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CMS proposing PAs be recognized as attending physicians


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Just came across this article which states that CMS will be proposing that PAs be recognized as attending physicians (apparently NPs already are, go figure).

"The proposed rule also includes regulatory language to reflect changes that were made in the Bipartisan Budget Act of 2018, which recognized physician assistants as attending physicians for Medicare hospice beneficiaries."

https://homehealthcarenews.com/2018/04/cms-proposes-340-million-increase-in-hospice-payments-for-2019/

You can scroll down on this link to find the actual proposal by CMS. 

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Washington State L&I did change their language, "AP" now means "attending PROVIDER" and can include NPs as well.

Yes, every primary care provider, everywhere, should be trained to deliver, and be reimbursed for, hospice care.  Helping people navigate end of life choices is a profoundly important part of what we do.

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Considering the amount of money is spent on futile care in this country, every single provider regardless of specialty, from pediatrics to geriatrics to neurosurgery should be trained and reimbursed for this service.  It's better for the bottom line and more importantly, its best for the patients. So more people can have an appropriate and dignified death. 

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1 minute ago, lkth487 said:

Considering the amount of money is spent on futile care in this country, every single provider regardless of specialty, from pediatrics to geriatrics to neurosurgery should be trained and reimbursed for this service.  It's better for the bottom line and more importantly, its best for the patients. So more people can have an appropriate and dignified death. 

I tend to agree with you, but I didn't want to make a statement outside my own experience, which has been in FM/Occ Med/Sleep/UC.

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It shouldn't be that hard to translate to Primary Care in general. 

At the VA - I have my own panel of patients - absolutely NO difference from a doc - same size panel - with the same complex issues, same responsibilities and same measures.  

I have a huge amount of autonomy and rarely if ever see the doc on my license. 

No one cosigns my charts.

It is time to adapt - we are PCPs - hospice, IM, Family Practice and we do the same jobs in ER, UC and Peds.

OTP makes sense - for everyone.

 

 

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Another article came out today. Now, CMS is considering reducing face-face physician time with rehabilitation patients and expanding the role of both NPs and PAs instead. CMS is reaching out to stakeholder and asking them these questions: 

"Officials are asking stakeholders whether they should allow non-physicians, such as NPs and PAs, to fulfill some of the requirements currently being imposed exclusively on physicians. To this end, the CMS proposal includes four specific questions:

  1. Do non-physician practitioners have the specialized training in rehabilitation that they need to have to assess IRF patients both medically and functionally?
     
  2. How would the non-physician practitioner’s credentials be documented and monitored to ensure that IRF patients are receiving high quality care?
     
  3. Are non-physician practitioners required to do rotations in inpatient rehabilitation facilities as part of their training, or could this be added to their training programs in the future?
     
  4. Do stakeholders believe that utilizing non-physician practitioners to fulfill some of the requirements that are currently required to be completed by a rehabilitation physician would have an impact of the quality of care for IRF patients?"

http://www.healthleadersmedia.com/quality/should-cms-expand-use-nps-pas-inpatient-rehab#

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6 hours ago, surgblumm said:

A long overdue proposition. We need this status in the VA and through all insurance carriers. Someday it will happen.

I agree, I think the AAPA and other PA organizations should be advocating for the same practice rights as NPs within the VA; that would be a great precedent for OTP when introducing legislation at the state level. 

 

Also, there is a bill in congress right now (H.R. 5506) to allow PAs to receive direct payment from Medicare, and we should all be writing or calling our representatives asking them to support this bill, as it's a huge step for the PA profession. https://www.aapa.org/news-central/2018/04/legislation-introduced-authorize-direct-pay-pas-medicare/  

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