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CMS is clear on PAs\u2019 dos and don\u2019ts under the new regs.<\/em><\/strong><\/span><\/p>\n You\u2019ll still need to get a physician to certify a patient\u2019s terminal illness and perform the face-to-face encounter, despite a change to physician assistant duties in the 2019 hospice proposed payment rule.<\/p>\n Thanks to a provision enacted in the Bipartisan Budget Act of 2018 earlier this year, \u201ceffective January 1, 2019, physician assistants (PAs) will be recognized as designated hospice attending physicians, in addition to physicians and nurse practitioners,\u201d notes the\u00a0Centers for Medicare & Medicaid Services\u00a0<\/strong>in the rule published in the May 8\u00a0Federal Register<\/em>.<\/p>\n Starting next year, \u201cMedicare will pay for medically reasonable and necessary services provided by PAs to Medicare beneficiaries who have elected the hospice benefit and who have selected a PA as their attending physician,\u201d the rule continues. However, \u201cattending physician services provided by Pas may be separately billed to Medicare only if the PA is the beneficiary\u2019s designated attending physician, services are medically reasonable and necessary, services would normally be performed by a physician in the absence of the PA, whether or not the PA is directly employed by the hospice, and services are not related to the certification of terminal illness,\u201d the rule says.<\/p>\n \u201cThere will be some providers that will benefit from the allowance of physician assistants to serve as the patient\u2019s attending physician,\u201d expects\u00a0Carrie Cooley\u00a0<\/strong>with\u00a0Weatherbee Resources\u00a0<\/strong>in Hyannis, Massachusetts.<\/p>\n The\u00a0National Association for Home Care & Hospice\u00a0<\/strong>cheers the implementation of the change which it has \u201clong advocated,\u201d it says in its member newsletter.<\/p>\n But while PAs will be able to take over some physician duties, there are other key ones they will not be allowed to perform. \u201cSince PAs are not physicians \u2026 they may not act as medical directors or physicians of the hospice or certify the beneficiary\u2019s terminal illness and hospices may not contract with a PA for their attending physician services,\u201d CMS specifies in the rule.<\/p>\n \u201cThe Bipartisan Budget Act of 2018 did not make changes to which practitioners can certify terminal illness for a Medicare beneficiary nor who may perform the face-to-face encounter,\u201d CMS underscores in the rule. \u201cNo one other than a medical doctor or doctor of osteopathy can certify or re-certify terminal illness. PAs were not authorized by [BBA \u201818] to perform the required hospice face-to-face encounter for recertifications.\u201d<\/p>\n The law \u201ccontinues to state that only a hospice physician or a hospice nurse practitioner can perform the encounter,\u201d the rule continues. \u201cThe regulations \u2026 will continue to state that the hospice face-to-face encounter must be performed by a hospice physician or hospice nurse practitioner.\u201d<\/p>\n For the duties that a PA may perform, remember that Medicare will pay 85 percent of the Medicare physician fee schedule rate, notes consulting firm\u00a0The Health Group\u00a0<\/strong>in Morgantown, West Virginia, in its electronic newsletter.<\/p>\n Note: The rule is at\u00a0www.gpo.gov\/fdsys\/pkg\/FR-2018-05-08\/pdf\/2018-08773.pdf<\/a>.<\/em><\/p>\n Source- SuperCoder<\/span><\/i><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"