A Change in Florida Statute and how it impacts our practice - Physician Assistants (PA)

Effective July 1, 2009

Amending Florida Statute 458.347 and 459.022

"A physician supervising a physician assistant pursuant to this section may not be required to review and cosign charts or medical records prepared by such physician assistant."

Benefits:

• Beginning July 1, 2009, surgeons are not required to co-sign all PA hospital notes provided in the surgical global period. ShandsUF continues to require the H&P, Discharge Summary, and Operative Report be signed by an attending. ShandsUF also continues to require the attending signature on all consultations except those where the PA or resident states an attending did not see the patient. [Where the PA performs a surgical procedure him/herself (such as vein harvesting) ShandsUF does not require an attending co-signature.]
• Requirements for PAs are now more akin to those for ARNPs. It is easier to draft guidance without minor distinctions.

What it does not do:

It does not change Medicare, Florida Medicaid and commercial payor requirements to support of a bill.

• Most of our commercial payors do not pay for services submitted in the billing number of a PA or ARNP.
• Florida Medicaid pays 100% of the physician fee schedule if a physician is in the building and SIGNS THE MEDICAL RECORD. Florida Medicaid pays 80% of the physician fee service for services submitted in the PA billing.
• Medicare continues its provisions (where conditions are met) for split/shared services and "incident to" services that pay for services at 100% of the physician fee schedule. PA/ARNP services submitted in the PA or ARNP billing number are paid at 85% of the physician fee schedule. For services submitted in the physician's billing number, the physician must provide required documentation, and sign the medical record.
• The physician's signature on an encounter form or billing document (in addition to any Medicare documentation requirements supporting their participation in the service) indicates the supervision requirements were met. A physician must not sign a medical record or encounter form for services provided when he or she did not meet the supervision requirements.

In summary, the rule change does not change the physician signature requirements for billable services provided by a PA.

If you have any questions, please contact the Office of Compliance (Gainesville) at (352) 265-8359.

Webmaster<athagan@ufl.edu>College of Medicine, Office of Compliance  This page created May 20, 2009. Maintenanced 01/15/2010. Please read our disclaimer and permitted use statement.