professional organization; or licensing authority?
The Board recognizes that licensees encounter potentially impairing health conditions just as their patients and other health care providers do, including psychiatric or physical illnesses which may impact cognition, as well as substance use disorders. The Board expects its licensees to address their health concerns, both mental and physical, in a timely manner to ensure patient safety. Licensees should seek appropriate medical care and should limit their medical practice when appropriate and as needed. The Board encourages licensees to utilize the services of the Alabama Professionals Health Program, an advocacy organization dedicated to improving the health and wellness of medical professionals in a confidential manner. The failure to adequately address a health condition, where the licensee is unable to practice medicine with reasonable skill and safety to patients, can result in the Board taking action against the license to practice as a physician assistant.

I have read and understand the statements above.

[Applicant Attestation]

Education/Training Experience:

As of the date of this application, has it been more than two years since the last time you were actively engaged in clinical practice or direct patient care?
Has you medical education, training, or medical practice been interrupted or suspended, or have you ceased to engage in direct patient care, for a period longer than 60 days for any reason other than a vacation or for the birth or adoption of a child?

When entering attendance dates below, you may use the first date of the month instead of the exact date. . (Ex: attended August 1990 – July 1994, enter 08/01/1990 – 07/01/1994)

Education (beginning with undergraduate degree)

Upload a copy of your diploma(s) reflecting graduation from a Physician Assistant Program

School Name

Start Date

End Date

School Address

Activities Since Beginning Undergraduate Degree (cover all time periods)

Place of Employment or Activity

Start Date

End Date

Address

Examination

Have you successfully completed the Physician Assistant National Certifying Examination?

If YES, upload verifying documentation from the National Commission on Certification of Physician Assistants (NCCPA).

If NO, have you ever taken the examination?

Are you registered to take the PANCE?

If YES upload verifying documentation from the NCCPA.

PANCE Test date:

Current Practice

Are you currently registered, certified to or working for any other primary supervising physician in another state? i.e., Are you presently working as a physician assistant? If so, answer yes.

If YES, provide the name and principal practice location of each primary supervising physician to whom you are certified. In addition, state your designated working hours per week for each physician listed.

Certification of Licensure in Other States

List all states where you have been certified/registered/licensed as an assistant to physicians. Primary source verification is required from any state that does not report physician assistant data to the Federation of State Medical Boards.

Certification and Release:

I, [full name], certify, that all of the information supplied in the submitted-application is true and correct to the best of my knowledge, that the photograph submitted herein is a true likeness of me and was taken within sixty days prior to the date of this application. I acknowledge that any false or untrue statement or representation made in this application may result in the denial of this application or revocation of any certification / licensure granted.

I further consent to and authorize the release of this application and any information submitted with it or information collected by the Alabama Board of Medical Examiners in connection with this application, including derogatory information, to any person or organization having a legitimate need for the information and release the Alabama Board of Medical Examiners from all liability for the release of this information.

I further consent to and authorize the release of information, including derogatory information, which may be in the possession of other individuals or organizations to the Alabama Board of Medical Examiners and release this person or organization from any liability for the release of information.

I understand and agree that by typing my name, I am providing an electronic signature that has the same legal effect as a written signature pursuant to Ala. Code §§8-1A-2 and 8-1A-7. I attest that the foregoing information has been provided by me and is true and correct to the best of my knowledge, information and belief.

Physician Assistant’s Signature

Attach Photograph, If one was not uploaded.

ALABAMA BOARD OF MEDICAL EXAMINERS

DECLARATION OF CITIZENSHIP AND LAWFUL PRESENCE OF AN

ALIEN FOR PUBLIC BENEFITS AND LICENSING/PERMITTING PROGRAMS

Title IV of the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 8 U.S.C. § 1621, provides that, with certain exceptions, only United States citizens, United States non-citizen nationals, non-exempt “qualified aliens” (and sometimes only particular categories of qualified aliens), nonimmigrants, and certain aliens paroled into the United States are eligible to receive covered state or local public benefits.

With certain exceptions, Ala. Code § 31-13-1, et seq. prohibits aliens unlawfully present in the U.S. from receiving state or local benefits. Every U.S. Citizen applying for a state or local public benefit must sign a declaration of Citizenship, and the lawful presence of an alien in the U.S. must be verified by the Federal Government.

Act 2011-535 also requires every individual applying for a permit or license to demonstrate his/her U.S. citizenship or if the applicant is an alien, he/she must demonstrate his/her lawful presence in the United States.

Directions: This form must be completed and submitted by individuals applying for licenses or permits.

SECTION 1 --- APPLICANT INFORMATION

NAME: (Last)(First)(M.I.)

DATE OF BIRTH:

SECTION II --- U.S. CITIZENSHIP OR NATIONAL STATUS

Are you a citizen or national of the United States (check one) Yes/No

If you answered YES: (1) Provide an original (only in person at agency office) or legible copy of document from attached List A or other document that demonstrates U.S. citizenship or nationality and (2) Complete Section IV.

If you answered No: Complete Sections III and IV.

Name of document provided:

SECTION III – ALIEN STATUS

Are you an alien lawfully present in the United States? Yes/No

If you answered Yes: (1) Provide an original (only in person at agency office) or legible copy of the front and back (if any) of a document from attached List B or other document that demonstrates lawful presence in the United States. (2) Complete Section IV. Information from the documentation provided will be used to verify lawful presence through the United States Government.

If you answered No: Complete Section IV.

Name of document provided:

SECTION IV -- DECLARATION

I declare under penalty of perjury under the laws of the State of Alabama that the answers and evidence I provided are true and correct to the best of my knowledge.

I understand and agree that by typing my name, I am providing an electronic signature that has the same legal effect as a written signature pursuant to Ala. Code §§8-1A-2 and 8-1A-7. I attest that the foregoing information has been provided by me and is true and correct to the best of my knowledge, information and belief.

