November 17, 2023
More States Say They’re Enrolling PAs as Billing Providers
December 20, 2021
By Trevor Simon
AAPA periodically issues a questionnaire to all 50 states and D.C. Medicaid agencies to clarify and update policies pertaining to PAs. This year, 84% of the Medicaid programs returned the survey. One key takeaway is that more states say they enroll PAs as billing providers – indicating that PAs are authorized to receive direct payment – than we were previously aware.
AAPA finds numerous benefits in surveying state Medicaid policies. First, it helps AAPA promote proper compliance with Medicaid policies for PAs and their employers. Second, written responses help us counter misinformation about what a PA can or can’t do under a state’s Medicaid program. Finally, by identifying state Medicaid policies that restrict PAs, it allows us to focus on what needs to be addressed through advocacy activities in conjunction with state chapters.
Currently, of the 51 surveys disseminated, 43 (84%) Medicaid programs have returned a survey, four have declined to participate, and four have yet to respond. AAPA will continue to seek responses from the remaining four states.
AAPA initially sent the survey by email and followed up through subsequent emails and telephone calls. AAPA attempted to limit the number of questions as to not overwhelm potential respondents or deter them from completing and returning the survey. The 2021 survey included 14 questions regarding issues such as whether:
We reviewed all responses and identified any instances in which a state reported a restriction. We then compared them to survey responses from previous years and language contained in state Medicaid provider manuals to validate information. AAPA has found a limited number of discrepancies between survey responses and other written policies, and is actively seeking to reconcile the information. Once review and analysis are complete, AAPA will make each state chapter aware of any problematic responses for advocacy purposes.
Preliminary review of data received from the surveys has resulted in a few takeaways:
The wealth of information we’re collecting will help us identify policies that still need to be changed and allow us to map out where we should concentrate our advocacy efforts. AAPA is also encouraged by the fact that most states have been highly responsive and have communicated an interest in getting PAs this information. AAPA hopes that contacts made through the survey process can be the beginning of constructive dialogues in advocacy efforts going forward.
Trevor Simon is a director with AAPA’s Reimbursement Department. Contact him at [email protected].