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Michigan PA Resources

 

Please note - this document is updated by the MAPA board with questions received by PAs across Michigan regularly.  If you have additional questions please submit them here

 

  

 

FAQ for Outpatient Health Care Facilities

Guidance for Ambulatory Care Settings

 

Provider + Patient Safety

 

 

  • What Proper Personal Protection Equipment (PPE) should I use when treating patients potentially caring COVID-19?
    • Eye protection, N95 mask, isolation gown
    • If N95 respirators are unavailable use an alternative:
      • Other classes of filtering facepiece respirators, elastomeric half-mask and full facepiece air purifying respirators, powered air purifying respirators
      • Limited reuse of N95 respirators are acceptable according to CDC guidelines if necessary secondary to shortage, for more information see CDC guidelines
    • Alternatives including surgical masks and surgical gowns are acceptable
    • Guidance for Extended Use of N95 Respirators

 

  • Instructions on how to properly put on and take off a disposable respirator (N95 mask) are available here

Michigan Licensing Requirements in an Emergency

 

  • Can PAs without a current license practice medicine in a state of emergency?
    • Yes. LARA’s guidance clarifies circumstances when PAs without a current license are eligible to practice medicine as part of an emergency response. LARA has clarified that in a state of emergency, retired PAs (with an expired license), PA program graduates (pre-PANCE testing), and out-of-state PAs (not licensed in Michigan) are eligible to practice medicine as a PA according to their education, training and experience.

 

  • Can PAs be reassigned by their employer to practice in a new specialty?
    • Yes. PAs are permitted in Michigan Law to practice in every type of medical specialty according to their scope of practice. It is the responsibility of each PA to ensure they do not practice beyond their education, training and experience.

 

  • If a PA changes specialty in a state of emergency, are they required to have a new practice agreement and new participating physician?
    • MAPA is seeking further clarification from LARA. We believe the answer is NO but we always recommend that a PA include a participating physician of the same specialty or the facility’s medical director in their practice agreement. Unless LARA provides further guidance, you are required to understand any and all limitations outlined within your practice agreement.

 

  • Do PAs receive medical liability protection when responding to an emergency?
    • Yes. According to Michigan Law (691.1502) , “
      • (1) If the individual's actual hospital duty does not require a response to the emergency situation, a physician, physician's assistant, dentist, podiatrist, intern, resident, registered professional nurse, licensed practical nurse, physical therapist, clinical laboratory technologist, inhalation therapist, certified registered nurse anesthetist, x-ray technician, or licensed EMS provider who in good faith responds to a life threatening emergency or responds to a request for emergency assistance in a life threatening emergency in a hospital or other licensed medical care facility is not liable for civil damages as a result of an act or omission in the rendering of emergency care, except an act or omission amounting to gross negligence or willful and wanton misconduct.
      • (2) The exemption from liability under subsection (1) does not apply to a physician if a physician-patient relationship, to a physician's assistant if a physician's assistant-patient relationship, or to a licensed nurse if a nurse-patient relationship existed before the emergency.
      • (3) The exemption from liability under subsection (1) does not apply to a physician's assistant unless the response by the physician's assistant is within the scope of the license held by the physician's assistant or within the expertise or training of the physician's assistant.
      • (4) This act does not diminish a hospital's responsibility to reasonably and adequately staff hospital emergency facilities if the hospital maintains or holds out to the general public that it maintains emergency room facilities.

 

Telemedicine

 

  • Can PAs provide telemedicine in Michigan?
    • Yes. According to Michigan Law (500.3476) Telemedicine services must be provided by a health care professional who is licensed, registered, or otherwise authorized to engage in his or her health care profession in the state where the patient is located.”

 

  • Can PAs bill for telemedicine services?
    • Yes. Billing codes and rates depend on the payer (i.e. Medicare, Blue Cross Blue Shield, etc.). Updated telemedicine billing information is available in this MSMS Coding Alert .

 

  • Can non-secure communication be used to provide telemedicine services?
    • Yes.  Effective immediately, the HHS Office for Civil Rights (OCR) will exercise enforcement discretion and waive penalties for HIPAA violations against health care providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype, during the COVID-19 nationwide public health emergency.  Visit HHS for more information.

 

  • Does Medicaid still require face to face visits?
    • Currently, “providers may use telephonic, telemedicine, and video technology commonly available on smart phones for program functions that require in-person communication as long as they meet HIPAA compliance standards and the beneficiary or legal representative consents to the method.” This includes both initial and re-assessments. More information available in this MDHHS Medical Services Administration Bulletin .

 

Evaluation and Testing for COVID-19


  • The guidelines for evaluation, testing, and treatment of patients with COVID-19 are ever evolving. Please see the CDC website or check with your local and hospital authority.
  • The CDC developed a Coronavirus Self-Checker which can be utilized for healthcare professionals and patients.
  • Risk Stratification:
    • High risk: Adults 65+ , People who have serious underlying medical conditions (i.e., heart disease, diabetes, and lung disease)
    • Moderate-to-high risk: Other populations that may be at increased risk include

 

 Additional Resources

 

State of Michigan

Childcare for Healthcare Workers

Emergency Response Qualifies for CME

Michigan Licensing Exemptions for Emergencies

SUD Treatment with COVID-19

Medicaid Face to Face Requirements

MDHHS Guidance for Testing Specimen

Michigan Governor’s Executive Orders

MDHHS COVID-19 Covered Services and Billing Guidance


Federal Government

CDC Provider Guidelines

Public Health Emergency Planning Checklist

Public Health Emergency Provider Tools

CDC Caring for COVID-19

CDC Infection Prevention

CDC March 24 Webinar for Providers

CMS Telehealth Fact Sheet

CMS: Halt Elective Procedures

OSHA Protecting Healthcare Workers

CDC Provider Webinars

CMS Provider Fact Sheet

CDC Face Mask Supply Strategies

COVID-19 FDA Treatment Prospects

NSAIDs for Treating COVID-19

CMS Toolkit

 

AAPA

CME Resources

AAPA Telemedicine Brief

 

 

PAEA

Statement to Programs

Program/Student Resources

 

Michigan State Medical Society

Telehealth Billing Brief

Telehealth Brief

Telehealth Legal Alert

Unemployment FAQs

AMA Provider Guide

 

 

Michigan Academy of Family Physicians

Telehealth Resources

Outpatient Office Checklist

 

Other

World Health Organization FAQs

UpToDate

 

 


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10/9/2020 » 10/10/2020
2020 Fall Virtual CME Conference

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