APPLICANT’S SIGNATURE

DATE

LIST A

DOCUMENTS DEMONSTRATING U.S. CITIZENSHIP

(1) The applicant's driver's license or nondriver's identification card issued by the division of motor vehicles or the equivalent governmental agency of another state within the United States if the agency indicates on the applicant's driver's license or nondriver's identification card that the person has provided satisfactory proof of United States citizenship.

(2) The applicant's birth certificate that satisfactorily verifies United States citizenship.

(3) Pertinent pages of the applicant's United States valid or expired passport identifying the applicant and the applicant's passport number.

(4) The applicant's United States naturalization documents or the number of the certificate of naturalization.

(5) Other documents or methods or proof of United States citizenship issued by the federal government pursuant to the Immigration and Nationality Act of 1952, and amendments thereto.

(6) The applicant’s Bureau of Indian Affairs card number, tribal treaty card number, or tribal enrollment number.

(7) The applicant’s consular report of birth abroad of a citizen of the United States of America.

(8) The applicant’s certificate of citizenship issued by the United States Citizenship and Immigration Services.

(9) The applicant’s certification of report of birth issued by the United States Department of State.

(10) The applicant’s American Indian card, with KIC classification, issued by the United States Department of Homeland Security.

(11) The applicant’s final adoption decree showing the applicant’s name and United States birthplace.

(12) The applicant's official United States military record of service showing the applicant's place of birth in the United States.

(13) An extract from a United States hospital record of birth created at the time of the applicant's birth indicating the applicant's place of birth in the United States.

LIST B

DOCUMENTS INDICATING STATUS OF QUALIFIED

ALIENS, NONIMMIGRANTS, AND ALIENS PAROLED

INTO U.S. FOR LESS THAN ONE YEAR

The documents listed below that are registration documents are indicated with an asterisk (“*”).

a. “Qualified Aliens”

Evidence of “Qualified Alien” status includes the following:

Alien Lawfully Admitted for Permanent Residence

· Form I-551 (Alien Registration Receipt Card, commonly known as a “green card”); or

· Unexpired Temporary I-551 stamp in foreign passport or on * I Form-94.

Asylee

· * Form I-94 annotated with stamp showing grant of asylum under section 208 of the INA;

· * Form I-688B (Employment Authorization Card) annotated “274.a12(a)(50”;

· * Form I-766 (Employment Authorization Document) annotated “A5”;

· Grant letter from the Asylum Office of the U.S. Citizenship and Immigration Service; or

· Order of an immigration judge granting asylum.

Refugee

· * Form I-94 annotated with stamp showing admission under § 207 of the INA;

· * Form I-688B (Employment Authorization Card) annotated “274a.12(a)(3)”; or

· * Form I-766 (Employment Authorization Document) annotated “A3”

Alien Paroled Into the U.S. for at Least One Year

· * Form I-94 with stamp showing admission for at least one year under section 212(d)(5) of the INA. (Applicant cannot aggregate periods of admission for less than one year to meet the one-year requirement.)

Alien Whose Deportation or Removal Was Withheld

· * Form I-688B (Employment Authorization Card) annotated “274a.12(a)(10);

· * Form I-766 (Employment Authorization Document) annotated “A10”; or

· Order from an immigration judge showing deportation withheld under §243(h) of the INA as in effect prior to April 1, 1997, or removal withheld under § 241(b)(3) of the INA.

Alien Granted Conditional Entry

· * Form I-94 with stamp showing admission under §203(a)(7) of the INA;

· * Form I-688B (Employment Authorization Document) annotated “274a.12(a)(3)”; or

· * Form I-766 (Employment Authorization Document) annotated “A3.”

Cuban/Haitian Entrant

· * Form I-551 (Alien Registration Receipt Card, commonly known as a “green card”) with the code CU6, CU7, or CH6;

· Unexpired temporary I-551 stamp in foreign passport or on * Form I-94 with the code CU6 or CU7; or

· Form I-94 with stamp showing parole as “Cuba/Haitian Entrant” under Section 212(d)(5) of the INA.

Alien Who Has Been Declared a Battered Alien Subjected to Extreme Cruelty

· U.S. Citizenship and Immigration Service petition and supporting documentation

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-293, 34-24-3-298, 34-24-299, 34-24-303. 34-24-306.
Repealed and Replaced: Filed September 21,1998; effective October 26, 1998. Amended: Filed July 23, 1999; effective August 27, 1999. Repealed and New Appendix: Filed September 19, 2002; effective October 24, 2002. Amended: Filed November 19, 2004; effective December 24, 2004. Amended: Filed December 18, 2008; effective January 22, 2009. Amended: Filed May 20, 2010; effective June 24, 2010. Amended: Filed December 16, 2010; effective January 20, 2011. Repealed and New Appendix: Filed February 27, 2018; effective April 14, 2018. Amended: Filed August 22, 2018; effective October 6, 2018. Amended: Published March 31, 2021; effective May 15, 2021. Amended: Published December 30, 2022; effective February 13, 2023. Amended: Published March 31, 2025; effective May 15, 2025.
Editor's note: Appendix B was repealed and Appendix D was renamed Appendix B per certification Filed February 27, 2018; effective April 14, 2018.

Ala. Admin. Code r. 540-X-7-Appendix-C Application For Registration Of Anesthesiologist Assistant

ALABAMA BOARD OF MEDICAL EXAMINERS

Appendix C

Application for REGISTRATION OF ANESTHESIOLOGIST ASSISTANT

ALABAMA BOARD OF MEDICAL EXAMINERS

P.O. Box 946 / Montgomery, AL 36101-0946 / (334) 242-4116

Application for Registration of Anesthesiologist Assistant

Under Alabama law, this document is a public record and will be provided upon request

Anesthesiologist

Supervising Anesthesiologist Name in Full

AL Medical License Number

Medical Specialty

Board Certified

Board Eligible

Principal Practice Location

Practice Name

Country

Street

Apt/Suite

City

State

Zip

Telephone Number

Is the anesthesiologist assistant for whom registration is sought employed by you or by your group, partnership or professional corporation?

You answered No, a Supplemental Certificate must be submitted

Anesthesiologist Assistant

Assistant Name in Full

AL A. A. License Number

Anesthesiologist Assistant Job Description

Listed below are duties approved by the Board as a basic job description. Any additional duties requested must be listed. Any additional duties must be individually considered and approved by the Board before performing them.

