PA Interstate Compact

[CAAdmission]

This might be interesting if it works out:

https://www.clinicaladvisor.com/home/my-practice/physician-assistant-career-resources/pa-compact-model-legislation-approved/

I would think there will be a lot of pushback from some states, especially those with fat licensing fees. 

[SedRate]

This is great news! I am hoping this gets enacted ASAP. Long overdue... 

[ventana]

Which 7 states are first to join??

[CAAdmission]

11 hours ago, ventana said:

Which 7 states are first to join??

I guess it is up to us to lobby our state to join in. It looks like there are a lot more states interested than I thought- there are a ton that do this with physician licenses already:

https://www.imlcc.org/

[Photograph51]

I have four state licenses, all for state within 20 miles of my home and all of which I have made use of this year, so I am one of the people who will be most affected by this.  I think it is a good idea, but I am baffled that the AAPA thinks that this is a high priority.  Sure, it took some time and money to get all of these licenses, but it wasn't really that big of a deal, especially since my employer pays for all of those DEA's.  Having to get extra licenses isn't having a big impact on my ability to practice medicine.  What is having a big impact is that insurance companies allow NP's to bill separately, but not PA's.  I have to have multiple collaborative agreements that NP's don't have to have.  The AAPA needs to prioritize independence for PA's over this licensing issue.

[rev ronin]

2 hours ago, Photograph51 said:

The AAPA needs to prioritize independence for PA's over this licensing issue.

Pretty sure PA independence is not only not an AAPA priority, it's not even AAPA policy. Optimal team practice is, but if you want to get PA independence in policy, you need to get involved in your state org and depose HOD reps who see no need for it.  AAPA HOD has plenty of time to pass resolutions on a ton of things that don't uniquely affect PAs--button battery safety was one from 2022--but didn't meaningfully address independence.

[iconic]

Just to give some idea NP's have been working on this since 2020 and I believe they have it in like 2 states lol..

Edited December 5, 2022 by iconic

[Photograph51]

59 minutes ago, rev ronin said:

Pretty sure PA independence is not only not an AAPA priority, it's not even AAPA policy. Optimal team practice is, but if you want to get PA independence in policy, you need to get involved in your state org and depose HOD reps who see no need for it.  AAPA HOD has plenty of time to pass resolutions on a ton of things that don't uniquely affect PAs--button battery safety was one from 2022--but didn't meaningfully address independence.

I'm trying to do what I can to move the profession in the right direction, but it's like swimming in molasses.  One of the states in which I work has a PA organization that, as far as I can tell, doesn't seem to do anything at all, aside from accept dues. 

For the AAPA to even work on optimal team practice would be a better use of their time than this multi-state compact.  It really wasn't that big of a deal to keep getting fingerprinted or filling out a few extra forms.  It would be nice if DEA numbers would cover more than one state, though.  It's costing my employer a lot of money to keep up 4 DEA numbers for me at $888 every 3 years for each one.

[iconic]

1 hour ago, Photograph51 said:

I'm trying to do what I can to move the profession in the right direction, but it's like swimming in molasses.  One of the states in which I work has a PA organization that, as far as I can tell, doesn't seem to do anything at all, aside from accept dues. 

For the AAPA to even work on optimal team practice would be a better use of their time than this multi-state compact.  It really wasn't that big of a deal to keep getting fingerprinted or filling out a few extra forms.  It would be nice if DEA numbers would cover more than one state, though.  It's costing my employer a lot of money to keep up 4 DEA numbers for me at $888 every 3 years for each one.

I agree OTP would be a better thing to work on. It seems that we are getting very scattered with a lot of different ideas. Ultimately, it is up to state chapters to enact change. State compact could certainly help, as medical licensing in this country is a cartel as is the DEA (which is the same for all providers).

[TeddyRucpin]

2 hours ago, iconic said:

Just to give some idea NP's have been working on this since 2020 and I believe they have it in like 2 states lol..

Yet they have independent practice in like what, 25 states?

[SedRate]

6 hours ago, Photograph51 said:

What is having a big impact is that insurance companies allow NP's to bill separately, but not PA's.

Medicare allows PAs to direct bill as of this year. Hopefully Medicaid and third party insurances will follow suite soon. 

