VirginiaHB7462026 Regular SessionHouseWALLET

Physician assistants; authorization to practice without a practice agreement.

Sponsored By: Rozia A. Henson, Jr. (Democratic)

Signed by Governor

Summary

Physician assistants; authorization to practice without a practice agreement. Authorizes a physician assistant with at least three years of full-time clinical experience to practice without a practice agreement upon receipt of an attestation from a patient care team physician or patient care team podiatrist who provided collaboration and consultation to such physician assistant verifying the length and nature of the physician assistant's practice. The bill establishes methods for a physician assistant who is unable to obtain the required attestation to submit other evidence that the physician assistant meets the requirements to practice without a practice agreement and establishes a method for physician assistants who obtain licensure by endorsement to practice without a practice agreement if they meet the applicable requirements. The bill also establishes a scope of practice for physician assistants who practice without a practice agreement. The bill specifies that the effective date of the foregoing provisions are contingent upon the Board of Medicine adopting regulations to implement the bill's provisions and to establish processes for granting authorization to physician assistants to practice without a practice agreement.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 1 benefits, 0 costs, 1 mixed.

Facility-employed physician assistants can skip separate agreements

Virginia physician assistants employed by qualifying facilities can practice without a separate practice agreement. Eligible employers are hospitals, state facilities run by the Department of Behavioral Health and Developmental Services, and federally designated health centers. The facility’s rules for approving staff and services must include all required practice-agreement components and name a team physician or podiatrist. Assistants must remain on a patient care team and continue working and consulting with its physicians or podiatrists. This option takes effect after implementing regulations are adopted and the Board certifies compliance to the Virginia Code Commission.

Physician assistants gain flexibility with approval fees

Experienced Virginia physician assistants can practice in their established specialty without a separate written or electronic practice agreement. They need three years of full-time-equivalent clinical experience: 1,800 hours per year, or 5,400 hours total. They must submit a team physician’s or podiatrist’s attestation confirming their experience, practice area, patient population, and collaboration period. Multiple attestations must be filed together; the Board can accept other evidence when an attestation cannot be obtained. Applicants pay a Board-set fee, with no amount specified, and need Board verification and a license designation. Assistants licensed by endorsement or through the interstate compact also need an experience attestation. Authorized assistants can prescribe controlled drugs and devices within their authorization, state law, and Board rules. They must follow care standards, consult other providers when appropriate, and maintain referral plans for complex cases and emergencies. These changes take effect after implementing regulations are adopted and the Board certifies compliance to the Virginia Code Commission.

Sponsors & Cosponsors

Sponsor

  • Rozia A. Henson, Jr.

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 329 • No: 3

House vote • 3/10/2026

Senate amendment agreed to by House

Yes: 99 • No: 0

Senate vote • 3/9/2026

Education and Health Amendment agreed to

Yes: 0 • No: 0

Senate vote • 3/9/2026

Passed Senate with amendment

Yes: 38 • No: 2

Senate vote • 3/6/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote • 3/5/2026

Reported from Education and Health with amendment

Yes: 14 • No: 0 • Other: 1

Senate vote • 3/3/2026

Motion to recommit to Education and Health agreed to

Yes: 0 • No: 0

Senate vote • 2/27/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote • 2/27/2026

Constitutional reading dispensed Block Vote (on 2nd reading)

Yes: 37 • No: 0

Senate vote • 2/26/2026

Reported from Education and Health

Yes: 13 • No: 1 • Other: 1

House vote • 2/17/2026

Read third time and passed House Block Vote

Yes: 97 • No: 0

House vote • 2/12/2026

Reported from Health and Human Services with substitute

Yes: 21 • No: 0

House vote • 2/10/2026

Subcommittee recommends reporting with substitute

Yes: 10 • No: 0

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0418)

    4/8/2026Governor
  2. Approved by Governor - Chapter 418 (effective - see bill)

    4/8/2026Governor
  3. Fiscal Impact Statement from Department of Planning and Budget (HB746)

    3/31/2026House
  4. Governor's Action Deadline 11:59 p.m., April 13, 2026

    3/31/2026Governor
  5. Enrolled Bill communicated to Governor on March 31, 2026

    3/31/2026House
  6. Signed by Speaker

    3/31/2026House
  7. Bill text as passed House and Senate (HB746ER)

    3/30/2026House
  8. Enrolled

    3/30/2026House
  9. Signed by President

    3/30/2026Senate
  10. Senate amendment agreed to by House (99-Y 0-N 0-A)

    3/10/2026House
  11. Passed Senate with amendment (38-Y 2-N 0-A)

    3/9/2026Senate
  12. Education and Health Amendment agreed to

    3/9/2026Senate
  13. Engrossed by Senate as amended

    3/9/2026Senate
  14. Read third time

    3/9/2026Senate
  15. Passed by for the day Block Vote (Voice Vote)

    3/6/2026Senate
  16. Senate committee offered

    3/5/2026Senate
  17. Reported from Education and Health with amendment (14-Y 0-N 1-A)

    3/5/2026Senate
  18. Recommitted to Education and Health

    3/3/2026Senate
  19. Motion to recommit to Education and Health agreed to

    3/3/2026Senate
  20. Passed by for the day

    3/2/2026Senate
  21. Read third time

    3/2/2026Senate
  22. Passed by for the day Block Vote (Voice Vote)

    2/27/2026Senate
  23. Constitutional reading dispensed Block Vote (on 2nd reading) (37-Y 0-N 0-A)

    2/27/2026Senate
  24. Rules suspended

    2/27/2026Senate
  25. Reported from Education and Health (13-Y 1-N 1-A)

    2/26/2026Senate

Bill Text

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