325 Physician Assistant Scope of Practice 2015
nition of “on-site” to allow PAs to practice medicine in a variety of settings
as long as the physician with whom they practice can be contacted. 370 Currently, twenty-one states have parity laws that require private insurers to reimburse for telemedicine visits, and forty-four state Medicaid programs reimburse in some form for telemedicine. 371 However, no two state laws are
alike and reimbursement policies vary wildly. 372 Medicare reimburses for
telemedicine, but only for patients who live in a designated rural Health
Professional Shortage Area or in a county outside of a Metropolitan Statistical Area. 373 Regarding PA practice specifically, Medicare clearly allows
PAs to be distant site providers. 374
Every state has law that authorizes physicians to provide supervision via
telecommunication, and physician-PA teams currently interact using a wide
variety of telecommunication modalities. 375 Telemedicine is an indispensable part of PA scope of practice and affords an essential and invaluable opportunity to care for patients, especially those in rural communities. 376
Some of the ways in which PAs accomplish this include: monitoring medications and the condition of patients with HIV and AIDS in isolated communities throughout the Southeast, conducting the initial assessments of
children with autism throughout rural and central Pennsylvania as members
of behavioral pediatrics teams, and working as both on-site providers and
consultants who treat patients with psychiatric conditions and connect rural
370. Kentucky Loosens Requirements on Physician Assistants, NEPHROLOGY NEWS
(March 21, 2013), http://www.nephrologynews.com/articles/109388-kentucky-loosens-
requirements-on-physician-assistants.
371. Chris Mazzolini, Telemedicine’s Next Big Leap, MED. ECON. 64, 66 (Oct. 25,
2013), available at http://medicaleconomics.modernmedicine.com/medical-economics/
news/telemedicines-next-big-leap.
372. Id.
373. Id.
374. CTR. FOR MEDICARE AND MEDICAID SERVS., TELEHEALTH SERVICES RURAL HEALTH
FACT SHEET SERIES 2 (2014), available at http://www.cms.gov/Outreach-and-
Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/telehealths
rvcsfctsht.pdf.
375. NAT’L. GOVERNORS ASS’N., THE ROLE OF PHYSICIAN ASSISTANTS IN HEALTH CARE
DELIVERY (2014), available at http://www.nga.org/files/live/sites/NGA/files/pdf/2014
/1409TheRoleOfPhysicianAssistants.pdf (“All states have laws and regulations that explicitly authorize physicians to supervise PAs through electronic communication.”); See specifically MINN. STAT. ANN. § 147A.01 Subd. 24 (2014) (defining “supervision” to mean overseeing the activities of, and accepting responsibility for, the medical services rendered by a
physician assistant. The constant physical presence of the supervising physician is not required so long as the supervising physician and physician assistant are or can be easily in
contact with one another by radio, telephone, or other telecommunication device. The scope
and nature of the supervision shall be defined by the individual physician-physician assistant
delegation agreement).
376. AMERICANACADEMY OFPHYSICIANASSISTANTS,PHYSICIANASSISTANTS AND
TELEMEDICINE: OPPORTUNITY FOR RURAL COMMUNITIES (2012) (on file with the author).
