Today’s Health Care Reform Timeline

The U.S. House of Representatives may vote on HR 3962, the Affordable Health Care for America Act, as early as Saturday. A manager’s amendment was released this week, which amends the original bill to include provisions designed to require insurers who sell policies in the new exchanges to justify any premium increases, to elevate attention to health disparities, and to address quality of care for patients with Alzheimer’s disease, diabetes, and mental illness. Reportedly, language is still being discussed to address members’ concerns regarding a stronger guarantee on the ban of federal funds to pay for abortion coverage and stronger assurances that illegal immigrants would not be able to purchase health insurance plans through the new exchange program. The AMA, AARP, American Cancer Society, and Consumers Union have endorsed the legislation.

The Senate is still waiting for a score from the Congressional Budget Office (CBO) on the merged Finance and HELP Committee bills. Senate floor action will not be scheduled before the CBO score is released.

PA Provisions in HR 3962

HR 3962 removes current barriers to care provided by PAs by allowing PAs to order skilled nursing facility care and to provide hospice care for Medicare patients. Additionally, the House bill reauthorizes the Title VII Health Professions Programs of the Public Health Service Act, the only federal source of funding for PA educational programs. The bill fully integrates PAs into new medical home and chronic care management models of care, including the following requirement for certification of community-based medical homes – “the organization provides medical home services under the supervision of and in close collaboration with the primary care physician, nurse practitioner, or physician assistant designated by the beneficiary as his or her community-based medical home provider.” The bill defines PAs, along with physicians and nurse practitioners as primary health care providers and makes it clear that PAs may lead the primary care team in the new chronic care management model.

House Republicans Release Health Care Reform Bill

Minority Leader John Boehner (R-OH) released the House GOP health care reform bill this week, which was drafted in the form of an amendment to HR 3962. The text and a summary of the Common Sense Health Care Reform and Affordability Act may be viewed here. In brief, the bill advances a number of longstanding GOP proposals on health care reform, including expansion of high-risk pools and reinsurance; medical malpractice reform; incentives for small businesses to offer health insurance; allowing consumers the ability to purchase health insurance across state lines; allowing employers to reward employees who adopt healthy lifestyles; incentives for states to reduce the number of uninsured; greater use of health savings accounts; and extension of young adult coverage on parents’ health insurance plans through age 25. The CBO analysis of the plan concluded that it would not do much to reduce the number of the uninsured. See the CBO analysis here.

Insure Kids Now Campaign

The U.S. Department of Health and Human Services has initiated a campaign to encourage states and communities to enroll the 5 million children who are currently eligible, but are not yet covered by Medicaid or the Children’s Health Insurance Program. Materials on encouraging children’s health care coverage through Medicaid and CHIP may be found here.

Applying to the NHSC Loan Repayment Program Just Got Easier!

The National Health Service Corps is anxious to place clinicians in medically underserved communities and repay educational debt. The new loan repayment application may be found here. Links to the new Application and Information Bulletin and Forms may be found here.

Research Announcements on Smoking Cessation

The National Institutes of Health recently announced that stimulus grant funds were awarded to a Maryland corporation to support the phase III trial of a nicotine vaccine. Early results show that smokers using the vaccine have a greater ability to quit smoking and abstain from smoking than those given a placebo. Learn more here. Meanwhile, the National Cancer Institute announced that the combined use of a nicotine patch and nicotine lozenge provide the best results for individuals attempting to quit smoking. The press statement and study may be viewed here.

A Worthy Goal for Veterans Day

Veterans Affairs Secretary Eric K. Shinseki announced a five-year plan to end homelessness among the nation’s veterans. The Secretary proposes to combine the resources of government, business, and the private sector. A summary of the plan may be viewed here.

PAs: Continue to Urge Legislators to Include PA Provisions in “Merged” Bills

While AAPA has not endorsed any of the health care reform bills that have been developed, AAPA has been working very hard to ensure that every measure contains provisions that improve PAs’ ability to practice and improve patients’ quality of and access to care. PAs must continue to make their voices heard. Congress needs to hear from the profession in support of these positive provisions within the bill. Please contact your Senators and Representatives today. Be sure to thank House members for PA provisions contained in the House bill. Urge both House and Senate members to support provisions in the final bills that would allow PAs to order skilled nursing facility care and provide hospice care for their Medicare patients, that integrate PAs into new models of are such as the medical home, and that provide critical support for PA education programs. Act now!

GAIN – 1300 Strong and Growing!

