scapanews 2015-04

SCAPA NEWS | Mar/Apr/May 2015 1

SCAPA NEWS

Mar/Apr/May 2015

NEWSLETTER OF THE SOUTH CAROLINA ACADEMY OF PHYSICIAN ASSISTANTS IN THIS ISSUE

I hope 2015 is off to a great start for you and that you are enjoying the beginning of

spring! The South Carolina Academy of Physician Assistants has certainly taken our momentum from 2014 into the new year with us! Under the guidance of our Executive Director, Janet Jordan, our board of directors, committee chairs and committee members are working hard to ensure that the needs of PAs in the state of South Carolina continue to be met.

On March 5th, SCAPA leaders hosted our 3rd Legislative Breakfast in Columbia and had the opportunity to thank our state

leaders for the work they have done for us in the past. This breakfast was a huge success, and I would like to thank David Astaphan for planning all of the details of the event from the food to the decorations to the publicity! We also used the breakfast as our platform to announce our partnership with a program called SCaledown, an organization designed to help multiple groups across the state combat the statewide obesity epidemic that we are facing. Last year, we launched a brand new philanthropy committee under the leadership of Mason Hicks and Emmy-Lou Dickinson and after months of research, our board agreed to make this our first major philanthropy project. I

PRESIDENT continued on p 2

The State of the Academy by Gabby Poole, PA-C – SCAPA President

The State of the Academy page 1

SCaledown Kickoff

page 3

Legislative Update page 4

Highlights from CORE

page 6

CME Conference Update page 7

Student News

page 8

New Leadership Team page 9

Member Spotlight

page 10

Reimbursement Updates page 11

News Briefs

page 12


PRESIDENT continued from p 1

truly believe that this is a project that all PAs can engage in as obesity is a problem that we all face in our jobs regardless of our specialty. This philanthropy project will be a central focus for us as we move into our next fiscal year, so please be on the lookout for ways in which you can be involved! Thank you to Mason, Emmy-Lou and the philanthropy committee for all you have done already for this project! Thank you to everyone who participated in elections for our 2015-2016 Board of Directors! I am very excited about the people who have been selected to represent our organization in this capacity and feel confident that each of them is committed to representing PAs in our state. The names of each person elected to serve will follow in another article in this newsletter, so please take a moment to congratulate each one of them with me! On April 18th and 19th, your current SCAPA leaders and newly elected and appointed leaders will meet in Charleston to plan for our next fiscal year, which promises to be one of our best ones yet. I would like to take a moment to thank Megan Fulton, our incoming SCAPA President, for the hard work she is doing to ensure that our

leadership team next year remains strong as she plans for this meeting. You can find out more information about our plans for next year and ways that you can be involved in her newsletter article. Thank you again Megan! As we begin the final quarter of this fiscal year, I would like to take a moment to recognize our current SCAPA leaders for their hard work and dedication to our organization and our profession. Most of the people on the list

below are committed to serving each of you for another year, and I am beyond grateful to each one of our volunteers for their time, ideas, and most of all support. I have loved serving as the SCAPA President for the past 18 months, and I am so proud of everything that our organization has been able to accomplish during that time. Thank you for giving me the opportunity to serve in this capacity. I look forward to serving you as Immediate Past President next year!

SCAPA 2014-2015 LEADERSHIP TEAM Board of Directors President – Gabby Poole President Elect – Megan Fulton Vice President – Mason Hicks Secretary – Emily Bagwell Treasurer – Melinda Carr Past President – Rebecca Johnson Upstate Area Representative – Amanda Brodie Low Country Area Representative – Ann-Marie Rader Grand Strand Area Representative - Lisa Moyer Midlands Area Representative – Eric Shoup Pee Dee Area Representative – Warren Pyles House of Delegates Chief Delegate – Chad Robinson House of Delegates Members - Megan Fulton, Victor Gomez

