Moderator ventana Posted May 7, 2015 Moderator Share Posted May 7, 2015 have a power wheel chair order, wondering if anyone has had luck with getting these through with out the doc signature with the new law. Link to comment Share on other sites More sharing options...
Guest Paula Posted May 7, 2015 Share Posted May 7, 2015 I ordered oxygen today, no co-signature was asked for by the company. They in fact called back because they were so ecstatic that I documented the face to face visit the right way, used the right words and documented the O2 sats correctly. I'm waiting for a box of thank you chocolates. I ordered something else, can't remember what it was now....maybe was a cane??? No co-sig asked for. Link to comment Share on other sites More sharing options...
SoCalPA Posted May 7, 2015 Share Posted May 7, 2015 This is a step in the right direction. What else changed with the new law? Where can I find info? Link to comment Share on other sites More sharing options...
LKPAC Posted May 8, 2015 Share Posted May 8, 2015 Has this been implemented already? Excuse my ignorance, but there is usually a delay between passage and rule-writing, then implementation. I don't want to pick an argument with medical supply company and find out I was wrong. Thanks! Link to comment Share on other sites More sharing options...
LKPAC Posted May 8, 2015 Share Posted May 8, 2015 https://www.aapa.org/twocolumn.aspx?id=2147485242 Link to comment Share on other sites More sharing options...
Guest Paula Posted May 9, 2015 Share Posted May 9, 2015 I got the final paper work back on my 02 order that needed my original signature. I did not have the physician co-sign so it will be interesting to see if it is back on my desk Monday morning. I did not think about a delay with implementation. I really wish when these things get passed that someone would give us these type of details! Link to comment Share on other sites More sharing options...
winterallsummer Posted May 13, 2015 Share Posted May 13, 2015 Have ordered home O2 solo without issue. Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 14, 2015 Author Moderator Share Posted May 14, 2015 as hx we used to be able to order then a few years ago congress said it had to be a Doc - trying to fight fraud but overlooked us now they changed it to PA.NP.MD.DO Law trumps regulation so it should have taken effect immediately upon signing unless there was roll out time frames in the law I just got a request for a power chair that I signed and returned, will see if it gets kicked back WE MUST ADVOCATE TO GET THE ABILITY TO ORDER VNA AND HOSPICE CONTACT YOUR REP'S TO GET THE PASSED SEE AAPA POLITICAL ACTION PAGE FOR THE EASY WAY TO DO IT Link to comment Share on other sites More sharing options...
LKPAC Posted May 14, 2015 Share Posted May 14, 2015 Law trumps regulation so it should have taken effect immediately upon signing unless there was roll out time frames in the law This is the kind of thing that AAPA should be telling us directly! Where's my email on the subject? I get other emails from them. This is important to those of us on the front lines in the practice of medicine. Link to comment Share on other sites More sharing options...
RURALMED Posted May 20, 2015 Share Posted May 20, 2015 Were there any changes to the ordering of home health for medicare beneficiaries by PA's and NP's? My friend is an RN for one of the largest home health services in Washington state and has told me all about the ridiculous loopholes when a PA/NP orders home health. For example, they can take a verbal order from a PA/NP for home health, but if the provider sends a written order it must be signed by the attending physician. Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 20, 2015 Author Moderator Share Posted May 20, 2015 No law changes on the home care or hospice, BUT AND this is a big BUT There is once again a bill before congress in both the house and senate that is designed to add PA and NP to those that can order. It has wide support, is gaining co-sponsors every few days but YOU ALL NEED THE WRITE/CALL/CONTACT YOU REPRESENTATIVES IN DC! AAPA has made this VERY easy to at least send a form email - which honestly does close to nothing..... but better then nothing.... http://capwiz.com/aapa/home/ is all you have to do BUT even better, take 15-20 min and call into you congress people and ask to speak to their specialist on health care and just explain to them that you would like them to support these bills hospice http://capwiz.com/aapa/issues/alert/?alertid=64205611 VNA http://capwiz.com/aapa/issues/alert/?alertid=64206866 more links on one page http://capwiz.com/aapa/issues/?style=D Even if you never order VNA or hospice, make a call for your fellow PAs that are being held back by senseless outdated regulations...... Link to comment Share on other sites More sharing options...
RURALMED Posted May 20, 2015 Share Posted May 20, 2015 I'm on it because even though I am just finishing up my didactic year, this will be a major obstacle in practicing rural medicine. Thanks for the info! Link to comment Share on other sites More sharing options...
Moderator ventana Posted June 15, 2015 Author Moderator Share Posted June 15, 2015 UPDATE So had my first order for a patient after this law passed Guess What Pharmacy denied based on no co-sign by a doc !!! I have previously spoken with and explained to them the new law....... They stated that since they enacted a system to comply with the old law, even though enforcement was suspended!, that the new law did not apply to them as they have to wait for it to be enacted!!! WHAT I have already spoken to both of my senator's offices, and am reaching out here to ask if anyone else has experienced this? This is just stupid and insulting and a classic example of the stupidity in business! Link to comment Share on other sites More sharing options...
