Attention! This is Huge!

[Guest Paula]

To Fellow PAs:  

 

I was involved in a telephone conference yesterday with AAPA/PAFT and we were informed of the legislation regarding the SGR, better known as the "doc fix."     I received more information from Tillie Fowler of the AAPA and am pasting the email she sent me.   

 

This will be historic legislation if it passes and in my opinion will make or break the  PA profession.  WE MUST ALL GET INVOLVED.  PAs must be included as equal providers and must attain equal status with the NPs.  Stay tuned to the next step and I will keep PA Forum members informed of the next call to action when it is due.  

 

In my mind we need to engage not just legislators but all state PA chapters, employers, PA constituent organizations, PAEA, NCCPA, etc. to advocate for these changes to be made into law.  We cannot rest on our laurels and have any mis-steps.

 

 

 

 

Paula,

Thanks for taking the time to talk to us on the phone yesterday. I look forward to meeting you in person at one of our upcoming events.

The legislation I mentioned on the call yesterday was the Sustainable Growth Rate legislation, better known as the "doc fix." Congress is attempting to pass a comprehensive bill that will fix the problem rather than doing an annual patch as has been the practice for the last ten years. The SGR bills were both just passed out of the House and Senate committees last week and will move to the floor of both chambers sometime in the first few months of next year. AAPA has been HEAVILY engaged in the development of the bills, as well as some of our amendments were included in the bills (see the below story from Medical Watch this morning for details). We engaged PAs in the states of the relevant senators and had them convey personal stories to their senators to help garner support. Once we find out early next year what the next steps are for the SGR legislation, we will put out a call to action to our members to ask for their support and for them to contact members of Congress to ask them to support these PA provisions. We know PAFT and our many members are the best advocates we have for the profession. Additionally, we will continue to work with other healthcare organizations with aligned interests and congress directly. Please let me know if you have any additional questions. 

Thanks. I look forward to working with you in the future.

Tillie


SGR Patch & Reform: PA Hospice Provision Added to Senate SGR Package at AAPA's Request

With a nearly 24% Medicare payment cut scheduled to take place January 1, Congress is poised to override the spending target determined by Medicare's Sustainable Growth Rate (SGR) formula and apply a 0.5% increase for payments to healthcare professionals through April 1, 2014. The three-month SGR patch was passed by the U.S. House of Representatives on December 12 as part of the budget agreement for federal discretionary spending levels for fiscal years 2014 and 2015. The U.S. Senate is expected to take up the budget agreement, along with the SGR patch, this week.

Meanwhile, both the House and Senate continue to move forward with bipartisan legislation to repeal the SGR and reform Medicare's payment system. The House Committee on Energy and Commerce was the first committee to pass legislation to repeal and replace the SGR in July. On December 12, the House Committee on Ways and Means and the Senate Finance Committee followed suit. All three bills repeal the SGR, replacing it with a payment system that moves away from fee-for-service and moves toward a new value-based performance (VBP) program and provides incentives to develop alternative payment models (APM), such as medical homes, accountable care organizations, bundled payments, and other Centers for Medicare and Medicaid innovation programs. Payment for fee-for-service would be frozen for 10 years with an increase of 1% in 2024. The VBP program would take into account quality, resource use, and clinical practice improvements and apply to payments for items and services furnished after January 1, 2017. The APM incentives would begin in 2016. PAs are treated in the same way as physicians and advanced practice nurses in the fee-for-service, VBP, and APM programs. Additionally, PAs, physicians, and advance practice nurses are eligible to provide chronic care management through the SGR reform bills. 
The Ways and Means Committee passed a SGR bill by a 39-0 vote, but did not allow any amendments to the bill. The Senate Finance Committee included several scheduled amendments into the "Chairman's Mark," the legislation to be considered by the Committee. Among those amendments included in the mark, and subsequently passed by the Committee, were --

*    an amendment sponsored by Senators Mike Enzi (R-WY) and Tom Carper (D-DE) to amend Medicare to allow PAs to provide and manage hospice care for Medicare beneficiaries
*    an amendment offered by Senators John Thune (SD),Michael Bennet (D-CO), Mike Enzi (R-WY), and Pat Roberts (R-KS) clarifying that general supervision by a physician or non-physician practitioner is allowed at critical access hospitals (CAHs) for payment of therapeutic hospital outpatient services, and that non-physician practitioners (PAs and advance practice nurses) may directly supervise cardiac and pulmonary rehabilitation services.

SGR reform has come a long way, but difficult hurdles remain. None of the committees that passed SGR legislation have included the cost offsets or "payfors" for enacting the reform. Once Congress returns in January, each body of Congress must determine the "payfors," which will be considered on the House and Senate floors when each SGR package is debated and voted upon. (Medicare extenders will also be considered during House floor action on SGR.) After the House and Senate have passed SGR legislation, differences must be reconciled through a House-Senate conference committee.