Special Appointments Physician Assistant Recovery Program Liaison – Joe Wehner Medical Care Advisory Committee Liaison – Tysha Holmes Committees Awards Committee – Sean Irvin (Chair), Amanda Brodie, Ann-Marie Rader, Eric Shoup, Lisa Moyer, Warren Pyles ASPIRE Committee – Rebecca Patton (Chair), Clint Blankenship, Karen Karpick, Catharine Wingate, Ivy Palas Communications Committee – Ryan Dadds (Chair), Jacqueline Eckert, Chad Robinson, Gretchen Reibold 2014 CME Planning Committee – Jen Marshall and Temisha Budden (Co-Chairs), Melinda Carr, Megan Walters, Eric Shoup, Rebecca Johnson, Temple Simpson, Martha Green Diversity Committee – Anjinetta Yates-Johnson (Chair), Anthony Poole, Kathryn Gonzalez Legislative Committee – Rebecca Johnson (Chair), Paul Jacques, Tim Stuart, David Astaphan Membership Committee – Elizabeth Spitz (Chair), Katy Conner, Jennifer Reeves, Crispin Reeves, Angela Sczypta Public Education Committee – April Smith (Chair), Allyson Harrell, Ryan Uberman, David Astaphan Philanthropy Committee – Emmy Lou Dickinson (Chair), Shantae Siefert, Ashley Meyers, Morgan Pearman Reimbursement Committee – Kelly Taylor (Chair), Sherlonda Adkins, Victor Gomez


On March 5, 2015, SCAPA members hosted a celebration breakfast at the State House in Columbia. This celebration was a platform to share all the great things SCAPA is doing statewide to fight obesity and officially announce our partnership with SCaleDown, a statewide obesity initiative that joins together over 800 partners statewide in a unified fight

against obesity. SCAPA partnered with SCaleDown earlier this year and is, in essence, their boots on the ground face for change. Mason Hicks, SCAPA Vice President, said "With over 500 active SCAPA members statewide, we are in a unique position to take a vision such as SCaleDown's and implement an immense action plan that begins within our own communities and medical practices. This unified action by PAs can, and will, create a domino effect for positive changes across our state. Starting in our own communities and stretching a helping hand outward, we can provide the tools needed to make a sizeable change statewide.” “We're in this together" and "we've got a lot to lose", were key phrases shared by both SCAPA members and our key partners at this celebration event. Invited guests in attendance included representatives from the Department of Health and Environmental Control (DHEC), SC Area Health and Education Consortium (SCAHEC), SC Institute of Medicine and Public Health (SCIMPH), as well as numerous Senators, House members, legislative staffers, and SCAPA representatives.The outpouring of support was universal among all of those in attendance. SCAPA members affirmed that this partnership would not be possible without the support of our state's health education and regulatory partners, legislators, and our own membership of PAs statewide.

SCALEDOWN continued on p 11

It's a Celebration! South Carolina PAs Join SCaledown and Our State Legislators in the Fight Against Obesity by Emmy‐Lou Dickinson, PA‐C, Philanthropy Committee Chair, and Mason Hicks, PA‐C, Vice President

ABOVE: Attendees shared SCaledown information with legislators during breakfast.

LEFT: Dr. Lee Pearson with SC Institute of Medicine &

Public Health and managing director of SCaledown thanks

SCAPA for our support.

BELOW: SCAPA and SCaledown leaders participate in

the kick-off celebration of the SCAPA philanthropy project.


The Legislative Committee has been busy the last couple of months with our legislative breakfast on March 5th, House bill 3508, and continued efforts to help our fellow PA’s with practice act questions mostly pertaining to CNII prescribing.

SCAPA introduced our partnership with ScaleDown at this year’s legislative breakfast. We served healthy breakfast options and discussed with our legislators how obesity is affecting our patients and how PA’s will be a part of the efforts to improve our state’s health. We would like to give a big thank you to all of those that helped make this breakfast a success. We plan to have another breakfast in March of 2017 and would love to have you join us.

As many of you are aware, the APRN’s introduced a bill in the house, H3078, for independent practice. A compromise bill, H3508, was introduced by the South Carolina Medical Association (SCMA) allowing APRN’s the same advances in their practice act that we received in 2013. This bill was not viewed as an acceptable compromise by the APRN’s. In testimony to the medical subcommittee, the APRN’s made incorrect statements about PA education and how we practice to

distinguish themselves from PA’s. SCAPA’s lobbyist, Ted Riley, was at the hearing and informed us of this testimony, and we were then requested by SCMA to attend the follow up hearing.

