Legislative Affairs Update

From the 2017 NAPA Breakout Meeting at the AAPA Conference
Presented by LT Thomas Hurtado
NAPA Legislative Affairs Chair and Delegate to AAPA House of Delegates

Full Practice Authority and Responsibility (FPAR):

An AAPA joint task force was put together, formerly known as FPAR, and now being proposed as Optimal Team Practice (OTP). Placed before the AAPA House of Delegates in order to advance the PA profession in several key issues:

• Team-Based Practice
• Elimination of "Supervisory Agreements"
• Autonomous State Boards
• Direct Reimbursements

Earlier this year there was a nationwide survey collating PA responses to the new proposal with an overwhelming positive support.

Federal Advocacy:

Additionally, there are several key issues at the federal level that AAPA will address. Most of these revolve around barriers to access in patient care or areas where PAs have traditionally been hindered from practicing medicine at the level accorded by their education and training. These issues are mostly based on Medicare laws.

• Hospice
• Home Health
• Cardiac and Pulmonary Rehabilitation
• Reimbursement and Transparency
• Physician Co-signatures
• Federal Worker’s Compensation
• Diabetic Shoes
• Program of All-inclusive Care for the Elderly (PACE)
• Graduate CME
• Medicaid EHR incentive
• Good Act (Grow Our Own Directive) promotes PA education for prior medics and Corpsmen to help supply the VA shortages

State Legislature

At the state level, AAPA endorses legislature that promotes the above changes.

These six key elements should be part of every state PA practice act:

1. "Licensure" as the regulatory term
2. Full prescriptive authority
3. Scope of practice determined at the practice level
4. Adaptable collaboration requirements
5. Chart co-signature requirements determined at the practice
6. No restriction on the number of PAs with whom a physician may collaborate

West Virginia Veto

April 14, 2017 "AAPA vs NCCPA"

• Recertification exams and licensure
• NCCPA lobbying

AAPA has been supporting state chapters to pass regulatory laws that promote PA-positive legislature. One of the more conservative states that has been receiving a lot of news is West Virginia, where a legislation allowing PAs to work with “collaborating” rather than “supervising” physicians, expanding prescriptive authority to some scheduled medications as well as forms, and removing the requirement to have NCCPA certification for state license renewal. NCCPA lobbying caused the governor to veto the legislation stating that certification is a necessary component to safe practice and patient care. Both AAPA and NCCPA have been at odds in regards to state legislature and recertification requirements. These issues will be addressed at the House of Delegates.