A Look Ahead: Advocacy Priorities for 2022

January 11, 2022

AAPA works to advance the PA profession and promote quality, accessibility, and cost-effectiveness in delivering patient-centered care. Our engagement includes initiatives related to federal and state advocacy, as well as specific work on PA-related reimbursement and regulatory issues.

While these are distinct advocacy areas, they are also intertwined. Since PA practice is regulated at the state level, much of AAPA’s advocacy work is focused on optimizing state laws and regulations. But PA practice is also impacted by federal statutes and regulations. Federal policies and programs, like national coordination related to pandemic response and Medicare, are overseen by the federal government. Additionally, the federal government is the largest employer of PAs. Federal policies – whether it’s related to Medicare or PAs who work at the Department of Veterans Affairs (VA) – often serve as a model for state laws and regulations, so policies established at the federal level may have an eventual impact on every PA, no matter where they practice. And reimbursement policies, which determine how PAs get paid, are regulated at both the state and federal level, depending on the state, the payer, and/or the program. Given these complexities, state advocacy, federal advocacy, and reimbursement efforts are all important to advancing the PA profession. AAPA’s advocacy team gives you a look into their priorities for 2022.

Federal Advocacy

2022 marks the second year of both the 117th Congress and of the Biden Administration, so AAPA’s federal advocacy team will continue work on a number of established priorities. They include the removal of supervision/collaboration requirements for PAs in federal employment, with significant focus on the VA as they work to create national standards of practice for health professions. Federal advocacy efforts will also focus on specific legislation that will advance PA practice: the Increasing Access to Quality Cardiac Rehabilitation Care Act (S. 1986 / H.R. 1956), the Improving Access to Workers’ Compensation for Injured Federal Workers Act (H.R. 6087), and the Department of Veterans Affairs Nurse and Physician Assistant Retention and Income Security Enhancement (VA Nurse and Physician Assistant RAISE) Act (H.R. 5575), among others.


AAPA works with all public and commercial third-party payers to ensure coverage for the medical and surgical services delivered by PAs. A thorough understanding of PA payment policies is essential for demonstrating PA value, maximizing the collection of appropriate reimbursement, and avoiding concerns related to fraud and abuse.

Our goal is to ensure that PAs are authorized to practice to the top of their medical education and training, and be reimbursed for the services they deliver. AAPA’s reimbursement team reviews the coverage and reimbursement policies of payers to determine if there are payment policies that hinder the full utilization of PAs. A recent nationwide Medicaid survey identified issues in a small number of states such as a lack of coverage for PAs first assisting or policies that prohibit PAs from providing behavioral health services. The reimbursement team then contacts and works with PA state chapters and state Medicaid programs to attempt to eliminate restrictive policies.

The reimbursement team will also continue their work to:

  • Advocate with major commercial payers to authorize direct payment to achieve consistency with federal Medicare policy;
  • Develop materials to educate PAs, physicians, employers, and billing personnel regarding Medicare’s new split/shared billing requirements in hospitals/facilities;
  • Review implications of the Fair Labor Standards Act to ensure PAs understand their rights regarding working overtime and being on-call.

State Advocacy

AAPA will continue to support constituent organizations as they pursue their state-specific legislative agendas. It’s important to understand that each state sets its own legislative agenda, which is appropriate given that the PAs who practice in each state are directly impacted by these changes. AAPA’s state advocacy team works closely with COs to advance PA priority areas, such as optimal team practice (OTP), changing the profession’s title, and responding to the COVID-19 pandemic. AAPA staff provides strategic and technical support ranging from drafting bills to developing grassroots campaigns, talking points, handouts, testimony, and everything in between.

This year, we are launching new tools and resources to help states that are pursuing OTP and planning for title change legislation. These tools and resources will complement the ongoing AAPA State Advocacy Grant program, approved by the Board of Directors, that provides financial support to state COs in pursuit of key AAPA legislative priorities. For more information on the grant program, please contact Lauren Bates-Rowe.

The state advocacy team will also continue to work on the PA Licensure Compact, which will reduce delays to providing patient care and increase patient access, as well as reduce administrative burdens for PAs. Read more detailed information about the PA Licensure Compact and what it means for you and your patients.

Ways You Can Get Involved

Who better to advocate for the PA profession than a PA? AAPA’s advocacy efforts rely on grassroots advocates – like you! Your perspective is unique, your story is compelling, and, as a constituent, your voice will carry weight with your state and federal legislators. To get involved:

  • Confirm your membership in your state’s constituent organization and sign up to receive state advocacy alerts. January through March is the busiest time in state politics; we need every PA to participate.
  • Join AAPA’s Grassroots Advocacy and Information Network (GAIN), a nationwide network of PAs who are strengthening the future of the profession by building relationships with members of Congress and their staff.
  • Help strengthen the PA voice on Capitol Hill by supporting AAPA’s Political Action Committee, PA PAC. PA PAC supports candidates for Congress (both Republicans and Democrats) who are committed to the principles that drive the PA profession. PA PAC increases the profession’s visibility in the halls of Congress, and enhances AAPA’s ability to build longstanding relationships with federal legislators. Support PA PAC today! (You must be a member to support PA PAC.)
  • Finally, make appointments with your state and federal legislators – and with the candidates running for election in 2022. During these conversations, inform them about what PAs do, how PAs improve healthcare, and about priority legislation they can support.

The federal, reimbursement, and state advocacy teams are looking forward to a productive 2022 – we hope you are too!

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