At this second hearing of the House medical subcommittee, Paul Jacques and I heard hours of testimony by those in favor of H3508 (mainly physicians) and those opposed to H3508 (mainly APRN’s). Once again, the APRN’s made the same incorrect statements and supplied the representatives with a comparison handout on NP versus PA versus MD education. Unfortunately, we were unable to stand and defend our education and our practice without remaining neutral on the

SCMA compromise bill or waiting for another 30 people to testify before we would be allowed to talk. Thankfully, Ted Riley was able to send text messages to the representatives immediately indicating we were present and the statements made were not correct. We were advised to write a response letter to clarify PA education. You may read this response, which will be sent to the legislators who may have heard the incorrect statements, on the next page. You can also hear the testimony from this hearing at following link and forwarding to minute 33:45: (http://www.scstatehouse.gov/video/videofeed.php)

The legislative committee would like to know if any of our state PA’s are experiencing restrictions with their practice that may seem inconsistent with our current practice act. We have heard from

LEGISLATIVE continued on p 10

Legislative Update by Rebecca Johnson, PA-C – SCAPA Legislative Chair

SCAPA members, left to right, participate in the legislative breakfast on March 5: Mason Hicks, Shantae Siefert, Melinda Carr, Ann-Marie Rader, Megan Fulton, Paul Jacques, Gabby Poole, Rebecca Johnson, Jen Marshall, David Fleece, Emmy-Lou Dickinson, Chad Watts, and Warren Pyles.

The South Carolina Academy of Physician Assistants Response to Subcommittee Testimony

Provided by an APRN on March 17th, 2015 related to H 3508

Debra Hublaw (sp) presented testimony comparing APRN and PA education. In addition, she submitted a document comparing APRN, physician and PA education. Among other inaccuracies that were documented incorrectly, the PA profession was reported as being Physician’s Assistant; whereas, the correct professional title is Physician Assistant. There are currently 190 Physician Assistant Programs in the United States and 92% of them award a master’s degree upon completion of the program. In 2020, all PA programs will be granting master degrees. The minimum requirement for admission to PA education is a bachelor degree which is typically 120 credits. PA’s complete a rigorous 110‐120 semester credit hour curriculum (national average) within a timeframe of 27 months. Physician assistant programs vary in their requirement for prior healthcare experience. In the PA Education Association 29th Annual Report, PA programs report the median amount of patient contact hours was 2,458 prior to admission to a PA program. Applicants have experience as EMTs, Paramedics, military hospital corpsmen or medics, certified nursing assistants, emergency room technicians and medical scribes, to name a few. PA program curricula is designed along the medical school model, which includes anatomy (dissection and prosecutions), physiology, pathophysiology, pharmacology, clinical pharmacokinetics, physical diagnosis, fundamentals of clinical medicine, clinical problem solving, and evidence based medicine. At MUSC, PA students earn 65 credits within 4 semesters of classroom study. Nationally, and at MUSC, PA students average 2,000 hours of clinical practice during the clinical year. As required by the accreditation body of PA education, PA programs provide students with clinical experiences in surgery, women’s health, mental health, family practice, internal medicine, and emergency medicine. This extensive exposure to clinical medicine helps them to integrate their medical knowledge and clinical reasoning with the mentorship of practicing physicians and/or physician assistants. The typical graduate from a PA program in the United States has a bachelor degree (120 credits) and more than 100 credits from the PA program, totaling a minimum of 220 credits. In higher education, a typical master degree is conferred after earning 36 to a maximum of 48 credits and a doctoral degree is earned after (48‐72) an average of 60 credits. Therefore, an individual with a doctoral degree has earned at a minimum 204 credits and a maximum of 240 credits. The PA profession is committed to the master degree for entry into the PA profession and does NOT endorse the entry level doctoral degree for the PA profession. The medical school graduate, MD or DO, who has completed a residency, has significant clinical knowledge and training and has earned the title “doctor”. PAs are committed to the physician led team because of the differences in educational levels. PA’s are provided extensive education and clinical experience to practice medicine with the supervision of a licensed physician as part of the physician‐led team.

The Twenty‐Ninth Annual Report on Physician Assistant Educational Programs in the United States, 2012‐2013.

SCAPA Post Office Box 2054 Lexington, SC 29071 Phone: 803/356-6809 Fax: 803/356-6826 [email protected] www.scapapartners.org


I was honored to have the opportunity to attend AAPA’s Leadership and Advocacy Summit in Washington, DC this year. This summit offered a variety of breakout sessions and lectures given by AAPA leaders sharing a wealth of knowledge. You would think overcoming 4 cancelled flights and walking 4 blocks in the snow with all of my luggage would have been the most difficult part of the trip. However, the most challenging part was determining which breakout sessions to attend as there were quite a few great ones to choose from. Below is just a brief summary of some of the highlights from this summit.

