Maine Medicine Weekly Update - 04/15/2020  (Plain Text Version)

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In this issue:
•  Maine Medical Association Zoom Meeting for Providers During COVID-19 Pandemic
•  Federal Enforcement Against COVID-19 Fraud, Hoarding and Price Gouging
•  HHS has Modified Emergency Fund Grant Language to Make its Meaning More Clear
•  WHO COVID-19 Strategic Preparedness and Response Update
•  Obtaining Unaffordable Medicines: A Challenge for Many Patients
•  Retirement Planning - Topics To Consider During Your Retirement Transition Years
•  MMA Joins the Medical Society Consortium on Climate and Health
•  A Message from Maine Responds
•  Nominations for the MMA 2020 Mary Cushman Award for Humanitarian Service
•  Information about the 2020 Census
129th MAINE LEGISLATURE, SECOND REGULAR SESSION
•  New Law Takes Effect Concerning Physician Assistant Scope of Practice
UPCOMING EVENTS
•  Upcoming Specialty Society Meetings
•  FREE WEBINAR - Risk Management & Ethics: COVID-19 Rationing - Thursday, April16th - 2-3pm
•  Webinar tomorrow April 16th at 6pm: Managing Student Debt
•  Webinar April 20 12:30pm: Tele-Tech 101-Lay Of the Land
•  April 29 webinar: MAT in a Time of Public Health Emergency & Social Distancing
•  Successful Opiate Recovery Strategies - June 3 at 2pm, Augusta Civic Center
•  Maine Suicide Prevention Program Training for Clinicians
HEALTHCARE EMPLOYMENT OPPORTUNITIES
•  Family Medicine Outpatient Physician
•  Medical Director, Primary Care Physician
•  Physician - Nasson Health Care
•  Nurse Practitioner - Nasson Health Care
•  Psychiatric Nurse Practitioner - Nasson Health Care
•  Family Medicine Opportunity in Beautiful Western Maine
•  Orthopedic Surgeon Opportunity in Beautiful New England
VOLUNTEER OPPORTUNITIES
•  Opportunities at the VA for Volunteer Physicians
•  Volunteer Opportunity with Partners for World Health - Portland, ME

 

New Law Takes Effect Concerning Physician Assistant Scope of Practice

LD 1660, An Act To Improve Access to Physician Assistant Care, was signed into law by Governor Mills on March 18. Because it was amended by the Legislature as an emergency law consistent with legislative rules in response to the COVID-19 pandemic, the law was effective the day it was signed.

 


MMA CEO Andrew MacLean expresses strong reservations about an increase in physician assistant scope of practice before a state legislative committee

New Law Takes Effect Concerning Physician Assistant Scope of Practice

LD 1660, An Act To Improve Access to Physician Assistant Care, was signed into law by Governor Mills on March 18. Because it was amended by the Legislature as an emergency law consistent with legislative rules in response to the COVID-19 pandemic, the law was effective the day it was signed.

What The New Law Does

Eliminates the requirement that physician assistants render care under the supervision and control of a physician and by extension any ‘plan of supervision.’

Eliminates the requirement that physician assistants complete a training program approved by the licensing board(s)

While physician assistants will still be required to be licensed, the new law eliminates the registration requirement. Licensure can still be obtained by the physician assistants’ choice of licensing boards.

Allows physician assistants to delegate “certain activities relating to medical care and treatment” to the “physician assistants employees, support staff or members of the health care team” and accepts liability for delegation.

The Board of Osteopathic Licensure and the Board of Licensure in Medicine will jointly adopt rules for the licensure and practice of physician assistants. Rules may include but are not limited to:

Education requirements

Requirement for collaborative agreements and practice agreements (*replaces a written plans of supervision)

Scope of Practice

Physician assistants “may provide any medical service” as “prepared by their education, training and experience and is competent to perform.” The scope is to be determined by practice setting  and includes hospitals, physician employers “or an independent practice setting” among others with a system of credentialing and granting of privileges.

Collaborative Agreements

For physician assistants with LESS than 4,000 hours of documented clinical practice

Collaborative agreement is defined as a document agreed to by a physician assistant and a physician that describes the scope of practice as determined by the practice setting and describes the decision-making process for a health care team including communication and consultation among health care team members. A “health care team” and ‘may’ include a physician. Other professions listed are, APRN, physical therapist, occupational therapist, speech therapist, social worker, nutritionist, psychotherapist, counselor, or other licensed professional.

Physician assistants with less than 4,000 hours of practice must work under a collaborative agreement. They may, however, used a system of credentialing and granting of privileges and scope of practice agreement from a health care facility in place of a formal individual collaborative agreement.

The collaborative agreement, or scope of practice agreement must be sent to the Board of Osteopathic Medicine or Board of Licensure in Medicine for approval.

(Note: while the agreement needs to be between the PA and physician, there’s no requirement that the decision-making process, communication or consultation needs to be with a physician, although the physician has ultimate control over that process through development of the collaborative agreement).

Practice Agreement

For physician assistants with MORE than 4,000 hours of documented clinical practice

Defined as, “a document agreed to by a physician assistant who is the principal clinical provider in a practice and a physician that states the physician will be available for collaboration or consultation.” (emphasis MMA).

Physician assistants may be the principal clinical provider in a practice without a physician partner but must have a practice agreement with a physician, “and other health professionals as necessary,” that describes the physician assistant’s scope of practice. The practice agreement must be approved by the Board of Osteopathic Medicine or Board of Licensure in Medicine. (emphasis MMA).

A special paragraph in the law states the sections covering scope of practice, consultation, collaborative agreements and practice agreements “must be liberally construed to authorize physician assistants to work at the full extent of their education, training and experience in accordance with their scope of practice as determined by their practice setting. (emphasis MMA).

Consultation

A physician assistant SHALL consult, with, collaborate with, or refer the patient to an appropriate physician or ‘other health care professional’  when indicated by consideration of a patient’s condition along with the education, competencies and experience of the physician assistant, and standard of care. The level of consultation will be determined by the practice setting. The law does require that a physician must always be available to a physician assistant  for consultation.

(Note: According to this definition the consult could be with another physician assistant as defined by ‘health care professional’ and ‘practice setting’ includes ‘private practice.’ The law does not prohibit physician assistants from opening their own private practice.)

Prescriptive Authority

Allows physician assistants to prescribe schedule II through schedule V and will be allowed to dispense prescription or legend drugs only when a pharmacy service isn’t available, it’s in the best interests of the patient or in an emergency.

Miscellaneous Provisons

Physician assistants are considered primary care providers and/or medical practitioners and/or health care professionals under:

managed care health insurance plans,

laws concerning drawing blood specimens to determine OUI,

probate court guardianship matters,

expediated partner therapy,

minors and abortions,

employee substance use testing,

provision of care concurrent with emergency medical services

One physician assistant will be added to the Board of Osteopathic Licensure AND the Board of Licensure in Medicine.

Do not hesitate to contact Dan Morin at dmorin@mainemed.com or (207) 838-8613 with any questions, comments or concerns with this or any other issue related to government affairs. Thank you.