Physician assistants still can’t practice without consulting. But some won’t need doctor sign-off.

The New Hampshire Medical Society opposed the bill, saying it stripped away guardrails. (Getty Images)

Come Jan. 1, the state’s nearly 1,340 physician assistants, the provider many patients see, will no longer have to have a signed “collaboration agreement” with a physician for their entire career. The sponsors of House Bill 1222 , which Gov. Chris Sununu signed Friday, said complaints from physician assistants prompted the legislation.

Some said they are being charged $1,000 a month for a collaboration agreement they don’t believe changes how they practice. Others said this year that they’ve lost jobs when new physicians arrive at their practice and refuse to sign agreements.

The agreements specify how a physician assistant will work with their physician and identify the scope of their practice, based on their education, training, and experience. It must state that the physician shall be available for consults in person, by phone, or by email whenever they are practicing.

The New Hampshire Medical Society opposed the bill, saying it stripped away guardrails defining a physician assistant’s scope of practice and identifying each party’s responsibilities.

Under the bill signed Friday, collaboration agreements will be required only for physician assistants who have fewer than 8,000 hours of post-graduate clinical experience whose office or health care system does not include at least one physician doing similar work.

Those with more than 8,000 hours whose practice does not include a physician working in their field of medicine will be able to seek a waiver to work without a written agreement.

The legislation, which takes effect Jan. 1, still requires physician assistants to consult with physicians or appropriate team members and prohibits them from practicing medicine if a physician or team member is not available for consultation.