Hochul plan would loosen leash on physicians’ assistants

ALBANY — A turf war between doctors and physician assistants has been ignited at the statehouse as the two sides clash over Gov. Kathy Hochul’s proposed health care budget.

The Medical Society of the State of New York, the lobby organization for doctors, argues the state would be “facilitating silos” in health care by removing restrictions that limit the ability of physician assistants to handle certain procedures without the supervision of a doctor.

“We are concerned with other proposals (in the Hochul budget) to address care shortages by expanding the services that can be provided by various non-physician providers that would eliminate entirely the important oversight a trained physician can have in overseeing a patient’s care,” said Dr. Parag Mehta, president of the Medical Society.

The physicians assistants, under executive orders enacted during the COVID-19 emergency, got a temporary green light for an expansion in the scope of procedures they can carry out without being under the eye of a doctor. The new proposal would apply to some, but not all of the work they were allowed to do during the pandemic without a doctor supervising them.

The New York State Society of Physicians Assistants, led by its president Patti Cuartas, said it welcomes the Hochul proposal to shelve “administrative barriers,” saying its members are poised to perform at a level determined by their education, training and experience.

“The meaningful changes proposed will increase New Yorkers’ access to care across the state and will allow PAs (physician assistants) to nimbly respond to patient needs,” Cuartas said.

According to her group, New York’s nearly 20,000 licensed PAs provide preventive services, managing treatment plans, diagnosing illnesses and prescribing medications. The PAs practice in surgical specialties, primary care, hospice, palliative medicine, telehealth and mental health.

William Hammond, a health policy fellow at the Empire Center for Public Policy, said the budgetary proposal at the crux of the debate trims costs for consumers.

“Our law currently doesn’t allow them to do the full scope of what they were trained to do,” Hammond said.

With the health care sector representing one of the largest areas of state spending, several other skirmishes are emerging in response to the package of Hochul proposals.

The New York Health Plan Association, which represents managed health care plans in the state, took aim at an initiative that it said would require hospitals to be paid before a determination is made as to whether a service is clinically appropriate.

If that ends up being enacted, warned Eric Linzer, the association’s president and CEO, health plans would have to engage in a “lengthy and cumbersome process to pursue refunds” while costs would rise for consumers, employers and taxpayers.

Another significant stakeholder, the Greater New York Hospital Association, said it is supportive of budget proposals that “curb certain practices of large, for-profit insurance companies that limit New Yorkers’ access to care and harm hospitals’ finances.”

But the hospital lobby group also noted it remains concerned about skyrocketing labor costs driven by nursing shortages and “post-pandemic burnout” of staffers, a trend that jeopardizes the fiscal health of hospitals.

Also weighing on the state budget was the New York State Association of County Health Officials.

The group lamented the spending plan has no funding for the counties to deal with a law that lowers the actionable blood lead level in young children exposed to lead contamination.

The group said the counties need an additional $36 million for local health departments to respond to lead hazards posing a health risk to those children.

Approximately 7,000 New York children are diagnosed annually with elevated lead levels in their blood, posing a risk to their learning capabilities and overall health.

On still another health front, state Sen. Dan Stec, R-Queensbury, is calling on the Hochul administration to shelve the statewide COVID-19 vaccine mandate for health care workers, suggesting the mandate has fueled the labor shortage being experienced by hospitals and nursing homes.


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