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Since 1979, Alabama has restricted the supply of health care with certificate-of-need (CON) programs. These programs prohibit health care providers from entering new markets or making changes to their existing capacity without first gaining the approval of state regulators.
§6542. No physician shall employ or supervise more than four physician assistants in his or her private practice.
(1) Physician supervision requires, at all times, a direct, continuing and close supervisory relationship between a physician assistant and the physician to whom the assistant is registered. (2) There shall be no independent, unsupervised practice by physician assistants.
Section 540-X-8-. 12 - Limitations Upon Utilization Of Certified Registered Nurse Practitioners (1) A physician may enter into collaborative agreements with certified registered nurse practitioners not exceeding a cumulative three hundred and sixty (360) hours (nine FTEs) per week.
How many PAs may a physician supervise? The determination is not made on the number of people. The Board limits a physician to supervise a total of 360 "full-time equivalent" (FTE) hours per week of mid-level practitioners. Mid-level practitioners include CRNPs, CNMs and PAs.
A supervising physician may be the primary supervising physician for six PAs but can be an alternate for an unlimited number of PAs.
NPs practicing in Alabama are required to have a written collaborative practice agreement with a physician. One physician may collaborate with no more than three full-time nurse practitioners, or 120 NP collaboration hours per week.
Section 420-5-6-. 06 - Assurance Of Access To And Continuity Of Care (1) A health maintenance organization shall have available sufficient personnel to meet the standards set forth in this Chapter and its contractual obligations.