ON APRIL 10, 2026, Kentucky Governor Andy Beshear signed Senate Bill 116 into law. This healthcare bill is designed to update outdated laws regarding the scope of practice of physician assistants (PAs) and streamline how PAs are able to deliver care to patients. The legislation was sponsored by Kentucky Senator Scott Madon (R-Pineville) and had support from groups such as the Kentucky Academy of Physician Assistants.
The key aspects of the bill included modification of the definition of physician “supervision,” and permits authorized, licensed PAs to prescribe and administer Schedule II controlled substances. The legislation permits individual healthcare practices to determine the scope of practice of a PA based on the needs of the practice. This allows practices to best determine how their PAs should be utilized, while maintaining physician oversight, to most effectively and efficiently deliver care to patients.
The Kentucky Revised Statutes outline the scope of practice for physician assistants in Chapter 311, sections .840-.862. One of the primary changes made to this Chapter is the definition of “supervision.” Specifically, language from the prior version of the statute that imputed responsibility for the medical services rendered by a PA to the supervising physician was removed. Now, rather, “supervision. . . means overseeing the activities and medical services rendered by a physician assistant.” See KRS 311.840(8)(a). Subsection (b) was newly added, and states that supervision “[d]oes not require the physical presence of a supervising physician when medical services are rendered by a physician assistant.” KRS 311.840(8)(b).
To be clear, physician supervision of PAs is still required; this bill just modified what that supervision looks like in practice. KRS 311.854 is the most heavily modified section of the Chapter and provides the language that allows individual practices to enter into supervision agreements that outline the scope of practice of a PA. The supervision agreement must include, at minimum,
- The scope of medical services and procedures approved by the supervising physician to be performed by the PA
- The level and method of supervision to be provided by the supervising physician
- Applicable requirement for review and countersignature of the PA’s notes, orders, or prescriptions
- Procedures governing communication and clinical decision-making between the supervising physician and the PA
- The primary practice location and any additional locations where the PA is allowed to provide services, and
- Any alternate physician supervision agreements authorized under this Chapter. See KRS 311.854(3)(a)-(f).
The language in KRS 311.854(d) obviates several supervisory requirements set forth in KRS 811.856, which governs the responsibilities of supervising physicians. Where many of these requirements are subsumed into the supervision agreement, the inclusion of these responsibilities in KRS 811.856 is redundant; for example, the inclusion of language relating to the review and countersignature of a PA’s notes.
KRS 311.858 provides for the restrictions placed upon PAs in terms of what medical procedures and treatment they can render. Previously, the statute enumerated that PAs were permitted to prescribe Schedule III, IV, and V controlled substances. The new statute permits PAs to prescribe and administer Schedule II controlled substances, so long as the PA has had at least one year of experience as a licensed PA, an application to the board has been submitted for prescriptive authority in conjunction with the PA’s supervising physician, board approval of that application, and the PA obtains a Controlled Substance Registration Certificate through the DEA and the related Kentucky agency. See KRS 311.858(4)(b)(1-4). There are additional guardrails put in place for the prescription of Schedule II controlled substances. The passage of this bill also removed language from this section of the statute providing that a PA is considered an agent of the supervising physician in performing medical services and procedures.
For physicians, this does not mean less oversight. Indeed, these changes do not authorize independent practice for PAs. However, oversight may look a little different, as the supervision agreement permits practices to tailor the use of their PAs to fit the needs of the practice. This more collaborative approach will allow for practices to most effectively and efficiently utilize their healthcare professionals in a way that best serves their patients.
Madeleine B. Loeffler is a healthcare law and medical negligence defense attorney with Sturgill, Turner, Barker & Moloney, PLLC. She can be reached at mloeffler@sturgillturner.com or 859.255.8581. This article is intended as a summary of state and/or federal law and does not constitute legal advice.