On May 16, in the final hours of its 2014 session, the Missouri Legislature passed Senate Bill 716 (SB 716), a comprehensive bill amending several public health laws.
AAPA joins with the Missouri Academy of PAs (MOAPA) in being extremely disappointed the bill contains language authorizing the Missouri Board of Healing Arts to license medical school graduates who have not completed a residency as “assistant physicians,” practicing within the confines of a collaboration agreement with a physician and restricted to providing primary care services in rural and underserved areas.
The bill also states the federal government should consider assistant physicians practicing in Rural Health Clinics to be considered “physician assistants” for the purpose of Centers for Medicare & Medicaid regulations.
The governor has not signed the bill into law at this time.
AAPA and MOAPA strongly oppose the assistant physician title and concept. The language has the potential to jeopardize PA practice and confuse patients, health systems and other providers. It is unfortunate that the Missouri State Medical Association and the Missouri Association of Osteopathic Physicians and Surgeons did not take into account these negative ramifications when they supported it.
Both AAPA and MOAPA were actively engaged in opposing this language since its proposal in a standalone bill (HB 1842). All our trusted sources, both inside and outside of the Missouri Legislature, had concluded the bill was not going anywhere during this legislative session.
However, in the final week of session, it was inexplicably and suddenly incorporated into a larger bill (SB 716) with broader, positive public health provisions that resulted in its passage, even though AAPA and MOAPA continued to express opposition to the assistant physician language.
AAPA and MOAPA are working together and pursuing all avenues to reverse this action. Our efforts include:
- Considering whether to seek a veto of the bill by the governor
- Working with other medical organizations and consumer groups to oppose this provision
- Writing opinion editorials to educate patients and providers in Missouri
- Working with the relevant state and federal regulatory agencies to present the difficulties in implementing this provision
The 2014 Missouri legislative session had been extremely positive for the PA profession until the passage of the negative provisions in SB 716. Due to the strong advocacy of MOAPA and AAPA working in partnership, legislation was passed to authorize PAs to enroll as Medicaid providers, a key step in helping to improve access to care for underserved Missourians.