Current through February, 2024
(a) A physician
assistant is an individual who is an employee of a supervising physician and
has been certified by the board of medical examiners, State of Hawaii, with the
department of commerce and consumer affairs, to practice medicine under a
physician supervision. The supervising physician must be a Hawaii Medicaid
provider.
(b) Physician assistant
services can only be provided to patients who have established a physician
patient relationship with the supervising physician. The physician assistant
shall only render services that are in the physician assistant's scope of
practice in the State of Hawaii.
(c) Physician supervision:
(1) Means overseeing the activities of, an
accepting responsibility for, the medical services rendered by a physician
assistant. The supervising physician also is responsible for assuring that the
physician assistant's services are medically appropriate for the
patient.
(2) Supervision may be
direct. Direct supervision shall require the physical presence of the
supervising physician to be at the same location the services are rendered and
only for those services the supervising physician is authorized to provide that
are within the scope of practice of a physician assistant.
(3) If supervision by the physician is other
than direct, the physician must be in the State of Hawaii and available at all
times by two way radio, telephone, fax machine, modem, or other
telecommunication devices. The physician assistant's progress note must
indicate that the physician was not physically present. The physician must
review the progress note written by the physician assistant and sign and date
it. The date must be the date he or she actually reviewed the progress
note.
(4) A supervising physician
can be a physician or group of physicians or an osteopathic physician and
surgeon licensed to practice medicine and surgery in the State who in writing
accepts the responsibility for the supervision of services rendered by a
physician assistant.
(5) The
physician assistant notes for services shall be personally acknowledged by the
supervising physician (no personal stamps allowed as acknowledgement) within
seven working days of service even if services are not claimed for
payment.
(d) The
supervising physician shall report to the department the name of any physician
assistants under their supervision. Any changes shall be reported by the
supervising physician.
(e) The
physician assistant must be an employee of the supervising physician and cannot
be the owner of or stock holder in the supervising physician's office, clinic,
or corporation.
(f) A physician
assistant shall meet all the requirements in accordance with chapter
453, Section
453-5.3,
HRS.
(g) Medical services rendered
by a physician assistant may include, but are not limited to:
(1) Obtaining patient histories and
performing physical examinations;
(2) Ordering, interpreting, or performing
diagnostic and therapeutic procedures;
(3) Formulating a diagnosis;
(4) Developing and implementing a treatment
plan;
(5) Monitoring the
effectiveness of therapeutic interventions;
(6) Assist at surgery;
(7) Offering counseling and education to meet
patient needs; and
(8) Making
appropriate referrals.
(h) The physician assistant shall introduce
themselves as physician assistant to all patients for whom the physician
assistant may provide services. They may not advertise in any manner without
the name or names of the supervising physician or physicians, as the case may
be, or in any manner that implies that the physician assistant is an
independent practitioner.
(i)
Hawaii Medicaid will reimburse physician assistant services if services are
provided at the supervising physician's place of business. All claims for
physician assistant services must be submitted by the employing physician.
(1) If the degree of supervision is not met
pursuant to section 16-85-49, Hawaii Administrative Rules, the services
provided by the physician assistant will not be covered by Medicaid;
(2) Payment for physician assistant services
cannot be made directly to the physician assistant. They must be made to the
actual qualified physician employer;
(3) Physician assistant claims are not
payable when the service is not covered by Medicaid;
(4) Physician assistant claims are not
payable if the service requires prior authorization and no authorization was
obtained; and
(5) If none of the
above requirements are met, then the service is not reimbursable under the
State Medicaid program.
