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   PA Practice in RI


Finding a Job

The RIAPA has joined forces with Job Target to help match
PAs looking for carriers with employers looking for PAs.

The way it works is that PAs can post their resume on the job 
for free and confidentially.  

Employers looking for PAs pay the site to provide them with PAs 
seeking jobs that they may have available.

The RIAPA benefits by earning a percentage of that transaction.

Practice Settings in RI

Rhode Island offers an endless selection of practice settings for you to chose from.  From small private practices and rural health to a Level 1 Trauma Left and Ivy League teaching hospital.  

Every specialty is represented in RI.


Although the RIAPA does not give legal advice, we strongly advise you to have a clear understanding, in writing, as to what the terms of your employment will be.  You can call it anything from a Letter of Understanding to an Agreement of Employment.  Do not get this confused with a Practice Agreement which outlines your scope of practice.  What we are talking about here is the terms of your employment.  Make sure you cover things like

How many hours a week?
How many hours of call and how often?
How is call paid?
Transportation compensation for multiple sites?
Terms of vacation, sick and CME time?
How is CME covered?
Do they cover State License, DEA, Prof. Organizations?
Do they cover recertification and exams?
Do they cover your phone bill?
Health, Life and Dental and Disability Insurance?
Retirement Planning, Matched contributions?

If it's not on paper you have no proof it was agreed to or discussed.

A good lawyer can keep you out of an expensive mess.

Roles, Rules and Responsibilities

Rhode Island is one of the 4 best states in the country for
PA Practice.  Our laws and regulations were carefully 
crafted with PA input and oversight but also in collaboration
with many others.   It is your responsibility to know and
understand the laws, rules and regulations under which you practice.

You may find the current laws and regulations here.

PA Practice Agreement

Are you aware that Rhode Island law requires that a written practice agreement between you and your supervising physician(s) be in place and immediately available should the Board of Licensure for Physicians request to see it? If you have an agreement in place are you sure it contains all the required elements?

To help you make sure your agreement meets the standards here’s the requirements:

-- The agreement must be in writing and available at the primary practice site

-- It must delineate the level of supervision provided by the supervising physician or designee with particular reference to differing levels of supervision depending on the type of patient services provided. Example: A new graduate performing procedures with potential for morbidity (e,g. central venous line, closed thoracotomy, thoracentesis) may require a higher degree of supervision than a PA with many years of experience performing the same procedures require

-- Requirements for communication between the supervising physician the physician assistant.

-- A job description for the physician assistant listing patient care responsibilities and procedures to be performed by the physician assistant.

-- A program for quality assurance for physician assistant services including requirements for periodic review of the physician assistant services. Example: Periodic chart reviews, direct observation of PA performance, case presentations would all fulfill this requirement. Documentation of each QA activity must be kept on file.

Practice agreements are required for all PAs employed directly by a physician or a group practice. Requirements for supervision of physician assistants employed or extended medical staff privileges by licensed hospitals or other licensed health care facilities or employed by other health care delivery agencies shall be delineated by the medical staff by laws and/or applicable governing authority of the facility.

Another important legal mandate to keep in mind is that both the PA and supervising physician are responsible to assure that there is adequate supervision at all times. Should you feel that your supervising physician is not providing adequate supervision you have the legal and ethical responsibility to present your concerns to the physician and if an agreement can’t be reached your only option may be to seek other employment arrangements.

To further assist RIAPA members in developing their practice agreements, templates are being developed and will be made available when complete.

Disclaimer: Nothing in this article should be considered as legal advice. This is a restatement of Rhode Island law. RIAPA recommends seeking legal counsel before executing any agreements.

Third Party Reimbursement

This is another sticky area that you really need to learn about and be aware as to how your practice is billing for your services.

When you see a patient and a bill to an insurance company is sent out (with the exception of certain situations) it will have your name on it and you will be legally responsible for what is on the paper.

This means if you are incorrectly billing (knowingly or unknowingly) you will be held liable.  You can be charged with fraud and receive fines, be banned from Medicare for life or jail time.  

Avoiding the Pitfalls of Practice

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