AAPA has engaged throughout the development of SGR proposals with the relevant congressional committees. Our overarching message has been straight forward - treat PAs in the same manner as physicians and NPs, whether it relates to new benefits or new quality measures - and modernize Medicare to reduce unnecessary barriers to the quality medical care provided by PAs. From our experience, any law that treats PAs differently than physicians or NPs, results in unintended consequences for PAs and the patients they serve. For patients, inequitable policy typically results in problems related to access to care and lack of continuity of care. For PAs, inequitable policy creates barriers to the utilization of PAs in the healthcare market. To date, all SGR proposals have embraced AAPA's overarching message, and the Senate Finance Committee has addressed two federal barriers to care provided by PAs. 

AAPA will continue to advocate for PAs in SGR repeal and reform, including retaining the PA Hospice and CAH provisions in the final legislation. Expect to hear from AAPA in the coming months as we ask you to add your voice as a PA to the continuation of this important public debate on Medicare payment reform.

-----Original Message-----

 

 

[ventana]

This is truly THE MOST IMPORTANT thing facing the PA profession right now

 

The time of dynamic change is NOW and every single PA needs to get involved and push for changes that benefit and preserve our profession

 

In one fell swoop of the pen (if PAs are included a full fledged providers) we will likely be able to update almost all federal legislation and therefore the states will likely follow suit

 

If we can become full fledged recognized, authorized providers of medical care across the specialties the regulations that follow the law will be forced to change and recognize the value of PA and the profession as a whole.  

 

If we fail at this (think not being listed in the incentive $$ for EHR - it is possible we fail) the PA profession will have to spend decades digging out the the hole we put ourselves in

 

 

I am not typically a doomsday type person, however if we are not included in laws and SGR fixes we stand the possibility of becoming obsolete.....

 

 

 

So I would suggest each and every PA or PA student or PA wanna be - or any family member of PA spend just a few minutes contacting their Federal Legislatures.  If we have 100,000 people calling in and emailing we should be heard

 

 

Also, AAPA and PAFT HAS TO GOT AFTER THIS WITH EVERYTHING THEY HAVE!

 

(Great job PAFT on getting out in front of this! - DRAG AAPA kicking and screaming into the next century!!)

[Soulfari]

I've always taken a back seat in politics, however, I'm about to matriculate into PA school next year so I feel the need to take action. 

 

What are the direct phone lines & email addresses of our 'Federal Legislature'? I live in Florida, but plan on moving to and practicing in California after school. 

[dmdpac]

I've always taken a back seat in politics, however, I'm about to matriculate into PA school next year so I feel the need to take action. 

 

What are the direct phone lines & email addresses of our 'Federal Legislature'? I live in Florida, but plan on moving to and practicing in California after school. 

 

 

Try this link to track down your congressional representatives.

[Soulfari]

Try this link to track down your congressional representatives.

Got it. Thanks!

[MedicinePower]

Dear Rep. Capuano,

 

Physician Assistants (PAs) play an ever increasingly important role in healthcare. Their educational requirements are on-par with physicians and the quality of care they provide is excellent. I strongly urge you to support any federal legislation which would help this noble profession advance. In particular the upcoming "Doc Fix" will be essential to accomplishing this goal. Please ensure that this legislation includes every advancement possible for PAs.

 

Sinerely,

 

bstone

 

[Guest Paula]

Thanks for writing your legislators.  Write now and you will all be asked to write again.  Ventana is correct in that this is a historic piece of legislation and PAs must be included as equals to NPs and Physicians and allowed to provide all aspects of care without restrictions, plus be reimbursed in the same way and at the same levels of reimbursement.

 

Stayed tuned.

[mashlee]

Thank you for posting this. I will spread the word!!!

[bobuddy]

I have contacted the PA group in KY and we will get the word out to everyone - thanks!

[ventana]

a few links to make sending comments easy

 

 

http://capwiz.com/aapa/home/

 

 

http://www.aapa.org/the_pa_profession/federal_and_state_advocacy.aspx

 

 

 

Spent 10 minutes once a week sending a few emails

 

 

if everyone on this site does this we will be heard!

 

 

 

for the next 3 months I would focus on the federal government as that is where the huge health care changes are taking place

 

 

 

 

 

 

 

as Nike says  "Just do IT!!"

[skyblu]

Done! I emailed my representative and both my senators. Thanks for bringing this issue to the forefront!

[Guest JMPA]

Is this in reference to the newly passed sgr 3 month "doc fix"?

[tariesen]

_{I contacted the congressman for Delaware as well as our 2 senators.}

[Guest Paula]

Yes.  PAs need to advocate for parity with NPs. 

[Deanj59]

For all interested, work on reforming the SGR can be followed here: http://energycommerce.house.gov/sgr

 

The senate legislation update can be found here: http://www.finance.senate.gov/legislation/details/?id=a275e061-5056-a032-5209-f4613a18da1b

 

You can also read the full text of the house bill at the first link as well.