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F I S C A L I M P A C T R E P O R T

SPONSOR Cote

ORIGINAL DATE

LAST UPDATED

1/21/08

2/1/08 HB 89/aHCPAC

SHORT TITLE Physician Assistant Requirements

SB

ANALYST Moser

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY08

FY09

NFI

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

NM Medical Board (NMMB)

NM Health Policy Commission (HPC)

Department of Health (DOH)

Human Services Department (HSD)

SUMMARY

Synopsis of HCPAC Amendment

The House Consumer and Public Affairs Committee Amendment to House Bill 89 made the

recommended change to the Provider Discrimination portion of the Bill (See Technical Issues

below).

Synopsis of Original Bill

House Bill 89 amends existing laws to include physician assistants within the definitions and

provisions of health care providers. The Physician Assistant Requirements bill proposes

amendments to the “Umbilical Cord Blood Banking Act" by adding physician assistants into the

definition of “health care provider."

The bill amends technical terms and phrases in the definitions of the New Mexico Drug, Device

and Cosmetic Act in addition to adding physician assistants to the list of providers authorized to

direct the use of a prescription device.

House Bill 89/aHCPAC – Page

2

The bill amends Chapter 45, Article 5, “Protection of Persons Under Disability and Their

Property" by including physician assistants to the list of qualified health care professionals

whose training and expertise aid in the assessment of functional impairment.

The bill also proposes amending Chapter 59A, Article 22, Section 32 “Freedom of Choice of

Hospital and Practitioner" by again including physician assistants on the list of practitioners that

an individual may select for treatment of an illness or injury within the terms and limits of the

individual’s insurance coverage plan and by adding physician assistant to the statement on -

Provider Discrimination Prohibited - as follows:

“All individual and group subscriber contracts delivered or issued for delivery in New Mexico

that, on a prepaid, service or indemnity basis, or all of them, provide for treatment of persons for

the prevention, cure or correction of an illness or physical or mental condition shall include

coverage for the services of a physician assistant and a certified nurse practitioner. Deductibles,

limits of coverage or other terms and conditions of coverage for certified nurse practitioners shall

not differ substantially from coverage for the same or similar services provided by other

practitioners. Nothing in this section shall restrict a health care plan from including in the terms

of its coverage any benefit differences based on differences in the scope of practice of health care

practitioners."

FISCAL IMPLICATIONS

No Fiscal impact.

SIGNIFICANT ISSUES

Physician assistants (PAs) practice medicine under the supervision of physicians and surgeons.

PAs are formally trained to provide diagnostic, therapeutic, and preventive health care services,

as delegated by a physician. Working as members of a health care team, they take medical

histories, examine and treat patients, order and interpret laboratory tests and x rays, and make

diagnoses. They also treat minor injuries, by suturing, splinting, and casting. PAs record progress

notes, instruct and counsel patients, and order or carry out therapy. In 48 States and the District

of Columbia, physician assistants may prescribe some medications. Physician assistants work

under the supervision of a physician. However, PAs may be the principal care providers in rural

or inner city clinics where a physician is present for only one or two days each week. In such

cases, the PA confers with the supervising physician and other medical professionals as needed

and as required by law. PAs also may make house calls or go to hospitals and nursing care

facilities to check on patients, after which they report back to the physician.

Many PAs work in primary care specialties, such as general internal medicine, pediatrics, and

family medicine. Other specialty areas include general and thoracic surgery, emergency

medicine, orthopedics, and geriatrics. PAs specializing in surgery provide preoperative and

postoperative care and may work as first or second assistants during major surgery.

Employment is expected to grow much faster than the average as health care establishments

increasingly use physician assistants to contain costs. Job opportunities for PAs should be good,

particularly in rural and inner city clinics, as these settings typically have difficulty attracting

physicians. Employment of physician assistants is expected to grow 27 percent from 2006 to

2016, much faster than the average for all occupations. Projected rapid job growth reflects the

House Bill 89/aHCPAC – Page

3

expansion of health care industries and an emphasis on cost containment, which results in

increasing use of PAs by health care establishments. Physicians and institutions are expected to

employ more PAs to provide primary care and to assist with medical and surgical procedures

because PAs are cost-effective and productive members of the health care team. Physician

assistants can relieve physicians of routine duties and procedures. Telemedicine—using

technology to facilitate interactive consultations between physicians and physician assistants—

also will expand the use of physician assistants.

TECHNICAL ISSUES

The HPC recommends the following amendment regarding the statement on - Provider

Discrimination Prohibited (See bold print for recommended revision in statement).

“Deductibles, limits of coverage or other terms and conditions of coverage for physician

assistants and certified nurse practitioners shall not differ substantially from coverage for the

same or similar services provided by other practitioners."

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL

New Mexico may continue to experience a shortage of health professionals (e.g. physicians,

nurses, etc.) practicing in the state based on current projections of available workforce. A

shortage in the health professional workforce will have negative impacts for New Mexico

residents in terms of access to health care and overall health status.

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