House Bill 10-71 cleared the House on final passage by a vote of 54 ayes to 13 nays, removing the requirement that physician assistants (PAs) maintain a written supervision agreement with a physician once they meet defined experience and certification standards.

Representative Mulder, sponsor of the bill, argued the change reflects modern PA training and would expand access to care across the state: “PAs have to pass the national examination to become licensed…this bill allows PAs to do what they are educated and competent to do as part of the health care team.” He said a newly graduated PA would still have oversight for at least 2,080 hours and must maintain national certification.

Opponents, including Representative Heinemann and Representative Garcia, pressed concerns about differences in training between PAs and physicians, potential expansion of scope without physician oversight, and risks to rural and tribal health services. Heinemann said the bill would “allow PAs to provide any medical service for which the PA believes they have been prepared,” and warned the change could permit independent prescribing and practice without equivalent training. Representative Poirier raised concerns about effects on Indian Health Service care and fiscal impacts for referrals.

Supporters countered with workforce and access arguments. Representative Baxter and Representative Wahlberg described local collaboration among medical staff and said PAs already perform many advanced procedures in practice; Baxter noted neighboring states have removed similar requirements. Sponsor Mulder cited neighboring states (Wyoming, Montana, North Dakota, Minnesota, Iowa, Utah) as models and said the bill includes continuing competency by requiring national certification maintenance and periodic re-testing.

The House debate addressed supervision language, liability and discipline by the state Board of Medicine. The recorded final vote was ayes 54, nays 13, excused 1. The bill was then recorded as passed by the House.