April 13, 2017

NCCPA lobbying derails PA legislation

Message from Josanne Pagel, MPAS, PA-C, DFAAPA, President and Chair of the Board, AAPA:

AAPA has been working diligently with our state chapters to advance PA-positive legislation. One of our primary areas of focus has been West Virginia where there has been overwhelming bipartisan support for improvements to the PA practice act.

Unfortunately, due to lobbying by the National Commission on Certification of Physician Assistants (NCCPA), West Virginia Gov. Jim Justice vetoed a bill on April 12 that had been unanimously approved by the legislature and would have expanded access to high quality healthcare, particularly in rural and medically underserved areas of the state.

We are not alone in noticing that one of the lobbyists hired by NCCPA is also a lobbyist for the Greenbrier Resort, which is owned by Governor Justice. This is quite concerning.

The vetoed legislation would have allowed PAs to work with “collaborating” rather than “supervising” physicians, expanded PA prescriptive authority for Schedule III medications to 30 days from the current restriction of 72 hours, and authorized PAs to sign an extensive list of forms that previously had to be signed by a physician, including death certificates. It would have also repealed a requirement for current NCCPA certification for license renewal.

Prior to the legislation being vetoed, the West Virginia Association of PAs, in partnership with AAPA, fended off an NCCPA amendment that would have required PAs to maintain their NCCPA certification to retain their licenses. In fact, in a committee hearing, legislators openly challenged the arguments presented by NCCPA and highlighted NCCPA’s financial motivations for pursuing the amendment.

The governor’s veto will hurt patients and is alarming to AAPA and its members. It’s possible that he made his decision without all of the facts. Members of the West Virginia Association of PAs are working with AAPA to quickly mobilize PAs in the state and to determine if the veto can be reversed.

AAPA has repeatedly asked NCCPA to halt its lobbying, which has thus far targeted West Virginia, New Mexico and Illinois. In all three states, NCCPA has pushed a false and self-serving narrative. Contrary to NCCPA’s claims, there is no evidence that recertification testing improves quality of care or patient safety. As a result, AAPA has consistently opposed statutory requirements for PAs to take NCCPA recertification tests for license renewal. In fact, 31 states and D.C. do not link PA recertification and licensure. AAPA believes that PAs should be required to maintain their licenses through continuing medical education (CME).

NCCPA lobbyists are also interfering in Illinois, and in the same way. NCCPA is attempting to add a new recertification requirement for license renewal in the must-pass reauthorization of the state’s PA practice act. If a reauthorization bill does not pass, PAs will no longer be permitted to practice in the state.

In New Mexico, the state PA chapter worked with members of the legislature and a number of stakeholders to craft a comprehensive and progressive bill. But NCCPA’s lobbying dealt a blow to the legislation. NCCPA was successful in inserting a requirement for current certification for license renewal into the bill. After NCCPA raised its objections, other groups also requested amendments, which ultimately weakened the bill. The legislature approved the measure and the governor signed it April 6.

AAPA continues to voice its vehement opposition to NCCPA’s harmful lobbying. In addition, we have been supporting state PA chapters by developing legislative strategies; drafting rebuttals, talking points, and letters of support; and sending out legislative action alerts.

We continue to closely monitor state registration of lobbyists by NCCPA. At the moment, we are not aware of any additional states where NCCPA is actively lobbying, but we cannot rule out the possibility of further interference. We do know, however, that NCCPA is discussing its position with PA regulatory boards across the country. We must be prepared to advocate on every front for what is best for the PA profession and our patients.

In addition, AAPA has contacted the state PA chapters in the 19 states where NCCPA recertification is required for maintenance of licensure, and has offered assistance to remove this requirement.

As the voice of PAs, AAPA will redouble our efforts to prevent NCCPA from hurting PA practice and restricting patient access to care. And we need your help!

We urge all PAs to contact NCCPA leaders at [email protected] or (678) 417-8100 and demand that NCCPA stop the lobbying that is so harmful to PAs and our patients.