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CMS expands medical staff definition to include APRNs, PAs

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Thank you for sharing this with us, this is great news. Unfortunately, AAPA staff has found a section of these new regulations, which starts on page 37, that makes a very derogatory statement inferring PAs are not being able to order restraints and seclusion. According to the Academy staff, they have been in contact with CMS officials to try to rectify this and will be making a press release on Monday. AAPA has also been in contact with many PAs across the country who are in leadership roles in their hospitals in the event the may need to get their institutions to write letters of support protesting this section of the regulations.


I read over the document and some other articles and I have to tell you CMS is truly schizophrenic. On one hand can CMS suggest expanding the medical staff (482.22) to give nonphysician practitioners privileges to perform duties that are within their scope of practice and permitted by state law so physicians can concentrate on more medically complex patients. CMS also reports the flexibility to consider other practitioners as eligible candidates for the medical staff could save $330 million in 2012 and up to $1.6 Billion over the next 5 years (page 8). Then on page 37 the rules suggests PAs should be excluded PAs from ordering restraint and seclusion, unless that is permitted by law. That our goverment are work!


I know we (in Ohio) have addressed this issue on restraint and seclusion in the past but because the reg. mentioned" unless permitted by law", to be on the safe side, I did a review of Ohio laws and confirmed that in fact PAs are permitted by regulation to order restraints and seclusion. This is permitted accordance to rules governed by the Ohio Department Health and the rules were recently amended in January 2012 (OAC 5122-26-16. 2 (E)). So according to these regs. PAs in Ohio should be safe. If any hospital administrator misinterprets the new rules the OAPA can reference the above mentioned Ohio regulations.


I think everyone should probably review your own state laws. Here is a link to the full regulations http://ofr.gov/OFRUpload/OFRData/2012-11548_PI.pdf

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