AAPA

Updating the Federal Workers' Compensation Program to Allow PAs to Diagnose and Treat Federal Employees who are Injured on the Job

Relevant Legislation and Congressional Committees

The Senate Committee on Homeland Security and Governmental Affairs and the House Committee on Education and Labor exercise jurisdiction over the Federal Employees Compensation Act (FECA).

Improving Access to Workers’ Compensation for Injured Federal Workers, (S. 1795/ HR 4651) was introduced in the 110th Congress by Senator Edward Kennedy (D-MA) and by Representative Phil Hare (D-IL). The legislation proposes to amend the Federal Employees Compensation Act to allow PAs to treat federal workers who are injured on the job. It is expected to be reintroduced early in the 111th Congress.

Background

U.S. federal and postal workers receive workers’ compensation coverage for employment-related injuries and occupational diseases through the Federal Employees’ Compensation Act (FECA). The program is administered by the Department of Labor’s Office of Workers’ Compensation Programs/Division of Federal Employees’ Compensation/Employment Standards Administration.

The FECA statute defines “physician” to include “surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law.” Coverage of services provided by chiropractors is limited to manual manipulation of the spine to correct a subluxation. “Medical, surgical, and hospital services and supplies” are defined as services and supplies provided by the health care professionals included in the definition of “physician” and hospitals.

Medical care provided by physician assistants (PAs) is not included in FECA’s definition of “medical, surgical, and hospital services and supplies,” and claims signed by PAs have been denied. In one instance, the AAPA was informed that federal workers were advised to use hospital emergency rooms for non-emergency care, rather than receiving care after-hours at local clinics where PAs were the only health care professional onsite. Unnecessary restrictions on the ability of PAs to diagnose and treat injuries and illnesses covered by the Federal Workers’ Compensation Program unnecessarily limits patients’ access to medical care. The example of the federal workers being advised to utilize the emergency room illustrates that the policy can also add unnecessary costs to the program.

Recommendation

The American Academy of Physician Assistants urges the 111th Congress to amend the Federal Employees Compensation Act to recognize PAs as covered providers through the Federal Workers’ Compensation Program.

Justification

PAs are legally regulated in all States, the District of Columbia, and Guam. All states, the District of Columbia, and Guam authorize physicians to delegate prescriptive privileges to the PAs they supervise. PAs work in virtually every area of medicine and surgery and are covered providers within Medicare, Tri-Care, and most private insurance plans. Additionally, PAs are employed by the federal government to provide medical care, including the Department of Veterans Affairs, the Department of Defense, and the Public and Indian Health Services. PAs are designated as covered providers in the overwhelming majority of State workers’ compensation programs. Yet, federal workers may not be treated by a PA for a workers’ compensation-related injury. It is time for Congress to update the Federal Employees Compensation Act to allow federal workers access to the cost-effective, quality medical care provided by PAs.

For further information, please contact:

Sandy Harding, Director of Federal Affairs
American Academy of Physician Assistants
Telephone: 703/836-2272, ext. 3205
E-mail: sandra@aapa

Kim Beer, Assistant Director of Federal Affairs
American Academy of Physician Assistants
Telephone:  703/836-2272, ext. 3204
E-mail:  This e-mail address is being protected from spambots. You need JavaScript enabled to view it


1/09