3108 - Permitting Physician Assistants to Order Post-Hospital Extended Care Services
Last updated: (May 9, 2016)
Implementation Status
This provision was effectuated by the CY11 Medicare Physician Fee Schedule Final Rule.
On May 1, CMS issued its FY 2014 Skilled Nursing Facilities (SNF) Prospective Payment System (PPS) and Consolidated Billing proposed rule. This rule addresses provisions pertaining to sections 3108 and 3401 of the ACA. Comments on the proposed rule are due by 5pm ET on July 1.
On July 31, 2013, CMS issued its FY 2014 skilled nursing facilities (SNFs) prospective payment system (PPS) and consolidated billing final rule for estimating that aggregate FY 2014 payments, relative to FY 2013, will increase by 1.3% (or $470M). In the rule, the agency addressed the ACA-mandated productivity adjustment under section 3401; provisions pertaining to the permissibility of physician assistants to order post-hospital extended care services at section 3108; and hospice wage index improvements delineated at section 3137.
2016
On Apr. 19, CMS released the FY 2017 inpatient prospective payment system (IPPS) and long-term care hospital PPS and policy proposed rule that, once, finalized, will apply to discharges beginning on or after Oct. 1, 2016. Under the rule, CMS estimates a net average payment increase of 0.7% (a roughly $539 million increase in spending, including capital) in FY 2017 for the IPPS. For LTCH’s, and stemming largely from the application of statutory site-neutrality provisions in the Pathway for SGR Reform Act, CMS estimates that FY 2017 payments will decrease by an estimated $355 million or -6.9% in FY 2017.
Statutory Text
SEC. 3108. PERMITTING PHYSICIAN ASSISTANTS TO ORDER POST-HOSPITAL EXTENDED CARE SERVICES. (a) ORDERING POST-HOSPITAL EXTENDED CARE SERVICES.— (1) IN GENERAL.—Section 1814(a)(2) of the Social Security Act (42 U.S.C. 1395f(a)(2)), in the matter preceding subparagraph (A), is amended by striking ‘‘or clinical nurse specialist’’ and inserting ‘‘, a clinical nurse specialist, or a physician assistant (as those terms are defined in section 1861(aa)(5))’’ after ‘‘nurse practitioner’’. (2) CONFORMING AMENDMENT.—Section 1814(a) of the Social Security Act (42 U.S.C. 1395f(a)) is amended, in the second sentence, by striking ‘‘or clinical nurse specialist’’ and inserting ‘‘clinical nurse specialist, or physician assistant’’ after ‘‘nurse practitioner,’’. (b) EFFECTIVE DATE.—The amendments made by this section shall apply to items and services furnished on or after January 1, 2011.