The following list includes the basic roles and functions to be performed by the Anesthesiologist Assistant. The list includes the acts, tasks and functions which the AA will be allowed to perform under supervision of an anesthesiologist, as well as those limited actions to be taken in life-threatening emergency conditions.

Administers anesthesia under the supervision of an anesthesiologist.
Performs initial acute cardio-pulmonary resuscitation in life-threatening situations as directed by an anesthesiologist.
Establishes multi-parameter monitoring of patients prior to, during and after anesthesia or in other acute care situations. This may include invasive / non-invasive monitoring under the direct supervision of an anesthesiologist. Also, other monitoring as may be developed for anesthesia and intensive care use may be incorporated.
Manages perioperative anesthetic care, including ventilary support and other respiratory care parameters as directed by an anesthesiologist.
Assists in research projects as carried out by an anesthesiologist.
Instructs others in principles and practices of anesthesia, respiratory care and cardio-pulmonary resuscitation as directed by the anesthesiologist.
Assists an anesthesiologist in gathering routine perioperative data.
Provide emergency medical services in the event of declared national emergency or natural disaster in accordance with the requirements of Board Rules.
The choice of anesthesia and drugs to be employed are prescribed by an anesthesiologist for each patient except:

(a) where standard orders for the conduct of specified anesthetic are prescribed; and

(b) where life threatening emergencies arise necessitating the utilization of standard therapeutic or resuscitation procedures. An anesthesiologist will be immediately available for consultation regarding changes from standard procedures.

ADDITIONAL DUTIES REQUESTED FOR THE ANESTHESIOLOGIST ASSISTANT (i.e. procedures requiring additional training). Provide, as an attachment to this Job Description, documentation of the training and/or certification which qualifies the anesthesiologist assistant to perform each additional duty/procedure which is requested. Training for the additional duty/procedure shall have been previously approved by the Board pursuant to Board Rules.

Do you want to request approval to train for additional duty/procedure at this time?

List each practice site where this Job Description will be utilized.

Practice Site Address

Site Name

Country

Street

Apt/Suite

City

State

Zip

County

Phone Number

Number of hours the AA will be working at this site each week

We hereby certify under penalty of law of the State of Alabama that the foregoing information in this Anesthesiologist Assistant Job Description is correct to the best of our knowledge and belief. We certify that we have reviewed the current rules and regulations of the State of Alabama pertaining to anesthesiologist assistants and understand our responsibilities. We understand that we are equally responsible for the actions of the Anesthesiologist Assistant.

Under Alabama law, this document is a public record and if requested it will be provided in its entirety.

Knowingly providing false information to the Alabama Board of Medical Examiners or Medical Licensure Commission of Alabama could result in disciplinary action.

SUPPLEMENTAL CERTIFICATE TO APPLICATION

FOR REGISTRATION AS AN ANESTHESIOLOGIST ASSISTANT

To: (Name and Address of Hospital or Corporate Employer)

The State Board of Medical Examiners has been presented with an

application from for registration as

an anesthesiologist assistant to

M.D. Information available to the Board indicates that

, M. D., is an employee of

(legal entity), and that

, Anesthesiologist Assistant, is an employee of (legal entity).

To assist the Board in evaluating this application, it is requested that this questionnaire be filled out and executed by the President, Chairman, Chief Executive Officer or Chief Administrative Officer of the corporation or other legal entity that employs the anesthesiologist and the anesthesiologist assistant. These questions relate directly to the supervisory relationship contemplated by Board Rules, Chapter 540-X-7. When an additional explanation is to be provided, please attach additional information on separate pages.

Is the anesthesiologist whose name appears above, employed by you to engage in the full-time practice of anesthesiology? If the answer to this question is no, please provide the Board with details of the employment agreement between your corporation and the anesthesiologist.
Does the anesthesiologist whose name is stated above have the unqualified authority to terminate the employment of the anesthesiologist assistant registered to him/her? If the answer to this question is no, please set out in detail the steps required to terminate the employment of the anesthesiologist assistant and identify the officer or officers of the corporation authorized to make that decision.
Does the anesthesiologist whose name is stated above, have the unqualified authority to determine the levels of compensation to be paid to the anesthesiologist assistant registered to him/her? If the answer to this question is no, please set forth in detail the manner in which the compensation of the anesthesiologist assistant is established and the identification of the officer or officers of the corporation who are authorized to establish increase or reduce the compensation of the anesthesiologist assistant.
Does the anesthesiologist whose name appears above have the unqualified authority in matters relating to patient care to enforce compliance with orders and directives issued to the anesthesiologist assistant? Please describe in detail the manner in which such orders and directives may be enforced.
Is the anesthesiologist assistant whose name appears above subject to the supervision, direction or control of any officer, director, supervisor or employee of the corporation other than the anesthesiologist to whom he or she is registered? If the answer to this question is yes, please explain in detail, identifying the individual exercising the supervision, direction or control and the circumstances in which such supervision, direction and control would be exercised.
In matters relating to patient care, is the anesthesiologist assistant whose name appears above subject to the immediate supervision, direction or control of any non-physician? If yes, explain the relationship.
Will the anesthesiologist assistant whose name appears above be expected or required to perform any part of his or her duties at any time when the anesthesiologist to whom he or she is registered is not on duty and physically present on the premises of the hospital, clinic, or facility where the anesthesiologist assistant services will be rendered? If the answer to this question is yes, please explain in detail all such circumstances.

I understand that the information submitted herein is to be used by the Board of Medical Examiners as the basis for certification of an anesthesiologist assistant and that the furnishing of false or misleading information or the future occurrence of substantial departures from or violations of the standards and procedures outlined in this response, may be considered by the Board as grounds for termination of the certification of the anesthesiologist assistant.

The undersigned hereby certifies that the foregoing information is true and correct to the best of my knowledge, information and belief.

