This bill makes broad statutory changes that rename the licensed profession now called "physician assistant" to "physician associate" across many Washington laws, rules, contracts, billing, and administrative materials, and it creates and amends licensing and practice rules for physician associates. It modifies existing law to require the Washington Medical Commission to adopt or amend rules on qualifications, education, training, practice limits, collaboration agreements, licensure application processes, fees, and renewals; it establishes supervision and postgraduate-hour thresholds (for example, under 4,000 postgraduate clinical hours requires supervision, 4,000 or more permits collaboration with specified supervised specialty-hour requirements, and separate provisions for 10 years/20,000 hours in a specialty and rural/HRSA underserved exceptions). Collaboration agreements must be written, may be signed electronically, be available at the primary practice site, include communication and termination protocols (generally 30 days’ written notice, with immediate termination allowed for good-faith concerns), and the chapter subjects physician associates to discipline under the Uniform Disciplinary Act. The bill also creates or amends procedural and fiscal obligations: state agencies, health plans, carriers, and managed care organizations must revise materials to reflect the title change and may use both terms interchangeably during the transition; an interim permit may be issued for one year; applicants must complete accredited training and pass a commission‑approved exam; a $70 per‑year surcharge is added to each physician, surgeon, and physician associate license issuance or renewal to fund participation in a physician health program, with impaired-physician-account funds to be paid to the contracted program entity within sixty days of deposit. The commission has deadlines and duties related to opioid-prescribing rules and patient notification of the right to refuse opioids, and physician associates practicing under older practice agreements must transition to collaboration agreements by the license renewal date or July 1, 2025, whichever is later. Beyond the licensure and naming changes, the bill amends many other statutes to reflect the physician associate title and to change procedures, definitions, or duties across state law. These include updates to workers’ compensation provider networks, hospital privileging and reporting, who may withdraw blood for law enforcement testing and immunities for providers and labs acting under warrants or exigent circumstances (with civil liability still possible for improper procedures), telehealth and health care practitioner definitions, midwifery and nursing delegation rules, public employee insurance coverage mandates (prostate and mammography screening), suicide training requirements for many health professions, cannabis program definitions and designated‑provider rules, firearm and controlled‑substance definitions and penalties, criminal justice diversion encouragement for some possession/use violations, and procedural rules for local boards of health. Many listed sections and details are truncated or not included in the extracted material, so some cross‑references, exact effective dates, complete penalty changes, and certain implementation details are uncertain from the provided text.

If enacted, the bill mainly renames "physician assistant" to "physician associate" across state law and requires state agencies, insurers, health plans, and managed care organizations to update their rules and materials and to accept either term during a transition. It also directs the Washington Medical Commission and the Department of Health to adopt or amend detailed rules on licensure, required education and exams, collaboration agreements, supervision thresholds tied to postgraduate hours (for example, under 4,000 hours requires supervision; 4,000 or more allows greater collaboration with specialty-hour requirements), and opioid-prescribing and practice limits. Practically, physician associates and the physicians or employers who collaborate with them will face clearer written agreement rules, mandatory verification steps before practice, and a deadline for converting older practice agreements to the new collaboration agreements by the license renewal date or July 1, 2025, whichever is later. The bill creates a physician health program funded by a new $70 yearly surcharge on each affected license issuance or renewal, with those receipts held in an impaired physician account and paid to the contracted program entity within 60 days; the secretary of health controls expenditures. Most affected are physician associates (who will pay the surcharge and must meet new collaboration and reporting requirements), participating physicians and employers (who must enter and manage written collaboration agreements and verify credentials), the Medical Commission and Department of Health (which must write many new rules and model agreements), and insurers/health plans (which must update materials and billing/credentialing language). Some details and exact timelines for many cross‑statutory edits and agency implementation steps are not fully shown in the extracted text, so the timing and administrative burden for affected parties remain partly uncertain.