[SedRate]

3 hours ago, Photograph51 said:

I'm trying to do what I can to move the profession in the right direction, but it's like swimming in molasses.  One of the states in which I work has a PA organization that, as far as I can tell, doesn't seem to do anything at all, aside from accept dues. 

For the AAPA to even work on optimal team practice would be a better use of their time than this multi-state compact.  It really wasn't that big of a deal to keep getting fingerprinted or filling out a few extra forms.  It would be nice if DEA numbers would cover more than one state, though.  It's costing my employer a lot of money to keep up 4 DEA numbers for me at $888 every 3 years for each one.

The way I look at the compact is it would help standardize state licensing (instead of individual ones with individual requirements and forms, fingerprints for each, references for each, graduation docs for each, etc) and then that would hopefully lead to standardizing state requirements so there aren't so many nuances in practice ability across state lines, such as practice agreements in one vs another or the requirement to have a Sponsoring Physician when even applying for a state license. I could see this standardization being important in removing practice barriers and supporting the implementation of OTP. 

[CAAdmission]

10 hours ago, rev ronin said:

button battery safety was one from 2022

Edited December 6, 2022 by CAAdmission

[rev ronin]

2 hours ago, CAAdmission said:

It was pulled from the consent agenda ("things everyone agrees are so no-brainer that we're not going to debate 'em") for the opportunity for a PA mom who had lost a child to a button battery ingestion to tell her truly heartbreaking story to the 500+ assembled people. I don't want to mischaracterize the floor speech, but I remember it being longer than allowed by the rules. I truly hope it was therapeutic and helpful for the PA in question, whose name I did not catch, but I do not believe it was a necessary use of HOD time.

It wasn't a terrible addition to the policy manual, but AAPA policies are bloated with political platitudes that have nothing to do with uniquely PA concerns. One of the policies on immigration (core PA competency, that) that the DEI commission had recommended sunsetting as redundant to a new policy that was adopted was kept because one delegate objected that the replacement didn't sufficiently condemn marriage inequality in immigration decisions. Mind you, I've singlehandedly (well, not quite--it was me and a tech writer and an oversight board) rewritten infosec policies for a Fortune 100 company from scratch. Working in the AAPA HOD is an entirely different kettle of fish--realize that it has more voting members than any state legislative house except one (NH, I think it was). Thus, you can't really tie two decisions together because the HOD can decide to amend one and accept the other, leaving an uncontrolled mess in the process.  Imagine building a LEGO model if you had to have hundreds of delegates voting on which piece goes where next: even with a clear roadmap, it's still going to be a mess, in part because the process is often too boring to keep everyone's attention.

[SedRate]

10 hours ago, rev ronin said:

It was pulled from the consent agenda ("things everyone agrees are so no-brainer that we're not going to debate 'em") for the opportunity for a PA mom who had lost a child to a button battery ingestion to tell her truly heartbreaking story to the 500+ assembled people. I don't want to mischaracterize the floor speech, but I remember it being longer than allowed by the rules. I truly hope it was therapeutic and helpful for the PA in question, whose name I did not catch, but I do not believe it was a necessary use of HOD time.

It wasn't a terrible addition to the policy manual, but AAPA policies are bloated with political platitudes that have nothing to do with uniquely PA concerns. One of the policies on immigration (core PA competency, that) that the DEI commission had recommended sunsetting as redundant to a new policy that was adopted was kept because one delegate objected that the replacement didn't sufficiently condemn marriage inequality in immigration decisions. Mind you, I've singlehandedly (well, not quite--it was me and a tech writer and an oversight board) rewritten infosec policies for a Fortune 100 company from scratch. Working in the AAPA HOD is an entirely different kettle of fish--realize that it has more voting members than any state legislative house except one (NH, I think it was). Thus, you can't really tie two decisions together because the HOD can decide to amend one and accept the other, leaving an uncontrolled mess in the process.  Imagine building a LEGO model if you had to have hundreds of delegates voting on which piece goes where next: even with a clear roadmap, it's still going to be a mess, in part because the process is often too boring to keep everyone's attention.

Wow, there is much more to it than I knew. Thanks for taking the time to explain.