Delaware Passes Physician Assistant/Associate Independent Practice Law
On May 12, 2026, Delaware signed House Bill No. 325 (HB325) into law, which grants physician assistants (now called “physician associates” (PAs) to reflect their increased autonomy) the ability to practice independently (i.e., without a physician collaborative agreement), provided that they meet certain eligibility criteria. This legislation is intended to expand practice opportunities for PAs in Delaware as well as increase access to health care for Delaware residents.
To qualify for independent practice, a PA must be licensed in Delaware and have completed at least 6,000 hours of post-graduate clinical practice. Qualifying PAs must apply to the Regulatory Council for Physician Associates (Council) to obtain independent practice authority. Once independent practice authority is granted by the Council, the PA will no longer be required to have a collaborative agreement with a Delaware-licensed physician to practice to the fullest extent of their licensure, education and training. However, the new law clarifies that, even with independent practice authority, the PA is still required to “collaborate with, consult with, and refer to the appropriate member of the healthcare team as indicated by the patient’s condition, and the education, experience, and competencies of the [PA].”
HB325 also takes measures to ensure that PAs are authorized to bill and collect for the medically necessary services they provide by requiring that: (1) the PA “be identified as the rendering professional in the billing and claims process when the physician associate delivers medical or surgical services to patients”; and (2) payers not impose any requirement or condition on PA reimbursement or eligibility that is more restrictive than the new law and forthcoming regulations. The foregoing limits establish that independently practicing PAs are treated as such by insurance companies, managed care organizations and other payers.
This new PA practice regime will take effect upon the issuance of regulations and accompanying forms by the Council (as are approved by the Board of Medical Licensure and Discipline), or May 12, 2027, whichever is earlier.
While we are still waiting on the specific application forms, definitions and procedures, HB325 makes it clear that the application and reporting requirements will be slightly different depending on whether the PA’s practice, group or health system includes at least one Delaware-licensed physician. If the practice includes a physician, the application form will require, at a minimum, the PA’s name, license number, physical practice location, mailing address, phone number, primary area of medical practice and proof of 6,000 post-graduate clinical practice hours. If the practice does not include a physician, then the PA will need to supply “proof that the [PA] has had training which aligns to the [PA’s] practice areas” as part of the independent practice application (and such PAs will also need to provide prior notice to the Council of any change in the PA’s practice area, accompanied by proof of the requisite training in that area).
By removing the administrative burden of formal collaboration arrangements for experienced PAs, Delaware aims to keep clinics open, reduce patient wait times and strengthen its overall medical workforce. We will continue to monitor the Council as it finalizes the rules, regulations and forms over the coming months and will provide updates as soon as available.
