Supervision Agreement · PA
Rhode Island Supervisory Practice Agreement for Physician Assistants
Recognized but not required in every case. The Supervisory Practice Agreement is the written instrument Rhode Island law names for a Physician Assistant working with a physician. Below: the board that governs it, what it contains when one is used, and the supervision rules that apply either way.
The 2019 reform (P.L. 2019, ch. 130/131) eliminated written practice agreements and hospital ratio caps, replacing them with a 'collaboration' standard — but a physician must still be 'accessible at all times for consultation' for as long as the PA practices (§ 5-54-2(3)). No experience-based exit from that requirement exists, so this isn't full independence.
What a Rhode Island Supervisory Practice Agreement contains when one is required
Not every Physician Assistant in Rhode Island needs one; the conditions are under "Written agreement" below. When one is required, these are its clauses.
The Physician Assistant ("PA") shall practice in collaboration with the Physician, consulting with or referring to an appropriate physician or other health care professional as the patient's condition, the Physician Assistant's education, competencies, and experience, and the applicable standard of care require. The Physician shall remain accessible for consultation, though no fixed proximity or on-site presence requirement applies.
Rhode Island law does not fix a numerical limit on the number of Physician Assistants with whom a physician may collaborate, and does not require a written supervision agreement to be kept on file with the state.
- The Supervisory Practice Agreement also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
Rhode Island's supervision rules
Ratio, proximity, chart review, meeting and prescribing rules for physician assistants, and the conditions under which a written agreement becomes required.
Proximity
Available remotely (no on-site requirement)
§ 5-54-2(3): 'a physician must be accessible at all times for consultation by the physician assistant.' No mile/minute radius or on-site standard is codified; the degree of collaboration otherwise 'shall be determined by the practice.'
Supervision ratio
Not codified — no cap on file
Chart review
Not codified
Meeting cadence
Not codified
Prescriptive authority
No agreement needed to prescribe · controlled substances permitted
Schedule II, III, IV, and V under the RI Uniform Controlled Substances Act (§ 5-54-8); Schedule I is not included.
Written agreement
Not required
No WRITTEN practice agreement is required — § 5-54-8 removed that requirement in 2019. But 'collaboration' isn't optional: an appropriate physician must be accessible at all times, and the degree of collaboration is set by the employer/practice/credentialing system rather than a document the PA and physician negotiate.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Service Corporation under R.I. Gen. Laws § 7-5.1-1 et seq. — PAs are explicitly listed among the healing-arts licensees (with physicians, dentists, RNs, podiatrists, optometrists, chiropractic physicians, physical therapists, psychologists, and midwives/nurse-midwives) who may jointly organize a multi-service PSC.
Confirm the 2026 bill's status before assuming either the current permissive PSC regime or a stricter CPOM ban applies going forward.
Sources for the supervision rules (4)
- R.I. Gen. Laws § 5-54-8 — Permitted Healthcare Practices by Physician Assistantssecondary
- R.I. Gen. Laws § 5-54-2 — Definitions ('Collaboration')
- Robinson+Cole — 'Rhode Island Removes Supervision Requirements for PAs in Favor of Expanded Collaboration Standard' (2019)secondary
- R.I. Gen. Laws § 7-5.1-1 et seq. — Professional Service Corporations
About Rhode Island's rules
RI is a Full Practice Authority state for NP/CNM (R.I. Gen. Laws § 5-34-44) and, since a 2019 reform (§ 5-54-8), no longer requires PAs to have a written practice agreement — 'collaboration' with an always-accessible physician replaced supervision and hospital ratio caps. CRNAs are the exception: RI has NOT taken the Medicare physician-supervision opt-out, and CRNA scope is statutorily bounded to the perioperative period.
Other clinicians in Rhode Island: see the state overview.