Promoting & Protecting the PA Profession
For years NYSSPA’s Governmental Affairs Committee has been active promoting the PA profession introducing legislation and regulatory changes that have improved PA’s practice. NYSSPA also plays defense by watching for and addressing legislation that may adversely affect PAs. To guide us in the legislative arena, NYSSPA now has Capital Health Consulting, a female-owned, Albany-based company as our lobbying team.
NYSSPA has had many successes in the past:
- Obtained prescriptive privileges
- Expanded to schedule III-V prescriptive privileges
- Further expansion to schedule II-V prescriptive privileges
- Eliminated of the 24hr physician countersignature requirement for inpatient orders
- Passed of Chapter 30 of the Laws of 2010, called the “Big Bill”
- Improved of PA-to-physician ratios
- Revised many state and local forms to allow for PA signature
- Retired the use of “registered” in lieu of licensed as the regulatory term for PAs in NYS.
MOLST: Bills A.1162 and S.4841 were passed in the last legislative session and signed into law by the Governor in December 2019 allowing PAs to complete MOLST forms. The law is effective 180 days after the date is was signed, which is June 14, 2020. Education on how to complete a MOLST form is hosted on NYSSPA’s website and is free for NYSSPA members.
The NYSSPA PAC Fund
Passing a bill often takes years to accomplish. The legislative process spins slowly and it takes focus, persistence, and patience to reach our goals. There are many steps in the process involving countless hours of volunteer work combined with the work of our lobbyist to advance each issue including attending meetings, emails, phone calls, travel to Albany, and attending fundraisers. All of this takes not only time, but money.
Learn more about our PAC Fund here >>
Legislative Agenda: What NYSSPA is doing for you now
Your Governmental Affairs Committee is very active working on advancements to remove barriers to PA practice and enable all PAs to practice at the level for which we have been trained.
Below is a synopsis of our current agenda:
- Fluoroscopy: For the past several years we have been working on changes in the laws so PAs could perform fluoroscopy. Recognizing the need for PAs to be able to utilize fluoroscopy and the need for standardized education, the American Academy of Physician Assistants and the American Society of Radiologic Technologists together developed an educational framework and competency assessment program that is nationally accepted to help ensure that PAs performing fluoroscopy are properly prepared. The education consists of forty hours of didactic and forty hours of clinical training, and includes radiation safety.
Senator Gustavo Rivera and Assemblyman Richard Gottfried, Chairs of the Senate and Assembly Health Committees, introduced same-as legislation (S.1812) and (A.2982) in 2019 to allow PAs to perform fluoroscopy after completing the above training. Unfortunately, the bills did not move forward due to objections by a physician groups to PAs performing fluoroscopy unless it was done with “direct” supervision. We do not have that restriction in other settings and did not elect set a precedent. NYSSPA is pursuing non-legislative avenues to address this and other barriers for PAs in NY.
- Big Bill Clarification: Since passage of Chapter 30 of the Laws of 2010 (what we have called “the Big Bill” which addresses PA practice), there has been ongoing misinterpretation and concern regarding what fits under the umbrella of the law. NYSSPA met with Assemblyman Gottfried and he subsequently wrote a letter clarifying the intent of the law. It is available on the website and on request. This has proven to be a very helpful resource when speaking with physicians, legislators, administrators, attorneys, and others.
- Optimal Team Practice (OTP): NYSSPA created an OTP Committee to work on advancing OTP in New York. A position statement was drafted, discussions initiated with legislators and the Medical Society of New York, and a draft of what NYSSPA would like to have placed into law is being created. There have also been many discussions with the AAPA, so we can learn from what other states have been doing.
- Worker's Compensation: As of 1/1/2020, Workman’s Comp allows PAs to be enrolled as providers to treat injured workers. While this is positive for PAs, there are several sections of the law affecting PAs that NYSSPA feels need revision. NYSSPA has had conversations with the Workman’s Comp staff and is working to clarify and update the law. Below are links to the Workman’s Comp site to assist with signing-up utilizing the current process. All PAs who see WC patients should enroll:
- Medicaid: There has been multiple conversations with the state regarding payment for PA services. Medicaid does not credential PAs as providers and does not allow PAs to have patient panels. This has created patient access and billing issues. NYSSPA is committed to addressing these issues.
- Medicaid Redesign Team 2: NYSSPA was involved with the first Medicaid Redesign Team in 2012 and it was during this process that NYSSPA was able to have the physician:PA ration improved. NYSSPA has been communicating with members of the new redesign team regarding advancements for PAs.
- At One Time: Currently the interpretation of the PA:Physician ratio is 6:1 in hospitals and correctional institutions, and 4:1 in outpatient settings. The prior Department of Health interpretation of 2002 that stated that it could be “at one time” was not included in the Medicaid Redesign Team actions several years ago.
- Lobby Day: This year NYSSPA changed from our previous Lobby Day format to a small group of Board members, the Governmental Affairs Committee Chair, and our lobbyist team. We have had ongoing meetings with key legislators and officials to discuss our agenda and strategy. In that NYSSPA does not currently have bills to promote, the aim is to talk about our profession, how we are the solution to many healthcare workforce issues, and to encourage them to contact NYSSPA whenever they note any legislation that includes “physicians” or may otherwise affect PAs. We emphasized that we want to be part of the discussions as legislation is being drafted, not afterwards.
While in Albany, NYSSPA President Maureen Regan presented at the Joint Legislative Budget Health & Ways and Means Committee hearing how PAs are invaluable to the healthcare of New Yorkers and how PAs can be integral to solving many of the issues facing New York by providing quality, cost-effective care.
- Forms: There continue to be forms found that do not include PAs, exclude PAs, or may continue to include the apostrophe “s” after “physician”. If you know of such forms, please send them to NYSSPA, so we can address them.
- Supervising physician’s name on prescriptions: This continues to be a barrier in all practice settings and is being addressed.
If you have any questions, suggestions, or want to become involved, please contact NYSSPA Government Affairs Committee Chair John Hallowell. We need your support!