Name of the Corporation Title of Officer Signing Certificate

Printed Name of the Officers Signing Certificate Signature

This form should be completed, printed, and provided directly to the Alabama Board of Medical Examiners. Facsimile and email of this form are accepted.

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-293, 34-24-3-298, 34-24-299, 34-24-303. 34-24-306.
Repealed and Replaced: Filed September 21,1998; effective October 26, 1998. Amended: Filed July 23, 1999; effective August 27, 1999. Repealed and New Appendix: Filed September 19, 2002; effective October 24, 2002. Repealed and New Appendix: Filed February 27, 2018; effective April 14, 2018. Amended: Filed August 22, 2018; effective October 6, 2018.
Editor's note: Appendix C was repealed and Appendix E was renamed Appendix C per certification Filed February 27, 2018; effective April 14, 2018.

Ala. Admin. Code r. 540-X-7-Appendix-D Application For Licensure Of Anesthesiologist Assistant

ALABAMA BOARD OF MEDICAL EXAMINERS

Appendix D

APPLICATION FOR LICENSURE OF ANESTHESIOLOGIST ASSISTANT

Under Alabama law, this document is a public record and will be provided upon request.

Required demographic information:

Name in full (First. Middle, Last, M.D./D.O.)

Alternate name(s) used

Address (Street, City, State, Zip)

Email address

Place of birth

Date of birth

Sex

Telephone (H or C)

Telephone (W)

Required background information:

If your answer is "yes," please provide a detailed explanation in the space provided.

Legal:

Have you ever been arrested for, cited for, charged with, or convicted of any crime, offense, or violation of any law, felony, or misdemeanor, including, but not limited to, offenses related to the practice of medicine or state or federal controlled substances laws, or driving under the influence (DUI)?

This question excludes minor traffic violations such as speeding and parking tickets but includes felony and misdemeanor criminal matters that have been dismissed, expunged, sealed, subject to a diversion or deferred prosecution program, or otherwise set aside.

Have you ever been arrested for, cited for, charged with, or convicted of any sex offender laws or required to register as a sex offender for any reason?
Have you ever had a judgment rendered against you or action settled relating to an action for injury, damages, or wrongful death for breach of the standard of care in the performance of your professional service ("malpractice")?
To your knowledge, as of the date of this application, are you the subject of an investigation or proposed action by any law enforcement agency?

Administrative/Regulatory:

Have you ever had any Drug Enforcement Administration registration and/or state controlled substances registration denied, voluntarily surrendered while under investigation, or subject to any discipline, including, but not limited to revocation, suspension, probation, restriction, conditions, reprimand, or fine?
Have you ever been denied prescription privileges for non-controlled or legend drugs by any state or federal authority?
Have you ever been denied a license to practice as an assistant to physicians in any state or jurisdiction or has your application for a license to practice as an assistant to physicians been withdrawn under threat of denial?
Has your certification or license to practice as an assistant to physicians in any state or jurisdiction ever been subject to any discipline, including but not limited to revocation, suspension, probation, restrictions, conditions, reprimand, or fine?
Have your privileges at any hospital or health care facility ever been revoked, suspended, curtailed, limited, or placed under conditions restricting your practice?
To your knowledge, as of the date of this application, are you the subject of an investigation or proposed action by any federal agency, any licensing board/agency, or any hospital or health care facility?

Fitness to Practice:

Are you currently suffering from any condition that impairs your judgment or that would otherwise adversely affect your ability to practice medicine in a competent, ethical, and professional manner?
Within the past five years, have you raised the issue of any physical or psychiatric health disorder as a defense, mitigation, or explanation for your actions during any administrative or judicial proceeding or investigation; any inquiry or other proceeding; or any proposed termination by an educational institution; employer; government agency; professional organization; or licensing authority?
The Board recognizes that licensees encounter potentially impairing health conditions just as their patients and other health care providers do, including psychiatric or physical illnesses which may impact cognition, as well as substance use disorders. The Board expects its licensees to address their health concerns, both mental and physical, in a timely manner to ensure patient safety. Licensees should seek appropriate medical care and should limit their medical practice when appropriate and as needed. The Board encourages licensees to utilize the services of the Alabama Professionals Health Program, an advocacy organization dedicated to improving the health and wellness of medical professionals in a confidential manner. The failure to adequately address a health condition, where the licensee is unable to practice medicine with reasonable skill and safety to patients, can result in the Board taking action against the license to practice as an assistant to physicians.

I have read and understand the statements above.

[Applicant Attestation]

Education/Training/Experience:

As of the date of this application, has it been more than two years since the last time you were actively engaged in clinical practice or direct patient care?
Has your medical education, training, or medical practice been interrupted or suspended, or have you ceased to engage in direct patient care, for a period longer than 60 days for any reason other than a vacation or for the birth or adoption of a child?

When entering attendance dates below, you may use the first date of the month instead of the exact date. (Ex: attended August 1990 - July 1994, enter 08/01/1990 - 07/01/1994)

Education (beginning with undergraduate degree)

Upload a copy of your diploma(s) reflecting graduation from an Anesthesiologist

Assistant Program

School Name Start Date End Date

School Address

Activities Since Beginning Undergraduate Degree (cover all time periods)

Place of Employment or Activity Start Date

End Date Address

Examination

Have you successfully completed the Anesthesiologist Assistant National Certifying Examination?

If YES, upload verifying documentation from the National Commission on Certification of Anesthesiologist Assistants (NCCAA).

If NO, have you ever taken the examination?

Are you registered to take the examination?

If YES upload verifying documentation from the NCCAA. Test date:

Current Practice

Are you currently registered, certified to or working for any other primary supervising physician in another state? i.e., Are you presently working as an anesthesiologist assistant? If so, answer yes.

Certification of Licensure in Other States

List all states where you have been certified/registered/licensed as an assistant to physicians. Primary source verification is required from any state that does not report anesthesiologist assistant data to the Federation of State Medical Boards.

Certification and Release:

I, [full name], certify that all of the information supplied in the submitted application is true and correct to the best of my knowledge, and that the photograph submitted herein is a true likeness of me and was taken within sixty days prior to the date of this application. I acknowledge that any false or untrue statement or representation made in this application may result in the denial of this application or revocation of any certification/licensure granted.