Have you joined our Grassroots Advocacy and Information Network (GAIN) yet? Our go-to advocacy corps, GAIN members are speaking out for the profession and making a difference on Capitol Hill. Sign up today and make your voice heard on Capitol Hill.

Key Contacts Still Needed!

A GAIN member mentions in passing that “Rep. So-and-So is a great guy and – oh, by the way – happens to be my neighbor.” And voila – a Key Contact is born! If you have an especially close or longstanding relationship with a Member of Congress, let us know by sending a quick note to Kristin Butterfield. We’ll plug you in to our network as someone to call on when a direct contact with a particular legislator is needed.

Register Now for AAPA’s Capitol Connection – February 22-23, 2010

Join forces with your fellow PAs and PA students in Washington, D.C., for a day on Capitol Hill and the opportunity to deliver an important message to Congress. AAPA's new Capitol Connection (formerly Adventures in Lobbying) conference will be held February 22-23, 2010. Make plans now to attend!  Register here.

 

 

 

AAPA Federal Affairs staff is your resource on health care reform and other federal advocacy efforts. Do not hesitate to contact Sandy Harding, AAPA Federal Affairs Director, Kristin Butterfield, Assistant Director of Federal Affairs, or Kimberly Beer, Assistant Director of Federal Affairs, with your questions and suggestions.

PA Elizabeth Sheehan, of Dover, Mass., has spent a long time working among some of the most medically underserved people in the world. Now, she has an ambitious but simple plan to improve the health of women and children globally by converting shipping container into primary health care clinics.

Sheehan's new nonprofit Containers 2 Clinics, or C2C, was recently profiled in lengthy feature story in The Boston Globe. She told the newspaper that she was "thumbing through Foreign Affairs magazine last year when an article and photo caught her eye. The story, headlined "The Global Health Burden,'' addressed the failure to deliver rural health care in developing countries. The photo of a prototype clinic was intriguing. [She] peered more closely: Could it really be one of those ugly metal shipping containers that litter ports everywhere?"
 
According to C2C's website, the clinics will be staffed by local health professionals in-country. C2C's approach to rural medical care is designed to strengthen the entire health care system of a country from the bottom up by building capacity to treat illness locally. C2C clinics will focus on improving the lives of women and children through vaccinations, safe pregnancy and delivery and health education. C2C's model allows for standard design and operations and for replication across regions.

Read the story here.

For more information, go to the Containers 2 Clinics website. 

On October 31, the AAPA Board of Directors (BOD) approved most of the recommendations outlined in a detailed report and presented by the Governance Work Group (GWG), laying the groundwork for revisions to the Academy's governance structure that will support the organization's ability to provide timely, relevant leadership for the profession as well as optimize organizational, fiduciary and policy-making decisions.

"The BOD's reaction to the report and recommendations was most favorable," said AAPA Director at Large and GWG Chairman Jeffrey Katz. "They recognized the amount of work that went into developing these recommendations. The Board amended only four of the recommendations and adopted the other 22 presented."

Over the course of six months, the work group reviewed virtually all aspects of AAPA's governance structure, evaluating the composition and terms of service of the BOD, the purpose and structure of the Student Academy of Representatives (AOR), all AAPA governance-related documents for related to committees, councils and congresses.

"The work group established operating principles at its first face-to-face meeting to facilitate discussion within the group," Katz explained. "This established an atmosphere where all ideas could be discussed and debated amongst all the members of the group."

Katz believes the five most important recommendations include the following: Revision to the committee/council structure to one with Commissions/Workgroups/Task Forces; enhancements to HOD operations; modifications to the composition of the BOD; establishment of term limits for Directors at Large and House Officers and changes to the role of student delegates in the HOD.

"I applaud the hard work and effort of the GWG led by Jeff Katz," said AAPA President Stephen H. Hanson. "It is consistent with our strategic plan, which the board approved last year. These recommendations now go to the House of Delegates, where they will be considered at its meeting next May."

In other business, the BOD took the following actions:

• Approved the concept for a leadership development and orientation plan, thus allowing staff to research relative to actual costs for development and execution of the program

• Received an update on the Sept. 26-27 Specialty Summit regarding AAPA's specialty section pilot program.

• Will review and consider revisions to the AAPA Strategic Plan at their February 2010 meeting. The board, committee and council chairs and senior staff met for a full day in advance of the October BOD meeting to review progress toward achieving goals and strategies in the current plan.

• Approved the PA Foundation's new strategic plan.