AAPA Regulatory Wins for PAs in 2014: Ordering fecal occult blood tests; ordering portable x-rays; increasing PA employment flexibility in Rural Health Clinics; clarifying that PAs are authorized to write hospital admission orders and perform admission H&Ps (it is still unclear if these need to be co-signed prior to hospital discharge); TRICARE issued new regulations that authorize PAs to order DME.

Regulatory Comments Submitted & Awaiting Action: AAPA submitted comments to (1) CMS on 9/2/2014 stating the need for PAs to order, manage & recertify Home Health Care, and (2) Federal Trade Commission on

4/30/2014 on network adequacy and competition in health care delivery.

The Advocate’s Toolbox: How to Advocate: Build a relationship with members of Congress & staff. Meet with the decision makers in person, and touch base often (mail, email, fax, phone). Offer to be a resource. Provide meaningful follow-up. Give examples, anecdotes, and stories of how PAs make a difference. Identify and use commonalities. Recognize your legislator’s support. Attend a Town Hall Meeting and introduce yourself as a PA. How NOT to advocate: call or write at crunch time, complain without offering a solution, make a reference to votes or money.

Putting The Profession’s Best Foot Forward – Strengthening the Description of PAs. AAPA is encouraging the use of “PA” instead of Physician Assistant as often as possible. The goal is to try and preserve PA identity and get away from MLP (mid-level provider) and APP (advance practice practitioners). It may be easier to use this terminology on facility policies, but focus on how you present yourself. Check out AAPA’s PA Communications Guide at https://www.aapa.org/workarea/d

ownloadasset.aspx?id=2147484763

Easing the Bottleneck: Model Legislation to Enhance Preceptor Sites - Currently there are 190 PA Programs, and this is expected to increase to 250 programs within the next 5 years. 78% of programs DO NOT pay preceptors, but this number is decreasing. Georgia offers a tax deduction to licensed Georgia physicians (MD or DO) providing uncompensated community based training for medical, NP or PA students matriculating at a Georgia program (public or private) for selected rotations. Learn more at https://www.gafp.org/preceptor-tax-incentive-program-ptip-live-website/. Other ways a state can enhance preceptor sites: offer adjunct faculty appointment, allow participation in state funded university medical school mini residency free of charge, offer reduction in licensure fee, university tuition decrease for children to attend state universities.

Medicare Billing Concepts: PAs became recognized Medicare providers in all settings in 1998. PAs/NPs are providers of services that a physician would otherwise have to provide. These are PART B professional services. Medicare

CORE continued on p 7

Highlights from the AAPA CORE Leadership Conference by Emily Bagwell, PA‐C, Secretary


The CME Planning Committee met March 28 to lay the foundation for another spectacular event. The 2015 Fall Conference will be held October 11-15 at Wild Dunes. This year’s room rate is $195, and the registration fee for a SCAPA member PA is $525 and $50 for a

SCAPA student member; however, you can enjoy an early bird discount of $50 if you register by September 1. Registration opens July 1, but if

you have CME money that expires prior to this date, contact Janet Jordan in the SCAPA office and get an early invoice.

As usual, the regular conference program will offer 24 hours of category 1 CME. Additional hours will be available through workshops on topics such as suture, injections, radiology, strategies for taking PANCE/PANRE, DOT exams, and ACLS/BLS recertification. Plus, we hope to incorporate all 20 required Self-Assessment hours in this year’s program in addition to the 4 required hours of controlled substance. We also plan to include a free workshop that can help you initiate a

Performance Improvement Project, one of the other new PA recertification requirements.

In addition to including topics that are covered on PANRE, we are making a concerted effort to invite new and exciting speakers for this year’s program, so if you have a speaker you would love to hear, please let us know! We also plan to incorporate some fun activities that highlight our involvement with SCaledown.

We hope all SCAPA members will make plans to attend this year’s event.

CORE continued from p 6

requires that services provided by a PA may only be paid to the employer of the PA (NPs can receive direct payment from Medicare). PAs MUST be enrolled in the Medicare Program to be a recognized program provider. Stay up to date by checking www.cms.gov. Medicaid only recognizes PAs in 36 states and does not recognize PAs at all in 14 states. SC has limited enrollment. Medicaid recognizes NPs in nearly all states.

