sas5814 Posted August 16, 2019 Share Posted August 16, 2019 I copies this from another forum but it is very big news and everyone needs to spread the word and make a comment: ATTENTIONWE ALL NEED TO RESPOND IN SUPPORT AND RALLY THE TROOPS!!!! Employers! Family! Everyone!!! "... This proposed change would substantially align the regulation on physician supervision for PA services at @ 410.74(a)(2) with our current regulations on physician collaboration for NP and CNS services at @@ 410.75(c)(3) and 410.76(c)(3)..." Excerpted from the huge document starts page 40546https://www.federalregister.gov/documents/2019/08/14/2019-16041/medicare-program-cy-2020-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other Given the commenters' understanding of ongoing changes underway to the state scope of practice laws regarding physician supervision of PA services, commenters on our CY 2018 RFI have requested that CMS reconsider its interpretation of the statutory requirement that PA services must be furnished under the supervision of a physician to allow PAs to operate similarly to NPs and CNSs, who are required by section 1861(s)(2)(K)(ii) of the Act to furnish their services "in collaboration" with a physician. In general, we have interpreted collaboration for this purpose at @@ 410.75(c)(3) and 410.76(c)(3) of our regulations to mean a process in which an NP or CNS (respectively) works with one or more physicians to deliver health care services within the scope of the practitioner's expertise, with medical direction and appropriate supervision as provided by state law in which the services are performed. ....... After considering the comments we received on the RFI, as well as information we received regarding the scope of practice laws in some states regarding supervision requirements for PAs, we are proposing to revise the regulation at @ 410.74 that establishes physician supervision requirements for PAs. Specifically, we are proposing to revise @ 410.74(a)(2) to provide that the statutory physician supervision requirement for PA services at section 1861(s)(2)(K)(i) of the Act would be met when a PA furnishes their services in accordance with state law and state scope of practice rules for PAs in the state in which the services are furnished, with medical direction and appropriate supervision as provided by state law in which the services are performed. In the absence of state law governing physician supervision of PA services, the physician supervision required by Medicare for PA services would be evidenced by documentation in the medical record of the PA's approach to working with physicians in furnishing their services. Consistent with current rules, such documentation would need to be available to CMS, upon request. This proposed change would substantially align the regulation on physician supervision for PA services at @ 410.74(a)(2) with our current regulations on physician collaboration for NP and CNS services at @@ 410.75(c)(3) and 410.76(c)(3). Quote Link to comment Share on other sites More sharing options...
Cideous Posted August 16, 2019 Share Posted August 16, 2019 Can you put it in layman's terms for us? I thought PA's and NP's supervision was pretty much identical in Texas? Quote Link to comment Share on other sites More sharing options...
sas5814 Posted August 16, 2019 Author Share Posted August 16, 2019 This is CMS rules at the national level. The NPs have had collaboration language for years. PAs were required to be supervised. This will change it so we are all required to collaborate rather than be supervise. 4 Quote Link to comment Share on other sites More sharing options...
SoCal_PA Posted August 16, 2019 Share Posted August 16, 2019 Wait a second.... are we seeing actual positive steps forward? 1 1 Quote Link to comment Share on other sites More sharing options...
SoCal_PA Posted August 16, 2019 Share Posted August 16, 2019 Was reading some comments....wtf "I am in support of the PTA/OTA 85% reimbursement reduction fee schedule if a OTA/PTA is the only one providing treatment. This is no different than the physician and ARNP/PA-C fee reduction requirement. By In-acting this rule, it ensures that payment will match the skill level provided. It will help to enhance quality of care by promoting the use of more educated therapists over organizations attempting to maximize profits by utilizing lower skilled PTA/OTA's with a lower salary. However, in instances where the more skilled therapist is not fully available, just as ARNP/PA-C's, it still allows payment enough for an OTA/PTA to be used in substitution, as these positions was originally attended." We are the same as a PT assistant everyone. Name change needs to happen Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted August 17, 2019 Moderator Share Posted August 17, 2019 CMS needs to get ride of supervision entirely Just let us bill Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted August 17, 2019 Share Posted August 17, 2019 How should we express our support for this change? Is there a public comment period like some agencies have for proposed rule changes? If so, what is the method for communicating with them? Quote Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted August 17, 2019 Share Posted August 17, 2019 (edited) I could swear that I got an email or some other form of communication on this several weeks ago. Since it wasn't going to impact me (it's all about me) I didn't mention it since I figured if I got it so did everyone else. Maybe it was on Medscape, Google News, Yahoo News, or some such that I read during my "overall stressful" work days? Edited August 17, 2019 by GetMeOuttaThisMess Quote Link to comment Share on other sites More sharing options...
Guest PAhopeful85 Posted August 17, 2019 Share Posted August 17, 2019 (edited) 16 hours ago, SoCal_PA said: Was reading some comments....wtf "I am in support of the PTA/OTA 85% reimbursement reduction fee schedule if a OTA/PTA is the only one providing treatment. This is no different than the physician and ARNP/PA-C fee reduction requirement. By In-acting this rule, it ensures that payment will match the skill level provided. It will help to enhance quality of care by promoting the use of more educated therapists over organizations attempting to maximize profits by utilizing lower skilled PTA/OTA's with a lower salary. However, in instances where the more skilled therapist is not fully available, just as ARNP/PA-C's, it still allows payment enough for an OTA/PTA to be used in substitution, as these positions was originally attended." We are the same as a PT assistant everyone. Name change needs to happen As a PTA of five years and a current PA student this makes me laugh. But the 85% will only be for Medicare part B services and begins in 2022. Edited August 17, 2019 by PAhopeful85 Quote Link to comment Share on other sites More sharing options...
surgblumm Posted August 18, 2019 Share Posted August 18, 2019 I think that Scott (SAS) did an excellent job at interpreting this. I started to read through the new regulations that are now out for public opinion and there are so many areas that bored me to death and were unclear that I finally gave up. Yes, I would comment on this area. Yes, this is ging to be new federal law and states and professions will have nothing to add after the thirty day period. This has nothing to do with our national organizations except for the fact that they can give a creative and thoughtful job in responding and I am sure although I do not know if, in fact , this is happening but the AAPA should have a task force that includes staff, committee members that are PAs and attorny's doing this and preparing the professions response. 2 Quote Link to comment Share on other sites More sharing options...
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