Practice Agreement · PA
Physician Assistant Practice Agreement in Alabama
Alabama law does not require a Physician Assistant to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.
Ala. Admin. Code r. 540-X-7-.23: 'There shall be no independent, unsupervised practice by physician assistants.' No experience threshold ever removes the supervision requirement.
What a Physician Assistant practice agreement covers in Alabama
Governed by the Alabama Board of Medical Examiners and the Alabama State Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Physician Assistant ("PA") shall practice under a direct, continuing, and close supervisory relationship with the Physician, as required by Ala. Admin. Code ch. 540-X-7, which does not require the Physician's on-site presence. The Physician shall maintain a quality assurance plan providing for review of a meaningful sample of the Physician Assistant's patient records and of all adverse outcomes.
A physician may not supervise or collaborate with Physician Assistants, Certified Registered Nurse Practitioners, and Certified Nurse Midwives whose combined scheduled hours exceed three hundred sixty (360) full-time-equivalent hours per week. The Physician Assistant's registration to the Physician shall be approved and filed with the Alabama Board of Medical Examiners, and any change in supervising physician shall be reported to the Board.
- The agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- Ala. Code § 34-23-77statute
Authorizes a Collaborative Practice Agreement between an Alabama-licensed pharmacist and physician; requires the agreement to be submitted to and approved by both the Board of Pharmacy and the Board of Medical Examiners before it is effective.
- Ala. Admin. Code r. 680-X-2-.44board rule
Alabama Board of Pharmacy rule implementing Collaborative Drug Therapy Management Agreements: required terms, eligibility, quality assurance, renewal, and limitations.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
PA with <2 years (4,000 hours) of experience, remote/satellite site: On-site presence required
Supervising physician must be physically present at the approved practice site for not less than 10% of the PA's scheduled hours (Ala. Admin. Code r. 540-X-7-.23).
PA with ≥2 years (4,000 hours) of experience, remote/satellite site: Available remotely (no on-site requirement)
On-site presence requirement drops away; physician must instead visit the remote site no less than twice annually and meet with the PA at least quarterly. No mileage/radius figure could be confirmed in the rule text retrieved in this research pass — flag as unconfirmed rather than absent.
Supervision ratio
Up to 9 at a time (combined across provider types)
A physician may not collaborate with/supervise any combination of CRNPs, CNMs, and PAs exceeding 360 hours/week (i.e., 9 FTE positions total, combined across all three provider types) — a shared cap, not a per-type cap (Ala. Admin. Code r. 540-X-8-.08, cross-referenced for PAs).
Chart review
Percentage set by agreement · Quarterly · countersignature required
Quarterly quality-assurance review of 'a meaningful sample of medical records plus all adverse outcomes' — no specific percentage codified. Countersignature required 'pursuant to established policy and/or applicable legal regulations and accreditation standards,' also with no fixed percentage (Ala. Admin. Code r. 540-X-7-.23, -.24). Records retained for duration of practice plus 3 years after termination.
Meeting cadence
Quarterly
Minimum quarterly meeting cadence; modality not specified as exclusively in-person or telehealth.
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
PAs prescribe legend drugs under the supervising physician's authority; controlled-substance prescribing appears to flow through the supervising physician's own DEA/Alabama Controlled Substances Certificate rather than a PA-specific certificate (unlike CRNP/CNM's QACSC, which by its own chapter title covers only CRNP/CNM) — this could not be fully confirmed in this research pass; recommend direct confirmation against 540-X-7's controlled-substances section.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Title 10A professional-entity statutes require PC/PLLC shareholders to be licensed to render 'the same specific professional services' as the entity — as a practical matter a PA cannot be the sole licensed owner of a medical practice entity (secondary-sourced characterization of Title 10A; not independently confirmed against primary statutory text in this research pass).
Alabama has no strict corporate-practice-of-medicine doctrine barring corporate ownership generally, but PAs cannot own/operate an independent practice outside a registered supervising-physician relationship.
Legal sources for these rules (3)
- Ala. Code § 34-24-290 et seq. — Assistants to Physicians
- Ala. Admin. Code r. 540-X-7-.23, -.24 — Physician Assistant Supervision Requirements
- Ala. Admin. Code r. 540-X-8-.08 — Combined CRNP/CNM/PA Supervision Ratio (cross-referenced)
About Alabama's rules
Alabama is a restrictive state: PA/CRNP/CNM all require an indefinite collaborative agreement with no independence pathway, and share a combined 360 hours/week (9 FTE) supervision cap per physician. CRNA's status is a genuine ambiguity — statute requires an 'immediately available' physician/dentist/podiatrist, but no filed agreement or ratio regime exists like CRNP/CNM's; flagged for legal review.
Other clinicians in Alabama: see the state overview.