I further consent to and authorize the release of this application and any information submitted with it or information collected by the Alabama Board of Medical Examiners in connection with this application, including derogatory information, to any person or organization having a legitimate need for the information and release of the Alabama Board of Medical Examiners from all liability for the release of this information.

I further consent to and authorize the release of information, including derogatory information, which may be in the possession of other individuals or organizations to the Alabama Board of Medical Examiners and release this person or any organization from any liability for the release of information.

I understand and agree that by typing my name, I am providing an electronic signature that has the same legal effect as a written signature pursuant to Ala. Code §§8-1A-2 and 8-1A-7. I attest that the foregoing information has been provided by me and is true and correct to the best of my knowledge, information, and belief.

Anesthesiologist Assistant's Signature

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-293, 34-24-3-298, 34-24-299, 34-24-303. 34-24-306.
Repealed and Replaced: Filed September 21,1998; effective October 26, 1998. Amended: Filed July 23, 1999; effective August 27, 1999. Repealed and New Appendix: Filed September 19, 2002; effective October 24, 2002. Amended: Filed February 17, 2012; effective March 23, 2012. Amended: Filed August 16, 2012; effective September 23, 2012. Amended: Filed July 22, 2013; effective August 26, 2013. Amended: Filed March 20, 2014; effective April 24, 2014. Repealed and New Appendix: Filed February 27, 2018; effective April 14, 2018. Amended: Filed August 22, 2018; effective October 6, 2018. Amended: Published March 31, 2021; effective May 15, 2021. Amended: Published December 30, 2022; effective February 13, 2023. Amended: Published March 31, 2025; effective May 15, 2025.
Editor's note: Appendix D was repealed and Appendix H was renamed Appendix D per certification Filed February 27, 2018; effective April 14, 2018.

Ala. Admin. Code r. 540-X-7-Appendix-E Physician Assistant/Anesthesiologist Assistant License Renewal

ALABAMA BOARD OF MEDICAL EXAMINERS

Appendix E

Physician Assistant/Anesthesiologist Assistant License Renewal

20XX Physician Assistant/Anesthesiologist Assistant License Renewal

Deadline: December 31, 20XX

Failure to apply for license renewal and pay renewal fee will result in the license automatically being placed in an inactive status, making it illegal for the holder to practice as a Physician Assistant/Anesthesiologist Assistant effective January 1, 20XX.

Under Alabama law, this document is a public record and will be provided upon request.

CME Certification: (Select One)

I hereby certify that I have met or will meet by December 31 the minimum continuing education requirement of 50 AMA PRA Category I Credits™ or equivalent continuing medical education earned within the immediately preceding two calendar years and have or will have supporting documentation if audited.

I hereby certify that I am exempt from the minimum continuing medical education requirement for the following reason (Select One)

I received my initial license to practice in Alabama in the calendar year 20XX.

I am exempt from the CME requirement for the calendar year 20XX because I am a member of a branch of the armed services and I was deployed for military service in the calendar year 20XX.

I have obtained a waiver from the Board of Medical Examiners due to illness, disability or other hardship condition which existed in the calendar year 20XX.

National Commission on Certification of Physician Assistants (NCCPA):

Are you currently certified by NCCPA?

If your answer is “yes”, provide your certification number and certification expiration date.

National Commission for Certification of Anesthesiologist Assistants (NCCAA):

Are you currently certified by NCCAA?

If your answer is “yes”, provide your certification number and certification expiration date.

Professional Responsibility Certification

If any answer is “yes,” please provide a detailed explanation in the space provided.

Legal:

Since your last renewal, have you been arrested for, cited for, charged with, or convicted of any crime, offense, or violation of any law, felony, or misdemeanor, including, but not limited to, offenses related to the practice of medicine or state or federal controlled substances laws, or driving under the influence (DUI)?

Since your last renewal, have you been arrested for, cited for, charged with, or convicted of any sex offender laws or required to register as a sex offender for any reason?
Since your last renewal, have you had a judgment rendered against you or action settled relating to an action for injury, damages, or wrongful death for breach of the standard of care in the performance of your professional service ("malpractice")?
Since your last renewal, to your knowledge, as of the date of this application, are you the subject of an investigation or proposed action by any law enforcement agency?

Administrative/Regulatory:

Since your last renewal, have you had any Drug Enforcement Administration registration and/or state controlled substances registration denied, voluntarily surrendered while under investigation, or subject to any discipline, including, but not limited to revocation, suspension, probation, restriction, conditions, reprimand, or fine?
Since your last renewal, have you been denied a license to practice as an assistant to physicians in any state or jurisdiction or has your application for a license to practice as an assistant to physicians been withdrawn under threat of denial?
Since your last renewal, has your certification or license to practice as an assistant to physicians in any state or jurisdiction been subject to any discipline, including but not limited to revocation, suspension, probation, restrictions, conditions, reprimand, or fine?
Since your last renewal, have your privileges at any hospital or health care facility been revoked, suspended, curtailed, limited, or placed under conditions restricting your practice?
To your knowledge, as of the date of this application and since your last renewal, are you the subject of an investigation or proposed action by any federal agency, any licensing board/agency, or any hospital or health care facility?

Fitness to Practice:

Are you currently suffering from any condition that impairs your judgment or that would otherwise adversely affect your ability to practice medicine in a competent, ethical, and professional manner?
Within the past two years, have you raised the issue of any physical or psychiatric health disorder as a defense, mitigation, or explanation for your actions during any administrative or judicial proceeding or investigation; any inquiry or other proceeding; or any proposed termination by an educational institution; employer; government agency; professional organization; or licensing authority?
The Board recognizes that licensees encounter potentially impairing health conditions just as their patients and other health care providers do, including psychiatric or physical illnesses which may impact cognition, as well as substance use disorders. The Board expects its licensees to address their health concerns, both mental and physical, in a timely manner to ensure patient safety. Licensees should seek appropriate medical care and should limit their medical practice when appropriate and as needed. The Board encourages licensees to utilize the services of the Alabama Professionals Health Program, an advocacy organization dedicated to improving the health and wellness of medical professionals in a confidential manner. The failure to adequately address a health condition, where the licensee is unable to practice medicine with reasonable skill and safety to patients, can result in the Board taking action against the license to practice as an assistant to physicians.