For questions regarding Medicaid enrollment, contact Trevor Simon, AAPA assistant director, regulatory policy, at [email protected].

Billing Opportunities and Challenges?? The Essential Guide to PA Reimbursement can be purchased at www.aapa.org/store. AAPA member price is $75. Non-member price is $125.

SAVE THE DATE: October 11-15, 2015

SCAPA 2015 Fall CME Conference by Jen Marshall, PA-C, and Temisha Budden, PA-C – SCAPA CME Committee Co-Chairs

Welcome to the world!

Jeremiah Jeffrey (JJ) Rader

Born January 30, 2015

8lbs 6 ounces


CLASS OF 2015 by Lauren Barsan, PA-S

The 2nd year MUSC PA students have completed over half of our clinical clerkships! Half of the class recently returned to

MUSC for our end of rotation callback, where we participated in practice-OSCEs in preparation for our final OSCE in May. President Elect, Megan Fulton PA-C, spoke to our class and explained how we can stay involved with SCAPA after graduation. We can continue to be active members through positions on the leadership teams and through our continued membership. I am sure August will be here before we know it, and we will be graduating! In anticipation, we are starting to compile our resumes and CVs, signing up for PANCE review courses, and networking for our future dream jobs!

. CLASS OF 2016

by Liz Scarborough, PA-S

The MUSC PA class of 2016 is completing our fourth semester of school, and we are looking

forward to the start of clinical rotations in August. The class is also preparing to welcome the class of 2017 to campus, and we are excited to finally earn the title of “second year” students.

This semester our class has worked to raise money for our class charity, the Dream Center Clinic in North Charleston. This clinic provides free medical care to underserved residents of North Charleston and Hanahan. Our class hosted a male beauty pageant called Mr. MUSC, and we also hosted penny wars between the colleges at MUSC, and a bake sale. In total, our class raised $4763.19 for donating to the Dream Center Clinic. We are so excited to be able to assist the Dream Center Clinic with its mission of serving the medically underserved in our area.

Our class has also completed our fundraising for the AAPA conference, and we will be sending 7 students to San Francisco to represent MUSC at the conference. The class’s AAPA representative, Vanessa Clark, was recently awarded the 2015 Student Academy Travel Grant by SAAAPA to aide with her travel costs to the conference. My classmates and I are excited about the educational and networking opportunities available at the conference and will bring this wealth of information from the conference back to our

classmates that are not able to attend.

Over spring break, five of my classmates traveled to Uganda for a medical mission trip. This experience left a lasting impression on these students and encouraged many students in our class to participate in medical missions in the future. In the coming months, there is a medical mission trip to Nicaragua that students from our class will be participating in as well. We are all very excited to finally be able to use some of the skills we are learning to provide aide in these developing areas of the world.

On April 8th, the class of 2016 will be participating in the SCAPA tele-education program for SCaledown. Our professors have moved our classes in order to allow us to attend this program. I am excited that we will be a part of this educational program and that we will be prepared to make an impact on the obesity epidemic.

This is a difficult time of year to study in the library in Charleston, but I know we will all persevere. Our class is excited to finish up the spring semester and move on to our final semester of the didactic year. We are excited and nervous to get our clinical rotation schedules, and we can’t wait to start seeing patients!

Student News


We are quickly approaching our annual SCAPA planning meeting weekend. We are meeting in Mt. Pleasant at the Wyndham Garden Mount Pleasant to formulate our strategic plan for the fiscal year that runs July 1, 2015-June 30, 2016. With strong momentum moving into the next year, new members of the board of directors have been elected and committee chairs have been appointed. We also have a few selected “special appointment” roles this year to accommodate our growing projects and the expansion of additional South Carolina PA schools. Our large focus at this year’s planning meeting is to involve each of our committees with our philanthropy initiative, SCaledown. We are in the process of identifying projects and our partners with SCaledown. You can read more about SCaledown in the Philanthropy Committee article found elsewhere in this newsletter. I am looking forward to leading the strategic planning session on Saturday and want to extend a huge thank you to President Gabby Poole and her husband, Anthony, for opening their home to us for a team building catered dinner that afternoon. After we lay the foundation for the 2015-2016 year on Saturday, the board of directors, under the capable leadership of Gabby Poole, will meet on Sunday morning to complete work on the 2014-2015 strategic plan. The 2015-2016 SCAPA LEADERSHIP TEAM Please join me in welcoming AND THANKING the following volunteers for their dedication and commitment to SCAPA. We are excited for the new year ahead and thank all leadership chairs, special appointments, board members and committee members for dedicating their extracurricular time and engaging to promote the PA profession.

