New Medicare Legislation Will
Aid PAs
Who Work for ED Staffing Companies
By Michael Powe, AAPA's Director, Health Systems & Reimbursement Policy
A legislative provision passed as part of the Medicare prescription drug benefit bill will have a positive impact on PAs who work for Emergency Department (ED) staffing companies. This provision effectively removes any remaining barriers in the area of payment policy for staffing companies to utilize PAs as W-2 employees or as independent contractors.
It is typical for ED staffing companies, such as PhyAmerica, to provide health care professionals to deliver services in EDs. PAs are an important component of the team of professionals who treat Medicare patients in many EDs.
Depending on the employment relationship, there were sporadic problems when staffing companies utilized PAs in EDs. The problem wasn't with Medicare covering services provided by PAs. Medicare by law covers all medically necessary services delivered by PAs if that same service would have been covered if provided by a physician. Medicare also allows PAs to function as independent contractors which is often the type of working relationship PAs have with staffing companies. The problem was that Medicare did not recognize staffing companies as eligible providers or suppliers of service and, therefore, would not allow these companies to bill for the services of PAs. PAs are not allowed to bill Medicare directly under their provider identification number.
Recent changes to Medicare policy allow PAs to own up to 99% of their own corporation which could directly bill Medicare. It is technically possible for these PA-owned corporations to bill Medicare for the PAs services and assign the payment back to the staffing company. However, this is a cumbersome process that could be problematic to PAs working as independent contractors.
The new legislation provision now allows physician and non-physician health care professionals to reassign Medicare payments to staffing companies as long as there is a contractual agreement between the health care professional and the staffing company. The language also supports the ability of health care professionals to have unrestricted access to view the bills submitted by the staffing company in their names.
