Assistant Physicians to be licensed in Missouri
Who reversed the order of the words? Aren’t Physician Assistants already licensed in Missouri? Nope, not a typo; a new licensure category of Assistant Physicians, not to be confused with Physician Assistants, became effective in Missouri on August 28th, 2014. That does not mean licenses will be handed out on the 28th because the Board of Healing Arts has to implement this new state law with rules and regulations.
This bill was pushed by Representative Dr. Keith Fredrick, and supported by the State Medical Association, who are all good folks. After the bill’s passage and various groups had time to digest the new licensure category, opposition began to form. When the Governor signed the bill in July, he noted in his written comments the need for the Board of Healing Arts to ensure proper consumer safe guards are included in implementing rules.
A “task force” of 3 has been formed by the Board of Healing Arts to solicit input from the public, and specifically from practitioners, for ideas on how to best implement the legislation.
Here is what the bill requires; the Board of Healing Arts may issue licenses to a medical school graduate who has successfully completed Step 1 and Step 2 of the USMLE, or the equivalent, within the previous 2 years of applying for AP licensure and who is not in a residency program. The bill then constrains the licensee to holding the license for only 3 years after graduation. So, regardless of when the graduate applies and becomes licensed, after 3 years from the date of graduation, such graduate no longer qualifies to be an AP, even if they are a currently licensed AP.
An Assistant Physician shall enter into a collaborative practice arrangement with a physician and shall limit the Assistant Physician to providing only primary care services (similar to what an APRN or PA can provide) and only in medically underserved rural or urban areas of this state. The AP, for 30 days, shall only practice where their collaborating physician is continuously present before practicing without such physician on site.
While this law certainly allows for an AP licensure category, the logistics could prove to be difficult. The AP can only be licensed for 3 years from the date of graduation. The licensure process is included in that timeframe. Once they receive a license, then they will have to apply to receive an NPI number, DEA number and enroll in Medicaid. This could take 3 to 6 months. Then a collaborating physician has to invest time to train the person to provide services for the remaining portion of the 3 year hard stop timeframe.
We will keep you updated as we learn more about what requirements the BoHA will require of AP’s to become licensed.
Med Mal Reform
I have had numerous meetings with Senate and House Republican leadership as well as the opposing Democrats on our plan of re-capping medical malpractice non-economic damages for personal injury (wrongful death cap of $350k was not tossed by the courts and remains in effect). We are making genuine progress. The gap between the trial bar and the medical community is closing and hopefully the legislature will apply enough pressure to close the gap and pass a bill. Our position is $400,000 cap and the trial bar is $650,000 with an annual CPI attached, as well as moving the current wrongful death cap of $350,000 to $650,000.
We are still separated from the 2015 session by Halloween, Thanksgiving, Christmas and New Year’s Day, when there will finally be a college football playoff. That BCS stuff was a scam, just like KU’s NCAA basketball “championships.”
There is plenty of time for you to get your legislator educated on our Med Mal effort. As the session draws nearer, we will need you to interact with your legislator to communicate the importance of re-instituting a cap on non-eco damages on personal injury med mal cases. After our series of meetings in September, we will send you brief talking points. Until then, get to know your legislator, they are running for re-election, soooo…… get involved.