(A) For a physician assistant who practices in an office-based setting, a special services plan approved by the board is required for all services beyond the scope of the services authorized under paragraph (A) of section 4730.09 of the Revised Code.
(B) An application for approval of a service under a special services plan shall be made on a form prescribed by the board and include such facts and materials as the board requires, including, but not limited to, all of the following information:
(1) Documentation of the supervising physician's normal course of practice, experience and training to perform the requested service, and any board certification;
(2) The minimum education, training, and experience required for any physician assistant providing service under the plan, including the following:
(a) Any formal postgraduate physician assistant training that will be provided to the physician assistant;
(b) The minimum number of procedures the physician assistant will observe the supervising physician in performing; and
(c) The minimum number of procedures performed by the physician assistant under the direct observation of the supervising physician in order to be certified by that physician as competent.
(3) The location or locations in which the service will be performed;
(4) The criteria that will be used in granting authority for the specific service to be performed by the physician assistant and the quality assurance process that will be utilized to review the performance of that service;
(5) Whether the service will be performed under direct supervision, on-site supervision, or off-site supervision, as those terms are defined in rule 4730-1-01 of the Administrative Code;
(6) The quality assurance process that will apply to the physician assistant in the performance of the special service;
(7) The minimum number of procedures per year the physician assistant will be required to perform in order to maintain authority to perform the service;
(8) If the service is a diagnostic procedure, whether a permanent visual record is maintained for the supervising physician's review and interpretation;
(9) A listing of all significant complications associated with the requested procedure and the processes in place to document and respond to those complications, should they occur;
(10) Any peer-reviewed articles on physician assistant or other ancillary personnel performance of the requested service and rate of complications, as applicable; and
(11) Any other information required by the board.
(C) The board may approve or deny a special services plan upon consideration of factors including, but not limited to, the following:
(1) Whether performance of the service will likely require complex observations or critical decision making during the performance of the service;
(2) Whether the potential complications that may occur if the service is not performed properly will likely include life threatening consequences or the danger of immediate and serious harm to the patient;
(3) Whether medical judgment requiring the exclusive expertise and training of a physician must ordinarily be exercised during the performance of the service;
(4) Whether the performance of the service is otherwise prohibited by statute or rule;
(5) Whether the supervision proposed is appropriate for the level of service to be performed;
(6) Whether the education and/or training proposed for the physician assistant will adequately and appropriately prepare the physician assistant to perform the service;
(7) Whether the service to be performed is within the routine scope of practice of the supervising physician;
(8) Whether, as proposed, performance of the service will not conform to the minimal standard of care of similar practitioners under the same or similar circumstances; and
(9) Whether the quality assurance system proposed presents sufficient opportunities for feedback to the physician assistant concerning the quality of the physician assistant's practice under the special services plan, including the frequency of performance of the special service to ensure competency.
(D) The approval of a special services plan may require the supervising physician to submit quarterly reports for one year following the date the service was approved by the board, including that the reports list the number of times each procedure was performed by the physician assistant and any complications that occurred