I have read and understand the statements above.

[Applicant Attestation]

Practice Interruption:

Since your last renewal, has your professional education, training, or practice been interrupted or suspended, or have you ceased to engage in direct patient care, for a period longer than 60 days for any reason other than a vacation or for the birth or adoption of a child?
As of the date of this application, has it been more than two years since the last time you were actively engaged in clinical practice or direct patient care?

Review the following Registration Agreements (RA) (If any):

Is this Registration Agreement still Active?

How many hours per week do you work under this Registration Agreement?

Please provide a date of termination

What was the reason this Registration Agreement was terminated

I understand and agree that by typing my name, I am providing an electronic signature that has the same legal effect as a written signature pursuant to Ala. Code §§8-1A-2 and 8-1A-7. I attest that the foregoing information has been provided by me and is true and correct to the best of my knowledge, information and belief.

Knowingly providing false information to the Alabama Board of Medical Examiners could result in disciplinary action.

History

Author: Alabama Board of Medical Examiners
Authority: Code of Ala. 1975, §34-24-299.
Amended: Published January 31, 2024; effective March 16, 2024. New Appendix: Filed July 23, 1999; effective August 27, 1999. Repealed and New Appendices: Filed September 19, 2002; effective October 24, 2002. Amended: Filed February 17, 2012; effective March 23, 2012. Amended: (Appendix C was repealed and original Appendix E was renamed Appendix C; Appendix I was renamed Appendix E) Filed February 27, 2018; effective April 14, 2018. Amended: Published December 30, 2022; effective February 13, 2023. Amended: Published March 31, 2025; effective May 15, 2025.
Editor's note: Original Appendix E was renamed Appendix C and Appendix I was renamed Appendix E per certification Filed February 27, 2018; effective April 14, 2018.

Ala. Admin. Code r. 540-X-7-Appendix-F Application For Reinstatement Of Physician Assistant/Anesthesiologist Assistant License

ALABAMA BOARD OF MEDICAL EXAMINERS

Appendix F

APPLICATION FOR REINSTATEMENT OF

Physician Assistant/Anesthesiologist Assistant License

Under Alabama law, this document is a public record and will be provided upon request.

APPLICATION FOR REINSTATEMENT OF

PHYSICIAN ASSISTANT/ANESTHESIOLOGIST ASSISTANT LICENSE

NAME

ADDRESS

INITIAL LICENSE NUMBER

ISSUE DATE

DATE OF REVOCATION/SUSPENSION/SURRENDER OF LICENSE:

REASONS FOR REVOCATION/SUSPENSION/VOLUNTARY SURRENDER OF LICENSE (Please give detailed reasons)

Required background information:

If your answer is "yes," please provide a detailed explanation in the space provided.

Legal:

Have you ever been arrested for, cited for, charged with, or convicted of any crime, offense, or violation of any law, felony, or misdemeanor, including, but not limited to, offenses related to the practice of medicine or state or federal controlled substances laws, or driving under the influence (DUI)?

This question excludes minor traffic violations such as speeding and parking tickets but includes felony and misdemeanor criminal matters that have been dismissed, expunged, sealed, subject to a diversion or deferred prosecution program, or otherwise set aside.

Have you ever been arrested for, cited for, charged with, or convicted of any sex offender laws or required to register as a sex offender for any reason?
Have you ever had a judgment rendered against you or action settled relating to an action for injury, damages, or wrongful death for breach of the standard of care in the performance of your professional service ("malpractice")?
To your knowledge, as of the date of this application, are you the subject of an investigation or proposed action by any law enforcement agency?

Administrative/Regulatory:

Have you ever had any Drug Enforcement Administration registration and/or state controlled substances registration denied, voluntarily surrendered while under investigation, or subject to any discipline, including, but not limited to revocation, suspension, probation, restriction, conditions, reprimand, or fine?
Have you ever been denied prescription privileges for non-controlled or legend drugs by any state or federal authority?
Have you ever been denied a license to practice as an assistant to physicians in any state or jurisdiction or has your application for a license to practice as an assistant to physicians been withdrawn under threat of denial?
Has your certification or license to practice as an assistant to physicians in any state or jurisdiction ever been subject to any discipline, including but not limited to revocation, suspension, probation, restrictions, conditions, reprimand, or fine?
Have your privileges at any hospital or health care facility ever been revoked, suspended, curtailed, limited, or placed under conditions restricting your practice?
To your knowledge, as of the date of this application, are you the subject of an investigation or proposed action by any federal agency, any licensing board/agency, or any hospital or health care facility?

Fitness to Practice:

Are you currently suffering from any condition that impairs your judgment or that would otherwise adversely affect your ability to practice medicine in a competent, ethical, and professional manner?
The Board recognizes that licensees encounter potentially impairing health conditions just as their patients and other health care providers do, including psychiatric or physical illnesses which may impact cognition, as well as substance use disorders. The Board expects its licensees to address their health concerns, both mental and physical, in a timely manner to ensure patient safety. Licensees should seek appropriate medical care and should limit their medical practice when appropriate and as needed. The Board encourages licensees to utilize the services of the Alabama Professionals Health Program, an advocacy organization dedicated to improving the health and wellness of medical professionals in a confidential manner. The failure to adequately address a health condition, where the licensee is unable to practice medicine with reasonable skill and safety to patients, can result in the Board taking action against the license to practice as an assistant to physicians.

I have read and understand the statements above.

[Applicant Attestation]

Education/Training/Experience:

As of the date of this application, has it been more than two years since the last time you were actively engaged in clinical practice or direct patient care?
Are you currently registered, certified to or working for any other primary supervising physician/anesthesiologist in another state? ie, are you presently working as a physician/anesthesiologist assistant? If so, answer yes.