• Approved the PA Foundation's new Board of Trustees officers - PA James ‘Rick' Kilgore as Treasurer and PA Lisa Mustone Alexander as Secretary.

• Approved the appointment of PA Tom Tran, Orlando, Florida, as a new PA Foundation trustee for a term beginning immediately through June 2011.

 

FDA issues Emergency Authorization Use for Peramivir IV

The Surgeon General’s office advised all health care providers — including PAs — that the US Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for the use of the investigational antiviral drug Peramivir intravenous (IV) in certain adult and pediatric patients with confirmed or suspected 2009 H1N1 influenza infection who are admitted to a hospital.

Specifically, Peramivir IV is authorized only for hospitalized adult and pediatric patients for whom therapy with an IV drug is clinically appropriate, based on one or more of the following reasons: the patient is not responding to either oral or inhaled antiviral therapy, when drug delivery by a route other than an intravenous route -- e.g., enteral (absorbed by the intestines) or inhaled — is not expected to be dependable or feasible; or for adults only, when the PA judges IV therapy is appropriate due to other circumstances.

Make your IMPACT on The PAnel!

Are you attending IMPACT 2010 in Atlanta? Do you like to write, take pictures or shoot video? Interested in sharing your opinions about conference before, during and after?

Well then you just might be what AAPA is looking for!

Last year we had an amazing time in San Diego & our bloggers covered it all. From nightlife, to tourist activities, to CME sessions, to breaking news, The PAnel was an all-access pass to everything IMPACT. Well we're doing it again this year, but asking for a slightly bigger commitment as we are expanding how long the blog will be active.

You will be asked to do one post some time between January & March, at least one post in April & then blog like crazy during the month of May!

We'd also love a follow-up post or two once you get home & let everything soak in.

Don't worry if you've never blogged before, if you have a unique opinion, insight to what happens at conference or if it's your first time, then you are who we are looking for. Last year we had many first-time bloggers & they did an awesome job. We'd love to have you join us!

Here's what we are asking for to help determine who our 2010 Bloggers will be:

• Write a sample post about something conference related. (If you are a photo or video blogger, get creative!)
• Submit your entry, along with all your contact info and a few short sentences about yourself, to This e-mail address is being protected from spambots. You need JavaScript enabled to view it by November 30, 2009

We will consider all types of bloggers (video, photo, text, etc.) and announce our decisions by December 4th, 2009.

So what will you get out of this?

• Recognition - You'll be known as one of the few invited to provide their insights & opinions on all thing conference. We'll also give you a ribbon for your conference badge so that everyone knows that you're a member of The PAnel!
• Insight - You'll start seeing the conference in a whole new light!
• Freebie - We'll give you an exclusive gift that recognizes you as one of The PAnel, only bloggers for the conference receive this great gift!

Hope you will consider lending your mad blogging skills to AAPA!

 

Did you know that Medicare will pay for certain types of family caregiver education when it's provided as part of a patient's medically-necessary face-to-face visit?

Chances are that you didn't because many PAs and other medical professionals aren't aware that they may be able to bill for family caregiver education as part of the counseling and coordination of care services provided during a patient visit, as long as the caregiver education directly involves the patient and is medically necessary.

During National Family Caregivers Month in November, the National Family Caregivers Association (NFCA) increases its ongoing campaign to tell health care providers and the public how they can help the nation's more than 50 million family caregivers.

So pass the word! Tell your colleagues about the Medicare benefit, and tell your patients, family and friends about the free webinar NFCA is hosting at 2 p.m. EST on Nov. 12 on "Safe & Sound: How to Prevent Medication Mishaps."

AAPA is a National Family Caregiver Month endorsing organization. For more information on Medicare and family caregiver education, go online to http://bit.ly/fPBB9.

To register for NFCA's free teleclass/webinar, call (800) 896-3650 or send an email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

AMA Physician Consortium for Performance Improvement Meeting Looks at EHRs

AAPA recently attended the American Medical Association (AMA) Physician Consortium for Performance Improvement (PCPI) meeting in Washington, D.C.

The two main objectives of the meeting were to engage the PCPI membership in discussions regarding national activities related to the integration of quality measures into electronic health records (EHRs). Secondly, to inform the PCPI membership of proposed pathways to ensure physicians across all specialties, have access to clinically relevant measures ready for integration into EHRs.

Also, a representative of The American College of Surgeons (ACS) spoke about the National Surgical Quality Improvement Program (ACS NSQIP) which is the first nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care.