Board of Directors for 2015-2016 President – Megan Fulton President-Elect – Mason Hicks Vice President – Emily Bagwell Secretary – Jacqueline Eckert Treasurer – Melinda Carr Grand Strand Rep – Lisa Moyer Low Country Rep – Ann-Marie Rader Midlands Rep – Eric Shoup Pee Dee Rep – Warren Pyles Upstate Rep – Amanda Brodie 2nd Year Student Rep – Liz Scarborough 1st Year Student Rep - tbd Committee Chairs for 2015-2016 Aspire Committee Chair – Rebecca Cumbee Awards Committee Chair – Tim Stuart Communications Committee Chair – Ryan Dadds 2015 CME Planning Committee Co-Chairs– Jen Marshall, Temisha Budden Diversity Committee Chair – Caroline Coates Legislative Committee Chair – Rebecca Johnson Legislative Committee Vice Chair – David Astaphan Membership Committee Chair – Lauren Barsan Philanthropy Committee Chair - tbd Public Education Committee Chair – Karen Karpick Reimbursement Committee Chair – Kelly Taylor Special Appointments for 2015-2016 Assistant Treasurer – Elizabeth Spitz SCMA Physician Advocacy & Assistance Committee Liaison – Joe Wehner Medical Care Advisory Committee Liaison – Tysha Holmes New Appointments MUSC PA Program Liaison – Clint Blankenship Plans for new South Carolina PA schools are underway, and SCAPA has developed a new position

NEW TEAM continued on p 10

New Leadership Team Gears Up for Another Successful Year by Megan Fulton, PA‐C, President‐Elect


Shantae Seifert is a 2009 graduate of the PA Program at St Francis University in Pennsylvania, and she currently practices at Waccamaw Orthopaedics in Murrell’s Inlet. She also attended Indiana University of Pennsylvania, graduating with a Bachelor of Science degree in Athletic Training. Shantae sites a general medicine class, where she shadowed a PA in Emergency Medicine during her senior year, as the inspiration for her career choice.

In her current position, Shantae works with physicians who specialize in Sports Medicine and shoulder arthroplasty and who serve as the team orthopedists for 4 local high schools. Her athletic training education helps her provide comprehensive sports medicine care to young athletes. Shantae became interested in working in orthopedics because of her active lifestyle and passion for sports. She enjoys running, golf and tennis.

Shantae says “helping people…get better and get back to doing what they love” is the most rewarding part of her current job. She enjoys helping student-athletes get back to their sport and the snowbird retirees get back to golf.

When moving to South Carolina two years ago, Shantae realized the importance of becoming a SCAPA member to network and promote the PA profession. She currently serves as a member of the Philanthropy Committee and recently attended the legislative breakfast in Columbia to help launch SCAPA’s partnership with SCaleDown.

NEW TEAM continued from p 9

to represent each of our PA schools in our planning and board meetings. We will be extending this position to the new schools in the future so that all events, programs and projects can be effectively communicated throughout our state. Thank you, Clint, for taking on this new role and for your enthusiasm in connecting our established PA school with SCAPA. We look forward to a new exciting partnership with MUSC.

Leadership Opening The Philanthropy Committee has worked diligently this year making key connections with the core administrative team of SCaledown. We are seeking someone to chair this committee and help us continue this important work. Emmy Dickinson is stepping down as chair but will continue as a member of the committee. Other committee members include Shantae Siefert and Morgan Pearman, and the executive board member overseeing this committee is Mason Hicks. Anyone interested in stepping into this exciting new SCAPA role as a chair or member should contact me at [email protected]. LEGISLATIVE continued from p 4

a few PA’s that some pharmacies are not filling their CNII prescriptions. Please know that we have asked for assistance on how to properly inform pharmacists of our practice act changes. The board of pharmacy sent out an update on our practice act to all pharmacists, and they are willing to do this again for us in their next newsletter. The BME decided that a pharmacist is not obligated to ensure that a PA and their supervising physician are in compliance with our CNII prescriptive authority. “The SC Board of Medical Examiners does not interpret the language of the PA Practice Act as amended to impose an obligation upon the pharmacy in question to verify compliance with 40-47-965. Licensees under the SC Board of Medical Examiners, supervising physicians and physician assistants are expected to comply with the Medical Practice Act and are subject to discipline if they do not. Pharmacies may or may not implement their own verification systems for prescriptions in accordance with the pharmacy practice act.” http://www.llr.state.sc.us/POL/Medical/Minutes/November%204,%202013%20mins%20with%20discussion%20Public.pd

