© 2018 American Medical Association. All rights reserved.9 State Co-Signature PA Ratios Rx Authority Supervision/ Collaboration Language Supervision/Collaboration Requirements/“Barriers”Physician/PA Board? Scope Determined at Practice Site? (KAR 100-28a-10) provide services at a different practice location. (KAR 100-28A-17) Additional requirements if the PA is practicing in a location different than the location that the supervising physician primarily practices. (KAR 100-28a-14) Kentucky Required for a sufficient number of medical notes, sufficiency determined at practice. (KRS 311.856) A physician may not enter into agreements with more than 4 PAs, and may not supervise more than 4 PAs at any one time. (KRS 311.854) No legend drugs (Ky. Rev. Stat. 311.858 and 311.856) Supervisory Physician is required to provide adequate, active, and continuous supervision of a PA’s activities to assure that the PA is performing as directed and complying with the statutes and all related administrative regulations. (Ky. Rev. Stat. 311.856) Under specific conditions, a PA may perform services in a location separate from the supervising physician if the supervising physician is continuously available via telecommunication. (KRS 311.860) Kentucky Board of Medical Licensure Yes Louisiana Required, but varies based on practice site arrangement, and physician-PA relationship. (LAC 46, XLV 4512) Physician may not serve as a primary for more than 4 PAs. (LAC 46, XLV 4507) Schedule II-V Supervisory Supervision means responsible direction and control, with the supervising physician assuming responsibility for the services rendered by a PA in the course and scope of the PA's employment. Supervision shall not be construed in every case to require the physical presence of the supervising physician. However, the supervising physician and PA must have the capability to be in contact with each other by either telephone or other telecommunication device. Supervision shall exist when the supervising physician gives informed concurrence of the PA actions, and when a medical treatment plan or action is made in accordance with written clinical practice guidelines or protocols.