Category: Legislative Update

Please find the following articles regarding the proposed changes (in the 2020 Physician Fee Schedule Proposed Rule) to evaluation and management documentation and reimbursement for outpatient new and established visits:

• Proposed Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2020

• Medicare Proposes Changes to Clinician Pay for E/M Visits

In addition, the American Academy of Physician Assistants prepared a document with reimbursement related information.

The PA-Physician relationship has undergone change, where patient-centered care is shared and the care plan jointly determined.  The PA profession has grown and proven itself; when in the remote past it may have been critically watched and directed, the practice standard now is jointly determined care with collaboration.  The term supervision is outdated and has been misunderstood in the administrative world, risking disenfranchisement.  The term collaboration will ensure ongoing communication between the PA and Physician team, ensuring the delivery of safe, cost-effective, and quality health care that the patients we serve will benefit from.

For additional information click here.

The VAPA legislation that creates a patient-care team model and replaces the term “supervision” with “collaboration and consultation” will take effect on July 1st. The Board of Medicine is currently in the process of amending the PA Regulations to conform to the legislation.

We have been informed by staff of the Board of Medicine that there should be no expectation or requirement from the Board that PAs change their existing practice agreement.

If you have any questions, please contact VAPA Executive Director, Jonathan Williams.

Please find important updates to the CMS Medicare Part D opioid prescribing guidelines which go into effect on January 1, 2019.

On February 9, 2018, Congress passed and the President signed into law a provision that will allow PAs to manage and provide hospice care to terminally-ill Medicare patients. The law modernizes outdated Medicare law with language specific to PAs in the Medicare Patient Access to Hospice Act.

As of January 1, 2019, PAs will be able to manage and provide hospice care to Medicare beneficiaries. Like physicians and APRNs, PAs will be able to be selected by patients as “attending physicians” for the purpose of Medicare hospice care. PAs will also be able to be employed by hospice organizations.

Regulations Governing the Practice of Physician Assistants (9-20-18)