Moderator ventana Posted June 15, 2015 Author Moderator Share Posted June 15, 2015 this is the actual law SEC. 504. MODIFYING MEDICARE DURABLE MEDICAL EQUIPMENT FACE-TO-FACE ENCOUNTER DOCUMENTATION REQUIREMENT. (a) IN GENERAL.—Section 1834(a)(11)(B)(ii) of the Social Security Act (42 U.S.C. 1395m(a)(11)(B)(ii)) is amended— (1) by striking ‘‘the physician documenting that’’; and (2) by striking ‘‘has had a face-to-face encounter’’ and inserting ‘‘documenting such physician, physician assistant, practitioner, or specialist has had a face-to -face encounter’’. (b) IMPLEMENTATION.—Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the amendments made by sub-section (a) by program instruction or otherwise. full law https://www.congress.gov/114/bills/hr2/BILLS-114hr2ih.pdf see page 223 for the above paragraph As the only way to reach the Sec that I could find was twitter I have posted a few tweets to her account at @SecBurwell to see if they get to her We all should reach out to the her this is her home page http://www.hhs.gov/about/leadership/secretary/index.html does anyone have any other contact info?? They are hiding behind that (b) Oh this is such an enormous stupid waste Link to comment Share on other sites More sharing options...
FfIghter23 Posted June 16, 2015 Share Posted June 16, 2015 The (b). Seriously? How do politicians sleep at night? Link to comment Share on other sites More sharing options...
Moderator ventana Posted June 16, 2015 Author Moderator Share Posted June 16, 2015 The (b). Seriously? How do politicians sleep at night? I meant the paragraph (b) no hidden meaning intended Link to comment Share on other sites More sharing options...
Guest Paula Posted June 16, 2015 Share Posted June 16, 2015 My orders for oxygen and a wheelchair have been returned for doc co-signatures too. The Home Medical Supply agency told me that they couldn't implement the new law until CMS updated their manual. They check every Monday as apparently that is the date that updates are done. The Home Medical supply company was thrilled with the new law and are frustrated as the PAs and NPs in my group. This is the time for AAPA to step in and make a difference and they need to talk to SecBurwell asap. It sounds like it is in her court. Link to comment Share on other sites More sharing options...
Guest Paula Posted June 16, 2015 Share Posted June 16, 2015 I checked out Sec Burwell's page. I found a section where one could make comments on rules and regulations that need to be updated. I made a comment on designating PAs as LIPs. It's a different issue but I decided to take the opportunity. More PAs should do the same! Link to comment Share on other sites More sharing options...
LAUNCHBRICK Posted October 9, 2015 Share Posted October 9, 2015 Any updates with this? Link to comment Share on other sites More sharing options...
Hemmingway Posted October 9, 2015 Share Posted October 9, 2015 No law changes on the home care or hospice, BUT AND this is a big BUT There is once again a bill before congress in both the house and senate that is designed to add PA and NP to those that can order. It has wide support, is gaining co-sponsors every few days but YOU ALL NEED THE WRITE/CALL/CONTACT YOU REPRESENTATIVES IN DC! AAPA has made this VERY easy to at least send a form email - which honestly does close to nothing..... but better then nothing.... http://capwiz.com/aapa/home/ is all you have to do BUT even better, take 15-20 min and call into you congress people and ask to speak to their specialist on health care and just explain to them that you would like them to support these bills hospice http://capwiz.com/aapa/issues/alert/?alertid=64205611 VNA http://capwiz.com/aapa/issues/alert/?alertid=64206866 more links on one page http://capwiz.com/aapa/issues/?style=D Even if you never order VNA or hospice, make a call for your fellow PAs that are being held back by senseless outdated regulations...... Message sent and shared with my colleagues! Our clinics are scattered out over a wide area and we have 1 doc for all of us. The paperwork burden and delay in care getting co signatures is significant for us. Link to comment Share on other sites More sharing options...
loliz Posted October 9, 2015 Share Posted October 9, 2015 I've signed orders for walkers, wheelchairs and home oxygen without any issues. The first time I saw the paperwork from the social worker another PA that has been in practice longer said- "you can't sign that." I said, "yes I can! New rules!!" Signed it, we laughed and it never came back. And the social worker, who is awesome, agreed that my signature was enough. Our forms have been edited to say "provider" instead of MD/DO. Link to comment Share on other sites More sharing options...
Guest Paula Posted October 10, 2015 Share Posted October 10, 2015 My signature still isn't recognized for DME. Apparently the law still has not been implemented. Very frustrated. Link to comment Share on other sites More sharing options...
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