06/08/2026
Why Does Ohio Need PA Practice Modernization?
Ohio House Bill 963 seeks to align state law with modern PA education and practice, for the benefit of Ohio patients and healthcare teams alike.
This bill eliminates outdated administrative burdens to improve patient care, reduce healthcare costs, and permit PAs to practice to the full extent of their education and training, in collaboration with a healthcare team.
Let's explore what is in the bill, and why it matters.
ACTION #1: Change the language of the PA and physician relationship from “supervision” to “collaboration.”
"Supervision" is outdated and misleading. Changing it to "collaboration" reflects modern healthcare teamwork, reduces administrative barriers, and improves access, efficiency, and quality of care, particularly in underserved areas.
ACTION #2: Remove language regarding physician liability, direction, and control of PAs and “physician- delegated” prescriptive authority.
Outdated terms misrepresent PA practice and create unnecessary barriers to employment. PAs are responsible for their own actions and are authorized to prescribe as a function of their state license. Aligning with modern team-based practice improves access and reduces confusion without creating immunity for physicians.
ACTION #3: Remove the requirement for 500 hours of direct, on-site physician prescribing supervision for new PA licensees.
This requirement is a remnant from when PAs were subject to a prescribing formulary. It hinders hiring PAs, especially in rural areas with physician shortages and in psychiatric roles relying on telehealth delivery models. PAs are well-trained in pharmacology and clinical care. Removing this barrier would help health systems address critical gaps in patient care. Physicians remain accessible via telecommunication as needed.
ACTION #4: Permit PAs to sign documents that are within the scope of their supervising physicians.
PAs should be authorized to sign necessary medical documents within their scope. This ensures timely care, particularly in mental health and emergencies, where PAs may be the first provider available.
ACTION #5: Eliminate the PA-to-physician ratio.
Removing the 5:1 PA-to-physician ratio increases staffing flexibility, especially in areas with provider shortages. This change improves access.
ACTION #6: Permit PAs to advertise their services.
Allowing PAs to advertise ensures that patients are aware of their care options. Physicians and APRNs can already advertise. This change promotes transparency, patient autonomy in decision-making, and professional opportunity.
ACTION #7: Modernize the PA Policy Committee (PAPC).
Repurposing the PAPC to help manage licensure and regulatory functions would improve efficiency, give PAs a greater voice, and reduce administrative burdens on the medical board.
ACTION #8: Authorize PAs to be directly paid by public and private insurers.
Direct payment allows PAs to fully participate in value-based care and new payment models. It reduces barriers to employment.
ACTION #9: Remove geographical proximity requirement for supervising physicians.
Supervising physicians are available in-person or via telecommunication. This update provides important statutory clarity on requirements for physician and PA interaction and access in order to provide optimal patient care.
ACTION #10: Authorize PAs to use ablative lasers.
PAs are trained and certified to perform many dermatologic procedures. Allowing them to use ablative lasers improves access to safe, in-demand treatments, particularly in underserved areas.
ACTION #11: Update PA authority as it relates to sedation in urgent or emergent situations.
PAs in emergency and critical care settings already provide care to sedated patients. By granting them the authority to administer and closely monitor sedation, in conjunction with proper training and facility credentialing, we can enhance efficiency and better support a collaborative, team-based approach to care.
ACTION #12: Eliminate the separate requirement of 12 pharmacology continuing medical education credits.
PAs are subject to standard continuing medical education requirements for licensure renewal, along with ongoing maintenance of national certification, ensuring that PA knowledge and expertise in prescribing are current. This unique-to-Ohio requirement of 12 additional pharmacology hours positions the state at a competitive disadvantage for PAs seeking to practice in Ohio, now and when the PA Compact is soon launched.
ACTION #13: Permit PAs to prescribe and dispense glasses or contact lenses.
As part of their education and ongoing training, PAs acquire the skills and knowledge needed to perform routine visual screening, provide medical care related to eye surgery, and assist in the care of eye diseases. It is natural that such activities may require prescribing and dispensing optical aids.
