Delaware is officially joining the nationwide movement toward modernizing the practice of Physician Assistants—now formally recognized in the First State as Physician Associates (PAs). With the passage of House Bill 325, Delaware has enacted sweeping changes that reshape the regulatory landscape, providing a clear pathway toward independent practice and reinforcing the PA’s role as a vital, flexible member of the healthcare team.
Here is a breakdown of the most significant changes and what they mean for PAs practicing in Delaware.
A Name Change with Meaning
First and foremost, the law officially updates the title “Physician Assistant” to “Physician Associate”. While this aligns with the American Academy of Physician Associates (AAPA) national branding, the law is careful to note that this change does not alter or impact existing billing, reimbursement, or payment policies. Essentially, your rights and privileges remain intact, but your title now more accurately reflects your professional standing.
The Move Toward Independent Practice
The most transformative aspect of HB 325 is the introduction of Independent Practice Authority. Previously, all PAs were required to practice under a collaborative agreement. Under the new law, PAs who have completed 6,000 hours of post-graduate clinical practice may apply to the Regulatory Council for Physician Associates to practice and prescribe independently to the full extent of their education and training.
Navigating the Two Application Scenarios
The law outlines two distinct pathways for PAs seeking independent practice authority, depending on their clinical setting:
- Settings WITH at least one licensed Delaware Physician: In a group, practice, or health system that already includes at least one licensed Delaware physician, the application process is streamlined. The PA must provide basic practice information (physician associate’s name, license number, physical location of practice, mailing address, phone number, and primary area of practice) and official proof of the 6,000 required clinical hours.
- Settings WITHOUT a licensed Delaware Physician: For PAs intending to practice in a setting where no Delaware-licensed physician is present, the requirements are more stringent. In addition to the basic practice information and proof of 6,000 hours, the PA must provide proof of training that aligns specifically with their intended practice areas. Furthermore, if a PA in this setting wishes to change their practice area later, they must notify the Regulatory Council and provide proof of training for the new area before making the switch.
Collaboration for Those Under 6,000 Hours
For PAs who have not yet reached the 6,000-hour threshold, the requirement for a Collaborative Agreement remains in place. However, the law clarifies that “collaboration” does not require the constant physical presence of a physician. The collaborating physician must simply be readily accessible via electronic communication.
It is the responsibility of the “physician-physician associate team” or the healthcare facility to create and maintain a written collaborative agreement on file that defines the physician associate’s scope of practice and the process for performance evaluation.
Expanded Roles and Responsibilities
HB 325 touches nearly every corner of the Delaware Code to ensure PAs are integrated into the healthcare system:
- Direct Billing: PAs are now authorized to bill for and receive direct payment for their services and should be identified as the rendering professional in the billing and claims process.
- Primary Care Designation: Insurers may now designate a PA as a patient’s primary care provider.
- Disaster Response & Volunteerism: The law provides robust protections for PAs volunteering at community events or responding to state emergencies, allowing them to provide care without a formal collaborative agreement in place.
Looking Ahead
House Bill 325 is effective immediately, though full implementation will occur either one year from enactment (May 12, 2027) or once the Board of Medical Licensure and Discipline approves the enabling regulations, whichever comes first.
This legislation represents a landmark shift for Delaware PAs, removing administrative hurdles and recognizing the high level of expertise PAs bring to the table. Whether you are a seasoned PA looking toward independence or a new graduate entering the workforce, Delaware’s regulatory landscape has never been more supportive of your practice.