October 16, 2019

States Adopt Scope of Practice Legislation, Address Out-of-Network Billing

In recent state legislative activities, California adopted a revised definition of ‘supervision’ of physician assistants, and Michigan state legislative committees held hearings that led to advancements for out-of-network legislation.

Scope of Practice

In California, Gov. Gavin Newsom has approved SB 697. The law will modify the definition of ‘supervision’ of physician assistants (PAs) to the following:

  • Require adequate supervision as agreed to in the practice agreement
  • Require that the physician and surgeon be available by telephone or other electronic communication method at the time the physician assistant examines the patient
  • Allow the Physician Assistant Board to require the physical presence of a physician and surgeon as a term or condition of a PA’s reinstatement or probation

Out-of-Network Billing

In Michigan, the House Committee on Health Policy heard testimony on HB 4459.

The bill would require out-of-network emergency medical personnel who provide a covered emergency service to be reimbursed at 125% of the amount covered by Medicare for the service, excluding any in-network coinsurance, copayments or deductibles. An out-of-network provider of an emergency service or of an elective service would not collect from the enrollee, directly or indirectly, any excess amount other than applicable coinsurance, copayments or deductibles. Providers may receive an administrative fine for attempting to collect from the enrollee.

Its Senate companion bill, SB 570, was referred to the Senate Committee on Insurance and Banking.