April 2, 2014
I wanted to give a brief update of current happenings.
In February I attended the annual AAPA Leadership conference in Washington DC.This was an exciting conference given the pending "SGR Repeal and Medicare Provider Payment Modernization Act of 2014" (H.R. 4015, S. 2000) sitting on the steps of the House and Senate.This bill represents the first time that PAs have made it to a point where we could become authorized to order and provide Hospice services to our Medicare eligible patients.As discussed previously, through the hard work and efforts of our former senior Senator, Mr. Max Baucus and the Senate Finance Committee, Physician Assistants were included in provisions introduced into this bill.
At this time, the SGR has passed the House, however it became tied to a provision that extended the ACA's personal health insurance mandate for 5 years.The reasoning behind this appears to be in an effort to offset the cost in order to pay for the SGR Bill.As I read it, it looks as if by delaying the personal mandate, the federal government may save an estimated 170 billion dollars in individual subsidies associated with the ACA by enrolling fewer individuals and this savings could, in turn, offset the esitmated 168 billion dollar pricetag of the SGR.It looks like this bill has died in the Senate at this time and another "Doc Fix" will be put in place for the next year.We have seen also with this temporary patch, the delay of the implementation of ICD-10 as well for another year.We should all encourage our elected leaders to move the SGR bill forward for next year with the provisions for Physician Assistants left intact.In addition to the Hospice issue, the other provision allows for PAs to order and supervise both Cardiac and Pulmonary Rehabilitation in Critical Access Hospitals (CAHs).As well all know inMontana, and other rural states across the nation, both of these provisions for PAs are very important.
During my visit to Washington, I had the opportunity to visit Capitol Hill once again (this is my 3rd trip to Capitol Hill as the President of MTAPA) and visit with staffers of our three elected officals.I must say that it is quite an honor to represent Montana in our nations capitol!Due to the timing of this visit, and the fact that the SGR was in the immediate picture, this was the primary issue at hand this year.There were other talking points discussed as well and I would like to highlight the AAPA's top 3 Legislative Issues:
1. Eliminating unnecessary federal barriers to care provided by PAs (e.g., allowing PAs to serve Medicare hospice patients, order home health services, and diagnose and treat inured employees under the federal workers' compensation program
2. Integrate PAs into all federal programs to promote growth in the healthcare workforce (e.g., by providing strong funcding for PA education through Public Health Services Act Title VII Health professions Program and opportunities to expand support for PA education through Medicare GME)
3. Promoting recognition, transparency, and accountability of medical care provided by PAs (e.g., updating Medicare's payment system to corrospond to that of all other healthcare providers under Medicare (Sustainable Growth Rate, promoting pay equity for PAs employed by the federal government and enrolling PAs in Medicaid).
The AAPA expressed its excitement in the overall picture facing PAs.Through ongoing efforts and discussions with those on Capital Hill, it appears more and more that people are becoming increasingly educated on what exactly a Physican Assistant is.They feel that we no longer have to spend our precious time speaking to those policy makers about what exactly it is that we are and can do!This is great.The word is out and it is increasingly understood and known what exactly a PAs is.That being said, we still have hurdles to cross as we move forward.I would challange each and every one of you throughout the state to become more active and involved in these policies that ultimately effect our ability to practice medicine.It is only through action that we continue to move forward!
Yours in good health,
Will Hunt, PA-C