GuamBill No. 123-38 (COR)38th Guam Legislature (2025-2026)legislatureWALLET

AN ACT RELATIVE TO INCLUDING PHYSICIAN ASSISTANTS ON THE GUAM BOARD OF MEDICAL EXAMINERS, UPDATING PRESCRIPTIVE AUTHORITY FOR PHYSICIAN ASSISTANTS, AND ADOPTING RULES AND REGULATIONS AND CODE OF ETHICS FOR PHYSICIAN ASSISTANTS BY ADDING A NEW (10) AND (11) TO §12215 AND AMENDING 12101(r), (7) OF §12202(a), (7) AND (8) OF 12202(b), §12203(a) (1) TO (4), AND §121609, ALL OF CHAPTER 12, TITLE 10, GUAM CODE ANNOTATED.

Sponsored By: Therese M. Terlaje (Democrat)

Became Law

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 2 benefits, 0 costs, 3 mixed.

PA licensing, renewal, and training rules

To get a PA license, you must graduate from an ARC‑PA–accredited program, pass the NCCPA exam, and keep NCCPA certification current. Licenses expire every two years on December 31 of even‑numbered years. To renew, pay the fee, show 50 hours of continuing education (at least 20 in your specialty), and show current basic CPR. The Board may prorate CE if you were licensed less than two years. If your NCCPA certification lapses, your license is automatically suspended.

PA prescribing and inpatient orders

PAs may prescribe, give, and dispense drugs only when the Board approves this in a Collaborative Practice Agreement. You must hold a valid federal DEA registration and a current Guam Controlled Substances Registration; the Board of Pharmacy must also approve the CPA for prescribing. If either registration is invalid or revoked, your prescriptive authority is suspended or revoked. If you have hospital or nursing facility privileges and bylaws allow it, you may write inpatient orders, and your supervising doctor must countersign or confirm within 24 hours. You may not work in specialties you or your supervisor are not qualified for.

Medical board now oversees PAs

The Guam Board of Medical Examiners now licenses and polices physician assistants. The board has nine members: at least six Guam‑licensed physicians, one Guam‑licensed PA, and one podiatrist; one seat is the GMHA Medical Director. Provider members have practiced in Guam for five years, and all members are U.S. citizens or permanent residents who lived in Guam for five years. Old Allied Health rules for PAs are repealed. The law adopts GBME’s PA rules (Exhibit A) and a PA Code of Ethics (Exhibit B), and the Board can update them under the Administrative Adjudication Law.

Short-term care by off-island clinicians

Doctors and PAs who live outside Guam may give short emergency or consult care on Guam without a Guam license in limited cases. A Guam medical institution or a federal agency must direct the care and take responsibility. The visitor cannot open a Guam office or usually issue a final written opinion directly to a Guam patient. They must follow Guam and federal privacy laws.

Supervision and practice limits for PAs

You must have a Board‑approved Collaborative Practice Agreement with a Guam‑licensed supervising doctor before you practice. The agreement must list your scope, drug lists, and alternate supervisors, and you must report supervisor changes at least 10 days before they take effect. One doctor may supervise no more than two PAs. The doctor must be reachable, provide written guidelines at each site, and co‑sign records within 7 days. You must wear PA identification, post your license at each office, and avoid titles or ads that mislead the public. The Board keeps a public registry of PAs and supervising doctors.

Sponsors & Cosponsors

Sponsor

Therese M. Terlaje
Democrat • legislature

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 0 • No: 0

legislature vote • 7/31/2025

Floor Vote