09/25/2026

HB 963 Spotlight: Removing the 500-Hour Prescribing Requirement

Ohio House Bill 963 seeks to align state law with modern PA education and practice, for the benefit of Ohio patients and healthcare teams alike.

This article is part of a series focusing on the 14 actions within HB 963 that modernize PA practice in Ohio.

Action:

Remove the requirement for 500 hours of direct, on-site physician prescribing supervision for new PA licensees.

Rationale:

This requirement is a remnant from when PAs were subject to a prescribing formulary. It hinders hiring PAs, especially in rural areas with physician shortages and in psychiatric roles relying on telehealth delivery models. PAs are well-trained in pharmacology and clinical care. Removing this barrier would help health systems address critical gaps in patient care. Physicians remain accessible via telecommunication as needed.

Before a newly licensed Ohio PA can prescribe, they must first complete 500 hours of direct, on-site physician supervision. This law is holdover from an era when PA prescribing was governed by a restrictive formulary that no longer exists. And for patients in rural Ohio, this outdated requirement can mean the difference between getting timely care close to home, or going without a provider altogether.

Modern PAs complete rigorous, graduate-level pharmacology training as part of their education, long before they ever see their first patient. They pass a national board certification exam, obtain state licensure, and aquire credentialing through their employer to practice. PAs are prepared to prescribe, and by the nature of their relationship with physicians, are always able to consult on prescribing decisions even when the physician is not on-site.

Ohio PA educator, Dr. Karen Graham-Burnet, PhD, PA-C, DFAAPA, understands the impact that this outdated requirement has on healthcare employment for new PA graduates.

"Some PA students feel a calling to work in Ohio's rural and underserved communities upon graduation. The requirement for 500 hours of on-site supervision during the initial licensure period is difficult for clinics in these areas to support, given their personnel limitations. This puts new PAs at a disadvantage in hiring considerations, and creates an unnecessary barrier between patient care and qualified professionals who want to serve where they are needed most."

Michael Vallas, who works in healthcare operations, has run into this issue many times in attempting to hire PAs into his organization.

"The 500 hour prescriptive oversight is a challenge when the supervising physician must be physically on-site with the PA, rather than just available. With an integrated EMR, the physician can review the assessment and discuss the patient telephonically if needed, rather than having to be available in person. In modern practice, there is no need for this requirement, which actively limits the recruitment and hiring of newly licensed PAs in Ohio and the delivery of efficient patient care, especially in primary care settings."

The 500 hours of on-site supervision requirement creates unnecessary challenges, especially in behavioral health, telemedicine, and rural or multi-site practices, where flexibility is essential. Removing the requirement doesn't remove the relationship a PA has with a physician. It simply modernizes how that collaboration happens, allowing physicians to remain accessible via telecommunication while giving health systems the flexibility to place PAs where patients need them most.

Learn more about this and other aspects of House Bill 963, and how you can advocate for PA practice advancement, today.