As part of the requirements in SHB 2378, the Washington Medical Commission (WMC) will no longer approve Physician Assistant (PA) practice agreements (formally known as a delegation agreement). The Physician (MD, DO), PA and/or entity will need to file a practice agreement with the WMC prior to the licensed PA performing their duties. The licensed PA can begin working as soon as the practice agreement is filed with the WMC.

Existing practice agreements submitted before July 1, 2021 do not need to be updated to reflect the changes required in SHB 2378.

Filing a Practice Agreement with the WMC

There are two options for filing a practice agreement with the WMC.

1. Use the practice agreement webform, prepared by the WMC. If you choose to use this option, once you have completed the required fields, no further action will be needed by you / your organization. The webform automatically files the practice agreement with the WMC and emails a copy of the practice agreement to the email address provided on the form. As the PA or MD, you may need to forward the copy to your organization to add to your employment file. You should check with your organization for their specific procedures.
2. You can submit a practice agreement, prepared by the organization or employer, to medical.delegations@wmc.wa.gov. The WMC will not accept handwritten practice agreements. The practice agreement may be in a format of your choosing, but must include:
   • The duties and responsibilities of the physician assistant, the supervising physician, and alternate physicians.
   • The practice agreement must describe supervision requirements for specified procedures or areas of practice.
   • A process between the physician assistant and supervising physician or alternate 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 practice agreement, such as a flu pandemic or other unforeseen emergency.
   • If there is only one physician party to the practice agreement, a protocol for designating an alternate physician for consultation in situations in which the physician is not available.
   • The signature of the physician assistant and the signature or signatures of the supervising physician.
   • A termination provision.

A model practice agreement can be found here.

Amendments to a Practice Agreement

A practice agreement can be amended for the following reasons:

• Changing or adding supervising physician(s)
• Changing or adding alternate physician(s)
• Technical corrections, such as: Name or license number and location of practice.

To file an amendment, please complete the Practice Agreement Amendment form and email it to medical.delegations@wmc.wa.gov. If a practice agreement needs to be amended to change the scope of practice, delegation of duties not previously included or a change in communication process or other protocols, a new practice agreement will need to be filed with the WMC.

Termination of a Practice Agreement

A physician assistant or physician may terminate the practice agreement as it applies to a single supervising physician without terminating the agreement with respect to the remaining participating physicians. If the termination results in no supervising physician being designated on the agreement, a new supervising physician must be designated for the agreement to be valid. To terminate a practice agreement, you can complete the Practice Agreement Termination form and email it to medical.delegations@wmc.wa.gov.