If YES, list the name and principal practice location of each primary supervising physician/anesthesiologist to whom you are certified. In addition, state your designated working hours per week for each physician/anesthesiologist listed.

Have you ever been certified as a physician/anesthesiologist assistant by the Alabama Board of Medical Examiners in the past?

If YES, please list the names of the physicians/anesthesiologists.

Please list all states in which you hold or have applied for licensure:

Certification and Release:

I, [full name], certify that all of the information supplied in the submitted application is true and correct to the best of my knowledge, that the photograph submitted herein is a true likeness of me and was taken within sixty days prior to the date of this application. I acknowledge that any false or untrue statement or representation made in this application may result in the denial of this application or revocation of any certification / licensure granted.

I further consent to and authorize the release of this application and any information submitted with it or information collected by the Alabama Board of Medical Examiners in connection with this application, including derogatory information, to any person or organization having a legitimate need for the information and release of the Alabama Board of Medical Examiners from all liability for the release of this information.

I further consent to and authorize the release of information, including derogatory information, which may be in the possession of other individuals or organizations to the Alabama Board of Medical Examiners and release this person or any organization from any liability for the release of information.

I understand and agree that by typing my name, I am providing an electronic signature that has the same legal effect as a written signature pursuant to Ala. Code §§8-1A-2 and 8-1A-7. I attest that the foregoing information has been provided by me and is true and correct to the best of my knowledge, information, and belief.

Assistant to Physicians’ Signature

History

Author: Alabama State Board of Medical Examiners
Authority: Code of Ala. 1975, §§34-24-293, 34-24-298, 34-24-299, 34-24-303, 34-24-306.
Repealed and Replaced (Entire Appendices for Chapter 7): Filed September 21, 1998; effective October 26, 1998. Amended (Appendices A D for Chapter is amended Appendices E J is new): Filed July 23, 1999; effective August 27, 1999. Repealed and New Appendices (A J): Filed September 19, 2002; effective October 24, 2002. Amended (Appendices I & J only): Filed May 21, 2004; effective June 25, 2004. Amended (Appendices B & F only): Filed November 19, 2004; effective December 24, 2004. Amended: Filed April 13, 2006; effective May 18, 2006. Amended (Appendix A only): Filed April 17, 2008; effective May 22, 2008. Amended (Added New Appendix K only): Filed October 15, 2008; effective November 19, 2008. Amended (Appendix B only): Filed December 18, 2008; effective January 22, 2009. Amended (Appendix I only): Filed July 16, 2009; effective August 20, 2009. Repealed (Appendix J only): Filed August 5, 2009; effective September 9, 2009. Amended (Appendix I only): Filed November 18, 2009; effective December 23, 2009. Amended: Filed March 11, 2010; effective April 15, 2010. Amended (Appendix B only): Filed May 20, 2010; effective June 24, 2010. Amended (Appendix I only): Filed October 21, 2010; effective November 25, 2010. Amended (Appendix B only): Filed December 16, 2010; effective January 20, 2011. Amended (Appendices A, D, E, H, and K only): Filed February 17, 2012; effective March 23, 2012. Amended (Appendices D and H only): Filed August 16, 2012; effective September 23, 2012. Amended (Appendices D and H only): Filed July 22, 2013; effective August 26, 2013. Amended (Appendices D, H, I and K only): Filed March 20, 2014; effective April 24, 2014. Amended (Appendix F only): Filed July 21, 2016; effective September 4, 2016. Repealed and New Rule (Appendix I only): Filed July 20, 2017; effective September 3, 2017. Amended (Appendix A only): Filed February 27, 2018; effective April 14, 2018. Repealed and New Rule (Appendix B was repealed and Appendix D was renamed Appendix B): Filed February 27, 2018; effective April 14, 2018. Repealed and New Rule (Appendix C was repealed and Appendix E was renamed Appendix C): Filed February 27, 2018; effective April 14, 2018. Repealed and New Rule (Appendix D was repealed and Appendix H was renamed Appendix D): Filed February 27, 2018; effective April 14, 2018. Amended (Appendix I was renamed Appendix D): Filed February 27, 2018; effective April 14, 2018. Repealed (Appendix F only): Filed February 27, 2018; effective April 14, 2018. Amended (Appendix K was renamed Appendix F): Filed February 27, 2018; effective April 14, 2018. Repealed (Appendix G only): Filed February 27, 2018; effective April 14, 2018. Amended (Appendices A D only): Filed August 22, 2018; effective October 6, 2018. Amended (Appendix A only): Published November 30, 2020; effective January 14, 2021. Amended (Appendices B and D only): Published March 31, 2021; effective May 15, 2021. Amended (Appendix A only): Published October 29, 2021; effective December 13, 2021. Amended (Appendices B, D & E only): Published December 30, 2022; effective February 13, 2023. Amended (Appendix F): Published January 31, 2023; effective March 17, 2023. Amended: Published March 31, 2025; effective May 15, 2025.

Alabama Administrative Code Chapter 540-X-7 — Assistants to Physicians

540 Alabama Board of Medical Examiners

Ala. Admin. Code r. 540-X-7-.01 Definitions

Ala. Admin. Code r. 540-X-7-.02 Categories Of Assistants To Physicians

Ala. Admin. Code r. 540-X-7-.03 Requirements To Practice As A Physician Assistant

Ala. Admin. Code r. 540-X-7-.04 Requirements For The Issuance Of A License To Practice As A Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.05 Issuance Of License To Practice As A Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.06 License Fee - Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.07 License Renewal-Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.08 Grandfather Clause - Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.09 Temporary License - Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.10 Grounds For Denial Of License - Physician Assistant (P. A.)

Ala. Admin. Code r. 540-X-7-.11 Denial Of Application For License To Practice As A Physician Assistant (P.A.) - Hearing

Ala. Admin. Code r. 540-X-7-.12 Discipline Of License - Physician Assistant

Ala. Admin. Code r. 540-X-7-.13 Administrative Fines - Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.14 Discipline Of License - Physician Assistant

Ala. Admin. Code r. 540-X-7-.15 Registration - Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.15.01 Exemption From Registration Requirement (P.A.)

