Obscure language tucked into a 2,225-page regulatory rule from the Centers for Medicare & Medicaid Services (CMS) threatens to disrupt the important role of PAs and other qualified licensed practitioners in the hospital admissions process by mandating new requirements that limit the ability of PAs and NPs to admit patients.
The rule, contained in the fiscal year 2014 Policy and Payment Changes for Inpatient Stays in Acute-Care and Long-Term Care Hospitals (see section 412.3 Admissions on p. 1,896), scheduled to be published in the Federal Register on Aug. 19, prohibits physicians from delegating to PAs the authority to admit patients to hospitals. By removing this long-standing authority from the physician-PA team, CMS will cause access problems for patients who need to be hospitalized when no physician is physically present at the hospital. The problem will be exacerbated in hospitals in rural and other medically underserved communities. AAPA sent an official letter to Department of Health and Human Services (HHS) Secretary Kathleen Sebelius expressing its serious concerns over the impact of the rule.
This rule is especially perplexing in light of the fact that AAPA has been successfully working with CMS, the White House and HHS over the past few months to eliminate unnecessary barriers to care. One positive outcome from this partnership was the elimination of the requirement that a physician be on site once every two weeks in certified rural health clinics staffed by PAs. Additionally, the new admissions requirements appear to run contrary to HHS Secretary Sebelius’ leadership role in removing unnecessary HHS regulatory barriers to the provision of healthcare in rural and other medically underserved communities.
AAPA is fully engaged in an effort to reverse this rule and is working with other stakeholders and organizations concerned with maintaining and increasing appropriate access to care for patients. Be assured that we will keep you updated as this issue progresses.
For additional information contact Tricia Marriott, AAPA director of reimbursement.
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