KentuckySB 1162026 Regular SessionSenateWALLET

AN ACT relating to physician assistants.

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Bill Overview

Analyzed Economic Effects

6 provisions identified: 1 benefits, 0 costs, 5 mixed.

PA controlled‑drug prescribing with strict caps

A PA may prescribe Schedules II–V if the supervising doctor allows it and the PA has one year of practice, Board approval, DEA registration, and is enrolled in the state monitoring system. The law sets limits: most Schedule II narcotics (not hydrocodone combos) are capped at 72 hours with no refills; hydrocodone combos, nonnarcotic Schedule II, and Schedule III are capped at 30 days with no refills; Schedule IV and V may have refills but the total cannot exceed six months; benzodiazepines and carisoprodol are capped at 30 days with no refills.

Clear supervision agreements and PA staffing caps

Before a PA provides care, a signed supervision agreement must be in place. The agreement must list approved services, supervision methods, review or countersign rules, how to communicate, practice sites, and any alternate supervisors. The Board provides a standard form, and copies must be filed with the Board and kept at the main practice site. Licensed facilities may name alternate supervising physicians to cover when the main doctor is away. A physician may supervise no more than four PAs at one time, and must apply for approval for each PA.

PA licensing and training requirements

PA applicants must pass a Board‑approved exam within three tries or get a Board waiver, and meet character and education rules. Licenses last two years, and renewal requires 100 hours of approved continuing education in the prior two years. Training must include 1.5 hours on pediatric abusive head trauma in the first two years or before first renewal and a one‑time one‑hour dementia course. If a PA is authorized to prescribe Schedules II–V, at least 7.5 hours must cover controlled‑substance topics.

PA practice limits and oversight rules

PAs may not practice independently and must have a designated supervising physician. PAs can work in the supervising doctor’s office; they may work in hospitals or other licensed facilities only with written permission, and the facility can limit their scope. The old separate‑location statute is repealed; practice now follows the supervision agreement and any facility permissions. In emergencies, a PA may start evaluation and treatment without specific approval. Supervising physicians must keep PAs within scope, ban dispensing of controlled substances, and report concerns or ending supervision to the Board within three business days. PAs must wear ID that says “physician assistant” and cannot bill patients or insurers directly.

Broader PA authority for routine drugs

PAs may prescribe and give nonscheduled prescription drugs and medical devices when their supervising physician approves. Approved PAs can also request, receive, and hand out professional samples of nonscheduled drugs. PAs may perform local infiltrative anesthesia. General or regional anesthesia is not allowed unless the PA meets the separate standards in KRS 311.862.

Driver vision testing: more places, small fee

Credentialed PAs, APRNs, doctors, osteopaths, and vision specialists can perform and sign driver vision forms. The Kentucky State Police can give required vision tests at or before application. A vision form is valid only if done within the past 12 months. The Transportation Cabinet may allow electronic form submission and may charge an administrative fee for on‑site testing; fee money goes to the state photo license account.

Sponsors & Cosponsors

Sponsor

Scott Madon
Republican • Senate

Cosponsors

Lindsey Tichenor
Republican • Senate
Stephen Meredith
Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 159 • No: 3

Senate vote • 3/31/2026

passed

Yes: 36 • No: 0

House vote • 3/27/2026

3rd reading, passed

Yes: 90 • No: 1

Senate vote • 3/9/2026