Committee hears testimony on expanding physician‑associate practice authority; PAs cite cost and access barriers, board urges data collection

Representative Michelle Boyer introduced LD 2088, saying Maine faces a health workforce shortage and the bill would update PA law by removing a practice‑agreement requirement in narrowly defined settings while preserving collaboration and a 4,000‑hour supervised period for new graduates.

Multiple physician associates and organizations testified in support. Elizabeth Getchell, a physician associate practicing cardiology, said the requirement adds approximately "$800 per month in fixed overhead solely to satisfy a regulatory requirement" and that those funds could be used to expand access to care. Kathleen Monaghan (president, Maine Academy of Physician Associates) and others argued the existing practice‑agreement mechanism has become a costly paperwork obstacle in many cases, sometimes supplied by private firms rather than an authentic clinical collaborator.

Supporters described clinical examples from rural Maine where PAs provide continuity of care when physicians retire or clinics close. David Wade (founder, Pine Tree Urgent Care) and others told the panel that practice agreements commonly range $750–$1,250 per PA per month and that the requirement can make startup clinics financially unviable.

The Board of Licensure in Medicine (Tim Terranova) testified neither for nor against LD 2088, noting that implementation of LD 1660 (2020) led the Board to approve 55 practice agreements since 2021 and that there have been no quality‑of‑care complaints tied to those agreements. Terranova urged the committee to consider reporting requirements so the state can assess the effect of further deregulation on access and patient safety.

Committee members asked for additional information for the work session, including: how many PAs practice in rural versus urban areas under current practice agreements, whether malpractice or complaint rates changed after prior reform, reimbursement and credentialing differences between independent practice and employed settings, and whether PAs actually move into underserved communities after regulatory changes.

What’s next: The committee closed the hearing and asked stakeholders and the Board for data and geography‑tagged practice information to inform amendments and any legislative action.