AAPA is a member of the AMA-PCPI.

Further information about the AMA-PCPI can be found online. Information about NSQIP can be found here.

Doug Scott, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

HHS Secretary Kathleen Sebelius announced Thursday the Senate confirmation of Regina Benjamin, MD, as U.S. Surgeon General.

"Dr. Benjamin will quickly become America's doctor as our next Surgeon General. Her deep knowledge and strong medical skills, her commitment to her patients, and her ability to inspire the people she interacts with every day will serve her well as Surgeon General," Sebelius said in a press release. "She will be an integral part of our H1N1 response effort, and America can expect to see her very soon communicating important information about how to stay healthy and safe this flu season. I commend the Senate for their unanimous vote, and I look forward to working with Dr. Benjamin in the days ahead."

Benjamin, who employs and works closely with a PA and AAPA member in her small rural clinic in Alabama, has long demonstrated support and understanding of the PA profession. The new Surgeon General is the founder and CEO of the Bayou La Batre Rural Health Clinic in Bayou La Batre, Alabama. Earlier this year, she was a keynote speaker at AAPA's 2009 CORE meeting in her role as chair of the Federation of State Medical Boards in 2008-2009.

She is currently the immediate past-chair of the Federation of State Medical Boards of the United States, and previously served as associate dean for rural health at the University of South Alabama College of Medicine. In 2002, she became president of the Medical Association of the State of Alabama, making her the first African American woman to be president of a State Medical Society in the United States.

House Unveils Merged Health Reform Bill and Floor Schedule

This week House Speaker Nancy Pelosi unveiled HR 3962, the Affordable Health Care for America Act, on the steps of the US Capitol. Nearly 2,000 pages long, the legislation proposes to insure 36 million Americans and will cost under $900 billion over ten years. The Congressional Budget Office estimates that the bill would cut the federal deficit by approximately $30 billion over the ten years, if long term care insurance is not included. Separate legislation, HR 3961, was introduced by Representative John Dingell (D-MI) to reform Medicare’s physician payment system.

See the AAPA press statement on HR 3962.

Beginning in 2010, the legislation would implement immediate insurance market reforms, including: a ban on insurance rescissions; new limits on pre-existing conditions exclusions; a ban on lifetime limits; transparency in insurance rate increases; administrative simplifications; and a requirement that insurers spend a minimum 85% of insurance premiums on medical care.

Additionally, the reforms allow young adults through age 26 to remain on their parents’ policies; allow individuals to maintain COBRA coverage until the Insurance Exchange is up and running; prohibit insurers from arbitrarily reducing retirees’ health benefits; and provide an interim high-risk pool for those who are currently uninsured because of pre-existing conditions. See additional provisions with implementation dates.

House debate on HR 3962 is expected to begin next week.

PA Provisions in HR 3962

The new House bill removes current barriers to care provided by PAs by allowing PAs to order skilled nursing facility care and to provide hospice care for Medicare patients. The provisions were added to the bill despite a last minute challenge by the Centers for Medicare and Medicaid Services that allowing PAs to provide Part B hospice care would increase utilization. Additionally, the House bill reauthorizes the Title VII Health Professions Programs of the Public Health Service Act, the only federal source of funding for PA educational programs. The bill fully integrates PAs into new medical home and chronic care management models of care, including the following requirement for certification of community-based medical homes – “the organization provides medical home services under the supervision of and in close collaboration with the primary care physician, nurse practitioner, or physician assistant designated by the beneficiary as his or her community-based medical home provider.” The bill defines PAs, along with physicians and nurse practitioners as primary health care providers and makes it clear that PAs may lead the primary care team in the new chronic care management model.

Senate Timetable on Health Care Reform

The Senate continues its work to merge the health care reform bills reported by the Senate Finance and HELP Committees. Despite Senate Majority Leader Harry Reid’s statements earlier in the week regarding a public option, it does not appear that the votes exist to pass a health care reform bill in the Senate that includes the measure. A merged Senate bill is expected to be released soon and considered by the Senate in November.

The Senate Finance and HELP bills also contain strong PA provisions, including the PA Medicare provisions, a 15% carve-out for PA educational programs in Title VII reauthorization, and full integration of PAs in primary care and chronic care management.

Preparation for H1N1 in High Gear

With the rapid rise of illness caused by the H1N1 virus, the federal government has increased efforts to respond to the virus. On October 24, President Obama declared a national emergency with respect to the pandemic to allow US health care facilities to implement emergency operations.

