As part of the requirements in ESHB 2041 (2024), the Washington Medical Commission (WMC) will no longer collect Physician Assistant (PA) practice agreements. The Physician (MD/DO), PA and/or PA employer will instead fill out a collaboration agreement prior to the PA performing their duties. A PA or their employer must make the collaboration agreement available upon the request of the WMC.

A PA practicing under a practice agreement that was entered into before July 1, 2025, may continue to practice under the practice agreement until the PA enters into a collaboration agreement. A PA must enter into a collaboration agreement no later than the date on which the PA’s license is due for renewal or July 1, 2025, whichever is later.

The collaboration agreement must:

1. Identify at least one participating physician and must be signed by at least one participating physician or the physician assistant’s employer.
2. Describe the duties and responsibilities of the physician assistant and the participating physician or physicians.
3. Describe the supervision requirements for PAs with less than 4,000 hours of post-graduate clinical practice or 2,000 hours of specialty practice and the collaboration requirements for PAs who have met that threshold.
4. Describe the process between the PA and participating physician or physicians for communication, availability, and decision making when providing medical treatment to a patient or in the event of an acute health care crisis not previously covered by the collaboration agreement.
5. If there is only one participating physician identified in the collaboration agreement, a protocol for designating another participating physician for consultation in situations in which the physician is not available.
6. The signature of the physician assistant and the signature or signatures of the participating physician or physicians, or employer.
7. If the physician assistant has not met the required hours for collaborative practice and is working under the supervision of a participating physician, in accordance with RCW 18.71A.030, a plan for how the physician assistant will be supervised.
8. Include an attestation by the PA of the number of postgraduate clinical practice hours completed, including those completed in a chosen specialty, when the physician assistant signs the collaboration agreement.
9. Include a termination provision.

A model collaboration agreement can be found here. Frequently asked questions regarding PAs can be found here.