Legislation that removes the requirement for a PA to be supervised by a physician to practice medicine was signed into law in Iowa by Governor Kim Reynolds on May 10, 2023. The bill (HF 424) is being touted as essential to solving the significant health care workforce shortage in Iowa.

More than 1300 licensed PAs practice medicine in Iowa and half (53.4%) practice in rural areas of the state. With the signing of the bill, Iowa becomes the sixth state to remove the supervision requirement for a PA to have a specific relationship with a physician or other health care provider, joining Arizona, Montana, North Dakota, Utah, and Wyoming.

“Passage of HF 424 not only makes Iowa one of the best states in the nation for PAs to practice, but it expands access to care in the state’s rural and underserved communities,” said Iowa Physician Assistant Society (IPAS) President Samantha Sparrow, PA.

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“This bill moves Iowa away from old and burdensome regulations toward a modernized and flexible approach to health care that will benefit PAs, their employers, and the patients they serve,” Sparrow said.

“Addressing health care provider shortages, an ongoing problem in rural areas, is one of the primary reasons driving the PA profession’s efforts to modernize PA practice laws,” said American Academy of PAs (AAPA) President and Chair of the Board Jennifer M. Orozco, DMSc, PA-C, DFAAPA. “Peeling away unnecessary red tape will empower PAs and expand access to care for so many patients being left behind. I am excited to see what Iowa PAs will be able to do for their communities in an updated practice environment that allows them to practice to the full extent of their education, training, and experience.”

More PA Legislative News

The Texas House of Representatives passed legislation to enact the PA Licensure Compact.  The bill (HB 2544) will head to the Senate Health and Human Services Committee. The compact will become effective once 7 states adopt the compact language through similar legislation.

Colorado signed into law SB 083, legislation that will update state law to allow most PAs to practice collaboratively with a physician rather than to practice under a supervisory agreement. The bill takes effect later this summer.


Iowa Governor Signs PA Practice Modernization Bill Into Law. News release. May 11, 2023. American Academy of PAs. Accessed May 11, 2023. https://www.aapa.org/news-central/2023/05/iowa-governor-signs-pa-practice-modernization-bill-into-law/

PA licensure compact bill passes Texas House of Representatives. News release. May 2, 2023. American Academy of PAs. Accessed May 11, 2023. https://www.aapa.org/news-central/2023/05/pa-licensure-compact-bill-passes-texas-house-of-representatives/

Modernization of Colorado PA Practice Act a Significant Win for Patients. April 27, 2023. American Academy of PAs. Accessed April 27, 2023. https://www.aapa.org/news-central/2023/04/modernization-of-colorado-pa-practice-act-a-significant-win-for-patients/