The HHS Office of Women’s Health also released an alert on the need for pregnant women to receive seasonal and H1N1 vaccines.

Access AAPA clinical information on the H1N1 influenza outbreak.

Breaking News: Dr. Regina Benjamin Confirmed as U.S. Surgeon General

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that the United States Senate unanimously confirmed Dr. Regina Benjamin as the nation’s Surgeon General. Benjamin, a family practice doctor, has spent most of her career serving patients at a rural health clinic in Bayou La Batre, Ala.

In addition to her work with the underserved in Ala., Benjamin has long demonstrated support and understanding of PA profession. Currently, she employs and works closely with a PA and AAPA member at the La Batre Rural Health Clinic. As surgeon general, she will bring a perspective to the delivery of health care that very closely allies with the policies and philosophies of the PA profession.

NIH Announces Stem Cell Breakthrough

Susan B. Shurin, M.D., acting director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development announced that researchers have discovered how to transform embryonic stem cells into germ cells, opening the door to learning more about infertility, birth defects, and chromosomal disorders. Learn more here.

PAs: Take Action!

As mentioned above, the House released its health care reform package Thursday, and it contains a number of very positive provisions for PAs on issues such as Medicare, primary care incentives, medical home and chronic care management. The Senate is still in the process of finalizing a package based on separate bills approved by the Finance and HELP Committees.

PAs must continue to make their voices heard.  Congress needs to hear from the profession in support of these positive PA provisions contained in the bills.  Please contact your Senators and Representatives today.  Be sure to thank House members for PA provisions contained in the House bill.  Urge both House and Senate members to support provisions in the final bills that would allow PAs to order skilled nursing facility care and provide hospice care for their Medicare patients, that integrate PAs into new models of are such as the medical home, and that provide critical support for PA education programs.  Act now!

Save the Date – February 22-23, 2010 – Lobby with Your PA Colleagues on Capitol Hill

Join forces with your fellow PAs and PA students in Washington, D.C., for a day on Capitol Hill and the opportunity to deliver an important message to Congress. AAPA's new Capitol Connection (formerly Adventures in Lobbying) conference will be held February 22-23, 2010. Make plans now to attend!  Online registration will begin November 2.

AAPA Federal Affairs staff is your resource on health care reform and other federal advocacy efforts. Do not hesitate to contact Sandy Harding, AAPA Federal Affairs Director, Kristin Butterfield, Assistant Director of Federal Affairs, or Kimberly Beer, Assistant Director of Federal Affairs, with your questions and suggestions.

For Immediate Release:
October 30, 2009

Brooke Braun
American Academy of Physician Assistants
703-836-2272 ext. 3502
This e-mail address is being protected from spambots. You need JavaScript enabled to view it

American Academy of Physician Assistants Applauds Senate Confirmation of Dr. Regina Benjamin as Surgeon General

WASHINGTON—The American Academy of Physician Assistants (AAPA), representing approximately 75,000 clinically practicing physician assistants (PAs) across the country, commends the United States Senate confirmation of Dr. Regina Benjamin as surgeon general.

“Dr. Benjamin has shown a career-long dedication to eliminating health disparities and preventable illness,” said AAPA President Stephen Hanson. “As surgeon general, she will bring a new perspective to the delivery of health care that very closely aligns with the policies and philosophies of the PA profession.”

Benjamin, a family practice doctor, has spent most of her career serving patients at a rural health clinic in Bayou La Batre, Ala. In addition to her work with the underserved, she has long demonstrated support and understanding of PA profession. Currently, she employs and works closely with a PA and AAPA member at the La Batre Rural Health Clinic. Most recently, Benjamin was featured as a keynote speaker at a February 2009 AAPA conference for constituent organization leaders during her tenure as Chair of the Federation of State Medical Boards in 2008-2009. She spoke about the physician-PA team, the important roles of professional organizations working together, the initiatives of the Federation that were important to PAs and PA practice, and the work to be done by all health professionals to assure access to care and the elimination of disparities of all kinds.

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The American Academy of Physician Assistants (AAPA) is the only national professional association that represents PAs across all medical and surgical specialties in all 50 states, the District of Columbia, Guam, the armed forces and federal services. Founded in 1968, AAPA works to increase the professional and personal growth of the entire PA workforce by providing comprehensive support and advocacy for physician assistants so that they may, in turn, provide patients with increased access to quality, cost-effective health care. Learn more at www.aapa.org.