Ala. Admin. Code r. 540-X-7-.16 Qualifications For Registration - Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.17 Qualifications Of The Supervising Physician – Physician Assistants (P.A.)

Ala. Admin. Code r. 540-X-7-.18 Grounds For Denial Of Registration - Physician Assistant (P.A.) And Supervising Physician

Ala. Admin. Code r. 540-X-7-.19 Denial Of Registration - Physician Assistant

Ala. Admin. Code r. 540-X-7-.20 Termination Of Registration - Voluntary - Physician Assistants (P.A.)

Ala. Admin. Code r. 540-X-7-.21 Interim Approval-Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.22 Physician Assistants (P.A) Not Employed By Supervising Physician/Physician Not In Full-Time Practice.

Ala. Admin. Code r. 540-X-7-.23 Requirements For Supervised Practice - Physician Assistants (P.A.)

Ala. Admin. Code r. 540-X-7-.24 Covering Physicians For Physician Assistants

Ala. Admin. Code r. 540-X-7-.25 Functions And Activities Of A Physician Assistant

Ala. Admin. Code r. 540-X-7-.26 Limitations Upon Utilization Of Physician Assistants (P.A.)

Ala. Admin. Code r. 540-X-7-.27 Prohibited Activities And Functions - Physician Assistants (P.A.)

Ala. Admin. Code r. 540-X-7-.28 Prescriptions And Medication Orders - Physician Assistants (P.A.)

Ala. Admin. Code r. 540-X-7-.29 Continuing Medical Education - Physician Assistant

Ala. Admin. Code r. 540-X-7-.30 Physician Assistants' Advisory Committee

Ala. Admin. Code r. 540-X-7-.31 Forms Requiring A Physician’s Signature - Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.32 Grounds For Termination Of Registration – Involuntary – Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.33 Termination Of Registration - Involuntary – Physician Assistant (P.A.) - Hearings

Ala. Admin. Code r. 540-X-7-.34 Investigations - Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.35 Examinations/Evaluations - Physician Assistant

Ala. Admin. Code r. 540-X-7-.36 Voluntary Surrender, Voluntary Restrictions, Reinstatements - Physician Assistant (P.A.)

Ala. Admin. Code r. 540-X-7-.37 Requirements To Practice As An Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.38 Requirements For The Issuance Of A License To Practice As An Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.39 Issuance Of License To Practice As An Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.40 License Fee - Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.41 License Renewal - Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.42 Temporary License - Anesthesiologist Assistant

Ala. Admin. Code r. 540-X-7-.43 Grounds For Denial Of License - Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.44 Denial Of Application For License To Practice As An Anesthesiologist Assistant (A.A.) - Hearing

Ala. Admin. Code r. 540-X-7-.45 Discipline Of License - Anesthesiologist Assistant (A.A.) - Grounds

Ala. Admin. Code r. 540-X-7-.46 Administrative Fines-Anesthesiologist Assistant

Ala. Admin. Code r. 540-X-7-.47 Discipline Of License - Anesthesiologist Assistant

Ala. Admin. Code r. 540-X-7-.48 Registration - Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.49 Qualifications For Registration - Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.50 Qualifications Of The Supervising Anesthesiologist – Anesthesiologist Assistants (A.A.)

Ala. Admin. Code r. 540-X-7-.51 Grounds For Denial Of Registration - Anesthesiologist Assistant (A.A) And Supervising Anesthesiologist.

Ala. Admin. Code r. 540-X-7-.52 Denial Of Registration - Anesthesiologist Assistant (A.A.) - Hearing

Ala. Admin. Code r. 540-X-7-.53 Termination Of Registration - Voluntary – Anesthesiologist Assistants (A.A.)

Ala. Admin. Code r. 540-X-7-.54 Interim Approval - Anesthesiologist Assistant

Ala. Admin. Code r. 540-X-7-.55 Anesthesiologist Assistants (A. A) Not Employed By Supervising Anesthesiologist/Anesthesiologist Not In Full-Time Practice.

Ala. Admin. Code r. 540-X-7-.56 Requirements For Supervised Practice - Anesthesiologist Assistants (A.A.)

Ala. Admin. Code r. 540-X-7-.57 Covering Anesthesiologists For Anesthesiologist Assistants (A.A.)

Ala. Admin. Code r. 540-X-7-.58 Functions And Activities Of An Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.59 Limitations Upon Utilization Of Anesthesiologist Assistants (A.A.)

Ala. Admin. Code r. 540-X-7-.60 Prohibited Activities And Functions - Anesthesiologist Assistants (A.A.)

Ala. Admin. Code r. 540-X-7-.61 Medication Orders - Anesthesiologist Assistants

Ala. Admin. Code r. 540-X-7-.62 Continuing Medical Education - Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.63 Forms Requiring An Anesthesiologist’s Signature – Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.64 Grounds For Termination Of Registration Involuntary

Ala. Admin. Code r. 540-X-7-.65 Termination Of Registration - Involuntary – Anesthesiologist Assistant (A.A.) - Hearings

Ala. Admin. Code r. 540-X-7-.66 Investigations - Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.67 Examinations/Evaluations - Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.68 Voluntary Surrender, Voluntary Restrictions, Reinstatements - Anesthesiologist Assistant (A.A.)

Ala. Admin. Code r. 540-X-7-.69 Expedited License For Military Members And Spouses

Ala. Admin. Code r. 540-X-7-Appendix-A Application For Registration Of Physician Assistant

Ala. Admin. Code r. 540-X-7-Appendix-B Application For Licensure Of Physician Assistant

Ala. Admin. Code r. 540-X-7-Appendix-C Application For Registration Of Anesthesiologist Assistant

Ala. Admin. Code r. 540-X-7-Appendix-D Application For Licensure Of Anesthesiologist Assistant

Ala. Admin. Code r. 540-X-7-Appendix-E Physician Assistant/Anesthesiologist Assistant License Renewal

Ala. Admin. Code r. 540-X-7-Appendix-F Application For Reinstatement Of Physician Assistant/Anesthesiologist Assistant License

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