Member Spotlight: Shantae Seifert, PA-C


The SCAPA reimbursement

committee has been participating in quarterly STAR conference calls. STAR conference calls are an opportunity for the AAPA reimbursement team to communicate information that is happening on a national scale to the constituent organizations so that each state’s chapter is current on reimbursement happenings. SCAPA would like to keep its members abreast of some of the recent reimbursement changes that have taken place or are in development. Medicaid Enrollment Medicaid policies vary from state to state. Between the states, there is variability as to whether or not physician assistants (PA) are enrolled as health care providers. Enrollment is defined as a provider who has undergone a credentialing process and is able to submit claims under their own provider number. Fourteen states and the District of Columbia currently do not enroll PAs in Medicaid. South Carolina is a “limited enrollment” state, which means that while PAs have provider numbers and are considered credentialed providers, Medicaid does not track PA productivity, nor does it allow for claim submission under the PAs provider number. All claims are billed under the supervising physician number.

Medicare Transition to “Fee for Value” Medicare is looking to move from the current “fee for service” to the “fee for value” model. With the fee for value model, the goal is care coordination with increased efficiency and redundancy reduction. The transition is anticipated to be a relatively rapid change with the goal of 90% of reimbursement being value-based by 2018. Medicare hopes to coordinate with private payers to switch to fee for value as well. PAs may benefit from this as we are one of the most cost-effective providers in the healthcare industry. More details will follow as Medicare moves from conception to more definitive guidelines. TRICARE Reimbursement The PA must be a certified provider with TRICARE regardless of whether or not he/she is a participating provider. Whether the employer is or is not a TRICARE participating provider, reimbursement for PA-provided services is 85% of the physician fee schedule. The claim is billed by supervising or employing physician and accompanied by assigned PA provider number (NPI). The difference between participating and non-participating provider reimbursements is that the non-participating provider reimbursement schedule is lower

than that of the participating provider. In explanation, the PA is reimbursed at the same percent of the fee schedule (85%), but the overall payment is less because the fee schedule is automatically lower. Additional note about TRICARE and PAs: TRICARE has now authorized PAs to be able to order Durable Medical Equipment (DME) for patients, which is a recent change attributed to AAPA lobbying. Medicare Reimbursement for Shared Services (Hospital and Emergency Settings Only) Shared services means that both the physician and PA have face-to-face time with the patient on the same day and the physician documents some portion of the patient note. Shared services allow the service to be billed with the physician’s NPI and thus receive 100% reimbursement (as opposed to 85% reimbursement when billing under the PA’s NPI). Criteria for billing Shared Services are: 1. Hospital setting 2. PA and physician are

employed by the same entity 3. This is for E/M services only,

not for procedures or critical care. The PA can do procedures and provide critical care, but it must be billed under his/her NPI.

REIMBURSEMENT continued on p 12

Reimbursement Updates by Kelly Taylor, PA‐C, Reimbursement Committee Chair


REIMBURSEMENT continued from p 11

4. PA and physician provide care on the same calendar day

5. Physician physically sees the patient and documents some portion of the note. Just a physician signature is not sufficient.

Of note, Aetna also recognizes Shared Services and reimburses at 100% if criteria are met. These are the highlights from the year-to-date STAR conference calls. SCAPA reimbursement committee will continue to

provide periodic updates regarding third party payers and reimbursement issues. Please contact SCAPA if you have any questions or concerns that arise within your practice regarding PA reimbursement.

MUSC’s New Master of Science in Health Infomatics

The United States is in the midst of its largest ever health IT investment, and there is high and growing demand for graduates with infomatics and health analytics skills. Can you help lead change? The Medical University of South Carolina is now accepting applications for its new Master of Science in Health Informatics program, Fall 2015 intake. Program highlights include: 4 semesters, 36 credit hours, part time option available, and courses offered online. Watch the webinar and learn more - MUSC Master of Science in Health Informatics - https://www.musc.edu/chp/MSHI/.

