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Bill proposal to allow NPs--AND PAs--independent practice


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Guest Paula

@corpsman89:  OTP.  WI has tried its best to get all parts of OTP.  Still working out details.  The Hospital Association has lots of power and we are in the process of getting our last discussion with them.  It's been a battle.  3 years in to the legislation process  and are on draft #10 which should be the final one.  They didn't like collaboration.....they wanted cooperative agreement (meaning the PA WILL COOPERATE) with them and  requested that our legislation be written such that we are supervised, physicians totally responsible for the care of the patient and that they must be available immediately to the PA.  (They want us to codify CMS language in our legislation....ahhh...NO!)  We  did not bend to that request and had to hire a special health care attorney to come to our defense. 

Disclaimer: My personal view is that PAs should be independent and has been my view since the beginning of my career in 2004. 

We seem to have support from all the legislators we have  been meeting with since June 2018. They all get the common sense OTP points.  So, PA FORUM colleagues:  Wish us well, pray for us, send us positive thoughts, and help us get to the finish line. 

 

Thanks!!!

 

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2 minutes ago, Paula said:

 

Disclaimer: My personal view is that PAs should be independent and has been my view since the beginning of my career in 2004. 

We seem to have support from all the legislators we have  been meeting with since June 2018. They all get the common sense OTP points.  So, PA FORUM colleagues:  Wish us well, pray for us, send us positive thoughts, and help us get to the finish line. 

 

Thanks!!!

 

AWESOME!!!  GOOD LUCK, we will push and support your endeavors

We don't want our livelihood depend on some EVIL-MINDED physicians that want to bully us (I say about 60% feel that way)

We should be indepdendent. I agree. If physicians are on board, they should lead the team. but that should not be mandatory. Let each clinic or practice decide. 

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@corpsman89:  OTP.  WI has tried its best to get all parts of OTP.  Still working out details.  The Hospital Association has lots of power and we are in the process of getting our last discussion with them.  It's been a battle.  3 years in to the legislation process  and are on draft #10 which should be the final one.  They didn't like collaboration.....they wanted cooperative agreement (meaning the PA WILL COOPERATE) with them and  requested that our legislation be written such that we are supervised, physicians totally responsible for the care of the patient and that they must be available immediately to the PA.  (They want us to codify CMS language in our legislation....ahhh...NO!)  We  did not bend to that request and had to hire a special health care attorney to come to our defense. 
Disclaimer: My personal view is that PAs should be independent and has been my view since the beginning of my career in 2004. 
We seem to have support from all the legislators we have  been meeting with since June 2018. They all get the common sense OTP points.  So, PA FORUM colleagues:  Wish us well, pray for us, send us positive thoughts, and help us get to the finish line. 
 
Thanks!!!
 
You guys rock! Praying and hoping WI bill passes and hopefully causes a wave of change in the other 49 states.

Sent from my SAMSUNG-SM-G891A using Tapatalk

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Guest Paula

NeoTrion:  What state are your from?  AAPA has all the info you need using the state guidelines for PA practice, plus they have a draft template.  Once our bill is submitted I can send you a copy, not til then.  Rhode Island  has submitted theirs and ours are similar.  

 

I'll keep you posted. 

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Similar Bill to the Florida one is set to pass in north dakota, hopefully in the next week or so. 

"..the NDBOM unanimously approved to support PAs in the upcoming legislative session in our efforts! Specifically, the NDAPA is pursuing the following:

  • Supervisory agreements currently mandatory for licensure in North Dakota will no longer be required. This means that PA’s will be responsible for the care they provide and the need to have a supervising physician will no longer be necessary.
    • This is a HUGE change for our practices and profession. It better aligns us in practice for those employers that don’t even consider PAs due to supervisory issues.
    • The NDAPA and PAs in North Dakota will still do what they have always done and practice in the team model. We are not looking to be “independent providers”, rather we want to be able to practice where we are needed.
    • One concession that was a deal-breaker for the NDBOM was that PAs would need to practice at clinics, hospitals and physician offices that are established or meet certain criteria. The NDBOM concern was that PAs would pursue privately owned clinics for things such as cosmetic dermatology, medi-spas, etc.
      • A PA may still be able to operate a clinic or practice of their own but would need approval from the NDBOM to do so.
      • This concession was felt to be a reasonable request as we are trying to get PAs in areas that need providers in primary care.
    • If we are able to get this legislation passed through the legislature, North Dakota will be the first in the nation where a PA can practice medicine without a supervisory or collaborative agreement with a physician."

      https://www.legis.nd.gov/assembly/66-2019/bill-actions/ba1175.html
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I emailed and tweeted my representative in FL. No response yet. She’s not on the committee, but I asked her to speak with members of the committee.

 

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I did steal some of the language from a FAPA Facebook post, but felt it was better to have something anyway and they wouldn’t mind.

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It appears there are 6 or 7 states that will have some form of OTP by next year. I am stunned we are making progress at this pace but very pleased. We, as a profession, need to keep supporting every state that is ding this kind of work. It will positively effect all of us at some point in time.

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16 minutes ago, sas5814 said:

It appears there are 6 or 7 states that will have some form of OTP by next year. I am stunned we are making progress at this pace but very pleased. We, as a profession, need to keep supporting every state that is ding this kind of work. It will positively effect all of us at some point in time.

Which states?

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On 3/14/2019 at 4:35 PM, sas5814 said:

Excluding arguments about bad actors what would change for most of us if a genie made us all independent practitioners today? For me the answer is pretty much nothing. I still have credentials. I still have departmental and regional medical directors. I still have to follow rules from insurance companies, the state and federal government. I'm still responsible and liable for my practice habits.

The only difference is I wouldn't be tied by law to a certain physician who does 10 meaningless chart reviews every month.

It is past time for some movement away from state mandated supervision.

It is this type of reasoning that kills a profession.

A big change would be the ability to stay employed after an aged physician dies. The ability to compete with NPs for hiring.

" I still have credentials. I still have departmental and regional medical directors. I still have to follow rules from insurance companies, the state and federal government. I'm still responsible and liable for my practice habits." all these things apply to physicians also, i don't see your point.

Lets lessen the "supervision burden" of physicians and grant opportunities for those PA's whom choose to practice at full capabilities.

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  • 3 weeks later...

From FAPA:

 

"the bill can not become law unless a bill is also passed out of the Senate. SB 972 has language similar to HB 821, but does not include PAs yet. Unfortunately that bill has yet to be heard in any committee. The Senate will most likely adjourn on May 3. That leaves just 12 days for the Senate to act. 
 
FAPA continues to watch the Senate committees closely for signs of life for SB 972. We will notify Florida PAs if action develops and action on your part is required. Watch your emails for updates."
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