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Policy & Practice

Physician Assistants Deeply Disappointed in Governor Bakers Healthcare Bill: Ignores Critical Role PAs Play in Cost Containment and Preventive Care


The Mass. Association of Physician Assistants (MAPA) is deeply disappointed by the healthcare bill released by Governor Charlie Baker on Friday, October 18th.


Governor Bakers healthcare cost containment bill (H4134, An Act to improve healthcare by investing in VALUE ) purports to reduce healthcare costs by prioritizing primary care and improving access to high-quality, coordinated care. The Governors press release itself states, The legislation aims to invest in team-based approaches to treat the whole individual in order to improve health outcomes and decrease costs over time The Commonwealth has some of the most restrictive practice requirements governing mid-level practitioners. The release goes on to note that loosening some of theserestrictions have shown immense cost savings and increases in quality of care in other states. MAPA is well-aware of the benefits of preventive care and comprehensive primary care - as PAs have been practicing as primary care providers in Massachusetts since 2012, as part of a team-based model, and as a mid-level practitioner.


And yet - Governor Bakers bill is solely focused on expanding the role of nurse practitioners, creating a dental therapist, and expanding the role of optometrists and podiatrists. While these are all noble pursuits to which MAPA is not opposed, the bill completely ignores the role of one of the most critical, fastest-growing, and effective mid-level healthcare professions: physician assistants.


Perhaps even more alarmingly, the legislation explicitly creates a hierarchy between nurse practitioners and physician assistants in one case, by specifying that a minor placed in restraint can only be examined by a PA if a nurse practitioner or physician is unavailable -- again, despite the clinical qualifications of physician assistants equalling those of nurse practitioners. Physician Assistants and Nurse Practitioners are both qualified mid-level professionals. The four thousand Physician Assistants in the Commonwealth could be used to expand access to primary care and lower costs for consumers, and studies have shown that both PAs and NPs provide healthcare and generate patient outcomes that are mainly the same (to one another and physicians). Moreover, patients see the two professions as largely indistinguishable.[1] De-elevating physician assistant practice is not only harmful to the thousands of current and future PAs in the Commonwealth, it is harmful to patients seeking access to quality, affordable care.


 We are frustrated by Governor Bakers failure to include PAs in the bill in their rightful place - as an experienced healthcare practitioner, with training and education on par with a nurse practitioner. Said Josh Merson, President of MAPA. While Governor Baker states the desire and need to leverage mid-level practitioners to improve our healthcare system, by ignoring the critical role that PAs can play, his bill does not accomplish this goal.


We implore the House and Senate to consider the critical role that Physician Assistants already play in primary and preventive care in the Commonwealth - and the expanded role that they can continue to play as deeply qualified mid-level practitioners. MAPA leadership looks forward to working with the members of the House and the Senate to ensure that the final healthcare bill sent to the Governors desk does not exclude the thousands of PAs practicing in the Commonwealth today, many as primary care providers.

[1] Hooker, Roderick S. and McMichael, Benjamin. Are PAs and NPs Interchangeable? Journal of the American

Academy of PAs. September 2019.


The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health

March 2015

JOINT ALERT: The Board Registration in Dentistry, the Board of Registration in Nursing, the Board of Registration in Pharmacy, and the Board of Registration of Physician Assistants

The National Transportation Safety Board has released a safety study, Drug Use Trends in Aviation: Assessing the Risk of Pilot Impairment. In response, the Board of Registration in Dentistry, the Board of Registration in Nursing, Board of Registration in Pharmacy, and the Board of Registration of Physician Assistants on behalf of the Massachusetts Department of Public Health, Division of Health Professions Licensure, would like to remind licensees who prescribe and dispense prescription drug products of their obligation to discuss with patients the effects of medical conditions and medications prescribed or dispensed, and encourage licensees to read the article below.

Read full alert (PDF)

Scope of Practice and Prescriptive Practice Guidelines
Updated May 2014 to reflect Hydrocodone Extended Release Medications. See section 5.07 Number 12.

The Board of Registration of Physician Assistants has asked that all PAs licensed to practice in the state of Massachusetts review their Scope of Practice and Prescriptive Practice Guidelines to ensure that they are compliant with regulations. Signed copies of these documents must be on file at the place of employment and are subject to audit at any time. They must be reviewed and signed by the supervising physician and the PA annually.

Attached is 263 CMR 5.00. Please review to ensure your compliance.

Head Injury & Concussion Training Requirement for Clinicians from the Massachusetts Department of Public Health (MDPH)
The MDPH Head Injuries and Concussions in Extracurricular Activities regulations provide procedures for persons involved in the prevention, training and management regarding students who incur head injuries while involved in extracurricular sports in order to protect their health and safety. These regulations apply to public middle and high schools serving grade 6 through high school graduation and other schools subject to the official rules of the Massachusetts Interscholastic Athletic Association.

The regulations require that physicians, nurse practitioners, certified athletic trainers, physician assistants and neuropsychologists providing medical clearance for return to play shall verify that they have received Department-approved training in traumatic head injury assessment and management or have received equivalent training as part of their licensure or continuing education. MDPH has developed a Medical Clearance and Authorization Form to include an affirmation that the clinician providing clearance has taken this approved MDPH Clinical Training.

For more information about the Department of Public Health's policies about sports related concussions go to and you can contact Linda Brown.

MA Board of Registration of Physician Assistants - Emergency Regulation Update
May 8, 2014 - Update for the dispensing of hydrocodone-only extended release medications. Please go to the MA Board of Registration website for this update.

MA Reimbursement Policies - View reimbursement briefs, the medicare policy chart, and Atena updates.

Certification of Death: A Reference Guide