Federal bills supported by AAPA remove outdated barriers to care

March 17, 2017

Today in the U.S. House of Representatives, Rep. Tom Reed (R-NY) and Rep. Earl Blumenauer (D-OR) introduced the Promoting Access to Diabetic Shoes Act of 2017 (H.R. 1617), one of several recent bills supported by AAPA to enhance the ability of PAs (physician assistants) to serve Medicare patients by removing outdated barriers to care.

Current Centers for Medicare and Medicaid Services (CMS) regulations prevent PAs from certifying that a patient needs therapeutic shoes, which are especially designed to reduce the risk of skin breakdown in patients living with diabetes or a pre-existing foot disease. With close to 30 million people living with diabetes in this country, preventative measures like therapeutic shoes can help with the onset of more serious complications.

PAs already have the ability to certify other often more expensive medical equipment and devices, such as prosthetics, walkers and power mobility devices. H.R. 1617 seeks to correct the omission of diabetic shoes enabling PAs to more effectively and efficiently treat patients.

“PAs are on the frontlines providing medical care, routinely treating complex and chronic conditions such as diabetes,” said AAPA President Josanne K. Pagel, MPAS, PA-C, Karuna®RMT, DFAAPA. “It’s wonderful to see legislation that not only puts patients’ needs first but also recognizes the important role PAs serve in getting healthcare to people who need it.”

PAs are nationally certified and state-licensed medical professionals who practice medicine on healthcare teams with physicians and other providers—as well as prescribe medications—in all 50 states, the District of Columbia and the uniformed services.

The PA profession, now in its 50th year, was created shortly after Medicare was first enacted. Therefore, persistent barriers have required advocacy efforts to recognize PAs as a provider within the regulations.

With a nationwide provider shortage, PAs are often the only medical professionals in many medically underserved or rural areas, so it is particularly important to remove these barriers now.

Earlier in March, Reps. Lynn Jenkins (R-KS) and Mike Thompson (D-CA) introduced the Medicare Patient Access to Hospice Act (H.R. 1284), which would give PAs the ability to provide and manage hospice care, which is something their education and training makes them capable of doing already.

“Removal of this outdated roadblock is necessary to ensure continuous care—for people who are often at their most vulnerable—that PAs can and should be able to provide,” said Pagel.

Another bill seeking to increase Medicare patients’ access to care was introduced in late February by Sen. Susan Collins (R-ME) and Sen. Benjamin Cardin (D-MD). The Home Health Care Planning Improvements Act (S. 445) would amend Medicare to permit PAs to order home health and manage the home healthcare plan for Medicare beneficiaries.

AAPA will be working to advance these important pieces of legislation in the weeks and months ahead.