Senate Legislation to Authorize Direct Pay to PAs Under Medicare Introduced

Contact: Carrie Munk, 571-319-4477, [email protected]

ALEXANDRIA, Va. (March 1, 2019)—The American Academy of PAs (AAPA), the professional organization representing more than 131,000 PAs (physician assistants) across the country, applauds U.S. Senators John Barrasso (R-WY) and Tom Carper (D-DE), for introducing S. 596, the Physician Assistant Direct Payment Act, authorizing PAs to receive direct payment under Medicare.

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

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, 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 are often unable to work for healthcare staffing companies or group practices, which are increasingly used by hospitals to deliver care, because they cannot reassign their Medicare payments to the hospital.

“The enactment of this legislation is crucial to improving the accessibility of healthcare for patients across the country, especially in rural and underserved areas. Through the removal of unnecessary administrative burdens and restrictions, this legislation will improve PAs’ ability to use their clinical competence to provide high-quality care 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 continuing to work with Senator Barrasso and Senator Carper to improve access to healthcare.”

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.

Last month, Representatives Terri Sewell (D-AL) and Adrian Smith (R-NE) introduced the Physician Assistant Direct Payment Act, H.R. 1052, in the U.S. House of Representatives.

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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.