DEPARTMENT OF
PUBLIC WELFARERevision to Physician Assistant and Midwife Supervision Requirements; Notice of Rule Change [26 Pa.B. 5847] The Department of Public Welfare announces that effective September 1, 1996, the Department is revising its policy to permit physician assistants and midwives to provide medical services, as allowed by State Law, to Medical Assistance recipients as long as the physician is accessible by telephone or some other means of communication. This Rule Change will be adopted by final rulemaking to 55 Pa. Code § 1141.53(f).
This Rule Change will maintain consistency between Medical Assistance regulations and the current practice standards and licensure for physician assistants and midwives. Failure to implement will produce inconsistency for the Medical Assistance Program with current practice standards and licensure.
This Rule Change has been reviewed by the Office of General Counsel and the Office of Attorney General.
This Rule Change is made under the Joint Committee on Documents Resolution 1996-1(3), 26 Pa.B. 2374 and will be in effect for 180 days pending adoption by the Department.
Public comments to this Rule Change can be made by contacting the Department of Public Welfare, Office of Medical Assistance Programs, c/o Deputy Secretary's Office, Attention: Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120.
Persons with a disability may use the AT&T Relay Service by calling 1 (800) 654-5984 (TDD users) or 1 (800) 654-5988 (voice users), or may use the Department of Public Welfare TDD by calling (717) 787-3616. Persons who require another alternative should contact Thomas G. Vracarich at (717) 783-2209.
FEATHER O. HOUSTOUN,
SecretaryPurpose
The purpose of this notice is to inform providers that the Department revised the supervision requirements for physician assistants and midwives.
Scope
This notice is applicable to all physicians and midwives enrolled in the Medical Assistance Program.
Background
Medical Assistance regulation Chapter 1141, Section 1141.53(f) states that a physician assistant and midwife must be under the direct supervision of a physician when providing medical services to a Medical Assistance recipient. Current practice standards and licensure for physician assistants and midwives now permit them to provide medical services to patients as long as the physician is accessible by telephone or some other means of communication.
Discussion
Since the Medical Assistance Program's policy is not consistent with current practice standards and license for physician assistants and midwives in the Commonwealth, the Department is revising its policy on this requirement to comply with these practice standards and licensure.
Beginning September 1, 1996, physician assistants and midwives will be permitted to provide medical services to Medical Assistant recipients on behalf of a physician without the direct supervision of that physician as long as the physician is accessible at all times by telephone or some other means of communication permitted under current Pennsylvania practice standards and licensure.
Policy
Beginning September 1, 1996, the Department will apply 55 Pa. Code Chapter 1141 as follows:
§ 1141.53. Payment conditions for outpatient services.
* * * * * (f) All covered outpatient physicians' services billed to the Department shall be performed by one of the following:
(i) The physician personally.
(ii) A registered nurse under the physician's direct supervision.
(iii) A physician assistant or midwife provided that physician is accessible at all times by telephone or some other means of communication as permitted under current Pennsylvania practice standards and licensure.
* * * * * Next Step
The Department will amend the Medical Assistance regulations through the regulatory process.
[Pa.B. Doc. No. 96-2023. Filed for public inspection November 29, 1996, 9:00 a.m.]
