Legislation Introduced to Authorize Direct Pay to PAs Under Medicare

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ALEXANDRIA, Va. (Feb. 7, 2019)—Today, the American Academy of PAs (AAPA), the professional organization representing more than 131,000 PAs (physician assistants) across the country, applauds members of the U.S. House of Representatives, Terri Sewell (D-AL) and Adrian Smith (R-NE), for introducing H.R. 1052, the Physician Assistant Direct Payment Act, to authorize PAs to receive direct payment under Medicare.

Currently, PAs are the only health professionals who are authorized to bill Medicare for their services but are not able to receive direct payment. Medicare permits all health professionals—physicians, advanced practice registered nurses (APRNs), physical therapists, psychologists, podiatrists, social workers, and others—to receive direct payment under their own name and National Provider Identifier number.

When PAs cannot be paid directly by Medicare or other insurance providers, they are unable to reassign their payments in a manner similar to physicians and APRNs. The inability to be paid directly further hinders PAs from fully participating in the increasing number of innovative value-based payment arrangements and emerging models of healthcare delivery. For example, the restriction means PAs have difficulty working for healthcare staffing companies, which are increasingly used by hospitals to deliver care, because they cannot reassign their Medicare payments to the hospital.

“When enacted, this legislation will improve access to care for patients. By removing unnecessary administrative burdens and restrictions, it will enhance the ability of PAs to bring their proven clinical competence and skill sets to patients in need,” said Jonathan E. Sobel, DMSc, MBA, PA-C, DFAAPA, FAPACVS, president and chair of the AAPA Board of Directors. “We look forward to continue working with Congresswoman Sewell and Congressman Smith to improve access to healthcare.”

“Our country is facing a significant shortage of healthcare providers, and this needed legislation will help ensure that PAs are a part of the solution” Sobel continued. According to the U.S. Bureau of Labor Statistics, the number of PAs is expected to increase by 37 percent from 2016 to 2026.

Enactment of this legislation will not change how PAs currently practice and it will not change PA scope of practice.

All PAs are encouraged to contact legislators in support of this important legislation. Go to AAPA’s Advocacy Action Center to take action. 

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About the American Academy of PAs
AAPA is the national membership organization for all PAs. PAs are medical professionals who diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient’s principal healthcare provider. Learn more about the profession at aapa.org and engage through Facebook, LinkedIn, Instagram, Twitter, and Snapchat using the handle @aapaorg.