Scope of Practice in Ohio FAQs

Per Ohio Revised Code 4730.02, "No person practicing as a physician assistant shall prescribe any drug or device to perform or induce an abortion, or otherwise perform or induce an abortion."

It is our understanding, based on extensive consultation with obstetrician-gynecologists and legal counsel, that this law forbids PAs from prescribing Methotrexate, or any medication, including over the counter, that would induce the end of a pregnancy, even in the case of ectopic or other nonviable pregnancy and/or if the pregnant patient's life is at risk. Such medication should be prescribed by the PA's supervising physician or the OB/GYN team.

UPDATE:  We are aware of the case of PLANNED PARENTHOOD SOUTHWEST OHIO REGION v. OHIO DEPARTMENT OF HEALTH which, among other things, seeks to remove the mifepristone prescribing ban on advanced practice clinicians (including PAs). Judge Alison Hatheway, per an August 2024 ruling, preliminarily enjoined the Defendant from enforcing [among other sections] Ohio Revised Code 4730.02(E), 4730.03(F), and 4730.42(A)(1) and Ohio Administrative Code 4730-2-07(E). Given the complexity and changes in this area of law, OAPA recommends that PAs consult legal counsel to understand how this ruling may impact their practice in Ohio if they intend to engage in this prescribing activity.

Per Ohio Revised Code 4730.201, "a physician assistant may administer, monitor, or maintain local anesthesia as a component of a procedure the physician assistant is performing or as a separate service when the procedure requiring local anesthesia is to be performed by the physician assistant's supervising physician or another person. A physician assistant shall not administer, monitor, or maintain any other form of anesthesia, including regional anesthesia or any systemic sedation."

Please note OAPA seeks to pursue legislation that would permit PAs to perform moderate sedation. Learn more about OAPA's advocacy priorities here.

Per Ohio Revised Code 4730.21, "The supervising physician shall be continuously available for direct communication with the physician assistant by either...being physically present...[or]...being readily available to the physician assistant through some means of telecommunication and being in a location that is a distance from the location where the physician assistant is practicing that reasonably allows the physician to assure proper care of patients."

A supervising physician can have multiple supervision agreements with PAs but can only supervise 5 PAs at any one time.

As you may suspect, the best path to address a concern with your practice as a PA will depend on the issue.

OAPA is here to field questions about PA practice and how to understand PA-related laws and rules in the Ohio Revised Code and Ohio Administrative Code as they may relate to your situation, along with our aim to improve the general public's understanding of PA practice.

For workplace challenges with your employer, we recommend working together with your manager, a director, the advanced practice provider lead, or whichever roles make sense within your organization to identify and resolve the concern. Serious situations that are not resolvable by these types of leaders may make sense to elevate through an HR, ethics, and/or compliance reporting process that your organization may have in place. In extreme cases, you may need to engage legal counsel (consider contacting OAPA for a referral to a firm with PA practice familiarity.)

Depending on the situation, these other entities may have resources that are of help to you:

• State Medical Board of Ohio
• Ohio Department of Health
• Occupational Safety and Health Administration
• The Joint Commission