Hawaii Governor David Ige signed the SB 1406 bill on July 2, 2019, which repealed the state’s outdated requirement for 100% chart review by a physician and included other changes to physician assistant (PA) laws currently in place in Hawaii.

“Repealing 100% chart review for all PAs within seven days is a huge administrative burden that we’re happy to finally have removed from our state laws,” said Christina Starks, PA-C, president of the Hawaii Academy of PAs (HAPA).

Additional changes implemented in the legislation include allowing chart review to be determined at the practice level for PAs with >1 year of experience. For PAs with <1 year of experience, 50% chart review should be conducted for the first six months and 25% for the second six months. A “group of physicians” are among the individuals who may establish a work relationship with a PA.

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Although the 100% chart review requirement was repealed, the requirement for 100% chart co-signature for all controlled substance prescriptions remains in effect under the Uniform Controlled Substances Act of Hawaii.

The bill went into effect on July 1, 2019.


Hawaii PAs Obtain Improvements in PA State Laws. Alexandria, VA: American Academy of Physician Assistants (AAPA) News Center; July 11, 2019. https://www.aapa.org/news-central/2019/07/hawaii-pas-obtain-improvements-in-pa-state-laws/. Accessed July 16, 2019.