Legislative Agenda for the 110th Congress

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Physician Assistants (PAs) are health care professionals licensed or, in the case of those employed by the federal government, credentialed, to practice medicine with physician supervision. PAs are located in almost all health care settings and in every medical and surgical specialty, providing high quality, cost-effective medical care. PAs deliver a broad range of medical and surgical services to diverse populations in rural and urban settings. In some small rural communities, a PA is the only medical provider. Based on its annual collection of data on the profession, the AAPA projects that over 230 million patient visits will have been made to PAs and approximately 286 million prescriptions will have been written by PAs in 2006.

More than 60,000 clinically practicing PAs are represented by the American Academy of Physician Assistants (AAPA).

The AAPA looks forward to working with the 110th Congress and the Administration to advance the following legislative initiatives.

Expanding Access to Affordable Health Care:  A central component of the AAPA's mission is to promote quality, cost effective, and accessible health care. The Academy first adopted policy calling for universal health care coverage in 1991 and remains committed to the goal. As an association that views its role and that of its members as one of advocacy for patient care, the AAPA will seek opportunities during the 110th Congress to expand access to affordable, quality health care, including prescription drugs, through public and private opportunities. In addition, the Academy will support federal initiatives to strengthen the viability of such publicly funded programs as Medicare, Medicaid, and the State Children's Health Insurance Program (SCHIP). The Academy looks forward to working with the 110th Congress to reauthorize a strong SCHIP.

Promoting Access to Care in Underserved Communities:  The PA profession has a long-standing commitment to practice in our nation's small towns, rural areas, and underserved urban communities. In states where PAs have been included as Medicaid covered providers, PAs have been credited with improving access to quality, cost-effective health care. Unfortunately, not all states include PAs as Medicaid covered providers, needlessly restricting access to care for one of our nation's most vulnerable populations. Nor do all states guarantee access to care provided by PAs through SCHIP. Accordingly, the AAPA seeks to ensure that underserved patients in all states consistently have access to care provided by PAs through enactment of legislation requiring that PAs be recognized as Medicaid and SCHIP covered providers. Additionally, the Academy will seek opportunities in the 110th Congress to expand access to care in underserved communities through federal legislation that is designed to strengthen America's rural health clinics, small rural hospitals, and other components of the rural health care safety net. The Academy will also seek opportunities to address disparities in health care research, access, and outcomes, as well as opportunities to confront limited health literacy and to promote the use of appropriately trained medical interpreters for patients with limited ability to speak or understand English.

Ensuring Access and Continuity of Care for Medicare Beneficiaries:  The AAPA seeks changes to the Medicare statute, clearly affirming that physicians may delegate to PAs the ability to order home health, hospice, and skilled nursing facility care, as well as to provide hospice care. The legislative changes are necessary to ensure Medicare beneficiaries' access to needed health care services, to ensure continuity of care, and to increase the availability of quality medical care. The Academy will work with the House and Senate to reintroduce and pass the Medicare Physician Assistant Continuity of Care Act. Additionally, the AAPA will work with the medical community to seek a long-term solution to ongoing problems in the Medicare physician payment update system.

Increasing Support for the Title VII, Public Health Service Act, Health Professions Programs, Including Support for PA Educational Programs:  The AAPA will work to ensure a strong reauthorization of the Title VII Health Professions Programs in the 110th Congress and will advocate for increased funding support for the programs, including support for PA educational programs, through the appropriations process. The Title VII program awards grants on a competitive basis and provides a unique opportunity to provide educational experiences in both urban and rural areas that are medically underserved. The program is essential to the development and training of the nation's health workforce and is critical to providing continued health services to underserved and minority communities. Title VII funding is the only federal funding available to PA educational programs.

Updating the Federal Workers' Compensation Program to Allow PAs to Diagnose and Treat Injured Employees:  PAs work in virtually every area of medicine and surgery and are covered providers within Medicare, Tri-Care, and most private insurance plans. Additionally, PAs are employed by the federal government to provide medical care, including the Department of Veterans Affairs, the Department of Defense, and the Public and Indian Health Services. PAs are also assigned to provide medical care to the President and Vice President of the United States. PAs are designated as covered providers in the overwhelming majority of State workers' compensation programs. Yet, the federal workers' compensation program does not recognize PAs' ability to diagnose and treat federal employees, or provide medical evidence for a worker's compensation-related injury. Accordingly, the AAPA seeks to reintroduce and pass the Improving Access to Workers' Compensation for Injured Federal Workers Act, amending the Federal Employment Compensation Act to recognize PAs as covered providers through the federal workers' compensation program.

Promoting Wellness:  The AAPA endorses the use of Healthy People 2010 as a guide to improve the health of the nation. The Academy will seek legislative opportunities in the 110th Congress to promote wellness, healthy lifestyles, and preventive medicine, including provisions to combat childhood and adult obesity; the identification of risk factors related to substance abuse and family violence; immunization against communicable diseases; counseling patients about behaviors that may lead to disease; and promotion of safety practices.

Advancing Stem Cell Research:  The AAPA believes the federal government is the single, best source for the large and sustained financial investment needed to move stem cell research forward. The Academy supports the development of federal stem cell policy that embraces the isolation of new embryonic cell lines and promotes the use of nuclear transplantation techniques as a desirable means to create embryonic stem cells for research purposes. The Academy opposes the cloning of human beings for the purpose of reproduction.

Acknowledging the Value and Role of Federally Employed PAs:  The AAPA will seek legislative and regulatory opportunities to update the qualification and classification standards for federally employed PAs; to promote the appropriate utilization of PAs throughout Department of Veterans Affairs medical facilities; and to acknowledge the contribution of PAs serving in our nation's armed forces.

In addition to its legislative priorities, the AAPA will continue its work with the Centers for Medicare and Medicaid Services and other federal regulatory agencies to promote optimal utilization of the quality medical care provided by physician assistants.

For more information, please contact Sandy Harding, AAPA's Director of Federal Affairs, at 703/836-2272, extension 3205, or via e-mail at sandra@aapa.org .