Georgia Medical Board Issues Position Statement on Use of Third-Party Staffing Entities for the Nurse Practitioner/Physician Assistant – Physician Relationship

Our healthcare and business law firm advises many physicians, advanced practice registered nurses (APRNs), physician assistants (PAs), and medical practices on Georgia regulatory compliance. On May 7, 2026, the Georgia Composite Medical Board (“GCMB”) issued its IV Hydration/Therapy Position Statement, that was emailed on May 19, 2026 addressing many important areas, including: the delegating physician role in APRN practice, whether an APRN or APRN-owned entity may employ the delegating physician, critically, whether a third-party company changes that analysis, and the PA–supervising physician relationship. If you would like to discuss this position statement or its implications for your practice, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

(1) The APRN–Delegating Physician Relationship

The position statement reaffirms Georgia’s nurse protocol framework under O.C.G.A. § 43-34-25 and Ga. Comp. R. & Regs. 360-32-.04 and 360-32-.05. A physician may delegate to an APRN only where the physician’s specialty area is comparable to the APRN’s specialty—meaning services the physician regularly provides in his or her own practice—and the parties maintain a compliant nurse protocol agreement. The delegating physician must conduct direct onsite observation at least annually, perform quarterly medical-record reviews, and retains ultimate responsibility for ensuring delegated acts are clinically appropriate, properly supervised, and adequately documented.

(2) Compensation Prohibition: APRN Employment of the Delegating Physician

Georgia law prohibits a physician from being employed by an APRN—alone or in combination with others—when that physician is required to supervise the employing APRN, with limited exceptions for certain institutional settings. The Board states that it interprets this prohibition broadly, extending it beyond W-2 or 1099 classifications to any compensation—monetary or non-monetary—paid by an APRN or APRN-owned entity to a physician in exchange for serving in the delegating role. How this broad interpretation applies to various indirect compensation and entity-ownership structures raises questions the position statement does not fully resolve. O.C.G.A. § 43-34-25(n); Ga. Comp. R. & Regs. 360-32-.04(5)

(3) CRITICAL CLARIFICATION: Third-Party Matching and Staffing Platforms

The position statement addresses use of third-party companies—such as platforms marketed as “Collaborating MD’s/DO’s,” “APRNMatch,” or “NP Collaborator”—to obtain a delegating physician. The Board states it will evaluate these arrangements based on substance rather than form: if an APRN is paying a third-party company for access to a delegating physician, and that physician is compensated through the arrangement to supervise the APRN, the Board views the arrangement as prohibited regardless of the intermediary structure. The involvement of a matching, staffing, or contracting company does not cure the prohibition if the practical result is that the APRN—directly or indirectly—is paying for the delegating physician relationship. How this standard applies to employer-paid or practice-level physician compensation arrangements involves factual questions the statement does not fully address.

(4) The PA–Supervising Physician Relationship and Public Disclosure

Georgia PAs must have a Board-approved supervising physician and a Board-approved job description. The prohibition on a physician being employed by the PA he or she supervises mirrors the APRN framework, with a narrow grandfather exception for arrangements approved before July 1, 2009.

The position statement also requires all licensees—APRNs and PAs—to clearly post the identity of the delegating or supervising physician and contact information in a manner accessible to the public without restriction.

If you would like to discuss how the Georgia Medical Board’s position statement applies to your practice structure, provider agreements, or compliance program, or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

 

 

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