National Center for Rural Health Works: Economic Impact of PAs and NPs in Rural Areas The National Center for Rural Health Works, funded through the Federal Office of Rural Health Policy, provides tools and templates by which community residents can evaluate their health systems. A summary of work and key findings during the past several years is available at the website: www.ruralhealthworks.org. Models to Estimate the Economic Impact of a Rural

Nurse Practitioner or Physician Assistant In addition to their medical contribution, NP/PAs

contribute economically to the community, and surrounding area including the hospital.

Given four different scenarios, a rural NP/PA can create between 4.4 and 18.5 local jobs and $280,476 to $940,892 in wages, salaries and benefits from the clinic and the hospital. To see the complete research study go to:

http://ruralhealthworks.org/wp-content/files/NPPA-Impact-Study-091014.pdf

Initially reported by the South Carolina Office of Rural Health; Rural Focus 2015

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Call for nominations coming soon!


SCALEDOWN continued from p 3 Dr. Joseph (Lee) Pearson, of the South Carolina Institute of Medicine and Public Health and managing director of SCaledown, reciprocated the feeling by sincerely thanking the SCAPA board of directors, and all of our 500 plus members for their dedication to our state’s health and for choosing SCaledown's initiative as our core philanthropy to support in the years ahead. He recounted the numerous ways that SCAPA has already been involved in the obesity initiative since our partnership was conceptualized a few months ago and discussed SCaledown's eagerness to grow this partnership over the next few years.

Thus far in the partnership with SCaledown, SCAPA helped secure a large monetary grant that has allowed us to provide a FREE obesity-related CME seminar in partnership with AHEC. This CME event provides PA’s and other key medical providers the opportunity to objectively evaluate the health of their own communities, learn about the obesity action plan in South Carolina, and implement their own obesity related changes in practices across the state. The FREE CME event titled “A How to for SC PAs: Communities and Practices Join the Obesity Fight” was offered in a teleconference format on April 8th and will be available online once the enduring CME approval is obtained through AAPA. Efforts are also underway to offer this program again in October during the SCAPA Fall CME Conference at Wild Dunes.

Additionally, SCAPA and SCaledown have pledged to support local initiatives in each of the SCAPA regions during the coming year. The SCAPA Board of Directors and the Philanthropy Committee are eagerly working with SCaledown and your local SCAPA representatives to develop more philanthropy-based programs in your area. Our area representatives are: Grand Strand-Lisa Moyer, Low Country-Ann-Marie Rader, Midlands-Eric Shoup, Pee Dee-Warren Pyles, and Upstate-Amanda Brodie. We encourage you to reach out to these individuals and get involved in whatever is being planned in your area. We would love to include you in our future philanthropy functions. Stay tuned for upcoming philanthropy events in your area and get involved. Not only is this a great way to serve our communities, but also meet other PAs in your area. Another great way to meet your fellow SCAPA members is by attending the annual Fall CME Conference in October. We will be incorporating several philanthropy events into this conference and would love to have you there! Don't miss out. To see more about this event and the SCaledown project, visit our SCAPA website at www.scapapartners.org or visit our partner's website at www.SCaleDown.Org. Be sure to "LIKE US" on Facebook (https://www.facebook.com/SouthCarolinaAcademyofPhysicianAssistants) and stay in the know about upcoming events with SCAPA and hundreds of other South Carolina PAs.


AREA MEETINGS

All area meetings are posted to the Community Calendar on the SCAPA website. Visit www.scapapartners.org and find out what’s going on in the state, or feel free to contact your area representative through the map located on the home page.

JOB SEARCH RESOURCES To place a job opportunity or look for a position, visit the Career Center on the home page of the SCAPA web site at www.scapapartners.org.

CME OPPORTUNITIES In addition to the Community Calendar and the CME Conference page, the SCAPA website also has pages for “Other CME Events” and “Controlled Substance CME”. For more information, please visit www.scapaparters.org.

SCAPA NEWS

SCAPA NEWS is published four times per year:

Sep/Oct/Nov, Dec/Jan/Feb, Mar/Apr/May, and Jun/Jul/Aug. Send news and articles of interest to:

SCAPA

PO Box 2054 Lexington, SC 29071

803.356.6809 [email protected]

www.scapapartners.org

scapanews 2015-04

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