May 31, 2019 – In early 2018, Congress passed the Medicare Patient Access to Hospice Act which allowed the Centers for Medicare & Medicaid Services (CMS) to change the regulations to recognize physician assistants as designated “Hospice Attendings” effective January 1, 2019. This was something all Coalition organizations supported. While the definition of “hospice attending” provider was changed to include PAs, the Centers for Medicare Services (CMS) continues to limit care for PAs with other statutes and discretionary rules.  Despite the changes that had bipartisan support last year, PAs will not be able to:

  • Prescribe medications to help manage comfort and symptoms for our patients on hospice
  • Re-certify our patients on hospice during “face-to-face” visits

Both of the actions above can be done by physicians and advance practice nurses (nurse practitioners). PAs have prescription privileges in all 50 states and hold DEA numbers just as their physician and advance practice nurse colleagues do—this restriction by CMS is inappropriate and limits access to quality hospice care that PAs could be providing.  Physician Assistants in Hospice and Palliative Medicine (PAHPM) along with all members of the National Coalition for Hospice and Palliative Care  signed on to a letter to CMS requesting the agency use their regulatory discretion to permit this change. See support Letter to CMS.