ACTION #14: Add PAs as an eligible provider type to complete the Guardian’s Report for the Statement of Expert Evaluation.
Along with physicians and APRNs, PAs are qualified to assess patients and document such assessments, such as in the case of the Guardian’s Report for the Statement of Expert Evaluation pertaining to guardianship of an incompetent.
To illustrate the importance of PA practice modernization, OAPA collected testimonials from PAs across the state, highlighting the issues that HB 963 aims to address.
Michell McDiffett, DMSc, PA-C, DFAAPA on the Impact of Outdated Regulations
Dawn Sodders, PA-C, on the PA Role in Healthcare Efficiency
Kelly Thobe, PA-C, on Modernizing PA Practice Law
Paul Amiott, PA-C, EMT-P on PA Provision of Sedation in Rural Ohio
Emily Keller, DMS, PA-C, on How the PA Workforce Expands Access to Care
PA Practice Modernization: Setting the Record Straight
Let’s address some common myths and clarify the facts surrounding this important initiative.
Myth: Patients will be less safe without physician oversight.
Fact: PAs already deliver a full range of high-quality care, and many patients' needs can be met without requiring direct physician involvement. This legislation preserves the relationship between PAs and the broader healthcare team, including physicians, but modernizes it from a supervisory model to a collaborative one, reflecting how care is already being practiced every day. PAs remain deeply committed to team-based care and have no interest in diminishing the vital role physicians play.
Myth: Physicians will lose control of care quality.
Fact: Modernizing PA practice is not about dismantling team-based care, it's about removing outdated bureaucratic requirements that no longer reflect the realities of modern medicine. PAs and physicians share the same fundamental commitment: putting patient safety and quality care first. This legislation strengthens that shared mission by fostering genuine collaboration rather than enforcing administrative hierarchy, to the detriment of effecieint and effective care.
Myth: PAs will practice independently and without accountability.
Fact: Modernization does not mean operating without guardrails. PAs will continue to be held accountable through state licensure boards, malpractice liability, facility credentialing, and established professional standards. This legislation explicitly preserves a collaborative relationship between PAs, physicians, and the broader healthcare team, and makes clear that PAs are fully responsible for the care they provide.
Myth: PAs are not educate or trained enough to have their practice modernized.
Fact: PAs are master's-level educated, nationally certified clinicians with more than 2,000 hours of hands-on supervised clinical training, fully equipped to perform physical exams, diagnose conditions, prescribe medications, and assist in surgery, and they are held to the same rigorous national standards as any licensed medical professional. Modernizing PA practice authority doesn't change what they're capable of; it simply removes unnecessary barriers that prevent patients from accessing the high-quality care PAs are already prepared to deliver.
Bottom Line: Modernizing PA practice in Ohio isn't about replacing physicians or cutting corners on safety. It's about removing outdated bureaucratic barriers so that highly trained, nationally certified clinicians can do what they are already educated, credentialed, and proven capable of doing, getting more patients the right care, faster, without compromising quality.
OAPA is moving Ohio PA practice forward.
Here's how to be a part of it:
- Support us financially. It takes a great deal of resources to move a bill from introduction to the Governor's desk. Please consider supporting the OAPA Legislative Fund (for lobbying and advocacy activities) and the OAPA Political Action Committee (PAC) (for candidate and campaign contributions).
- Spread the news. Share this page with your work colleagues, your professional network, even your family and friends. The more Ohioans who understand our efforts for PA modernization, the better!
- Tell your story. How have practice limitations impacted your ability to provide care? Please complete this brief form to share your story.
- Recruit physician colleagues. Do you know physicians who are supportive of PA-advancing legislative changes? Please introduce us so that we can work together to improve patient care and the healthcare workforce in Ohio.
- Stay tuned. Follow the bill's progress on the Ohio House website to access the full legislation and monitor any hearings.