Sponsored by Senator Justin Brown, R-Rolla, Senate Act 177 would remove the requirement that “a physician sign off home health certification or that Medicare approve care” and instead “allow a nurse’s medical assistant to certify home health when it is needed … and give patients the right to do so Choose your home as a place to relax. “
Only when a doctor is allowed to sign off home health care are delays, Brown said. “These delays in getting signatures, and thus delays in maintenance, can make a chronic illness worse [and cause] unnecessary emergency room visits. “
The first witness to speak out in favor of the bill was Carol Hudspeth with the Missouri Alliance for Home CareDue to the COVID-19 pandemic, these provisions have already been implemented by the federal government.
“At the federal level, Medicare requirements allow it. The Missouri Home Health Act forbids it because it uses the word “doctor”. A doctor’s written, signed care plan. So we need to change that to include nurses, clinical nurse specialists, and medical assistants to reflect federal regulation, ”said Hudspeth.
She stated: “[the bill] Missouri Cooperation Agreements will not be modified in any way. It just follows the change of covenant. “
The final witness, Shantel Dooling, contradicted Hudspeth’s testimony that it would still be cooperative.
“I don’t think that would be the case,” she said. “IIf there is already a collaborative practice … iIf you have to wait for the doctor regardless, what is this legislation about? “
Dooling is the director of legislative affairs for the Missouri State Medical Association. Your main problem with the bill is that “there is a huge difference between managing a treatment plan and creating a treatment plan.”
The MSMA, Dooling said, “rarely get[s] Many of our member doctors contact us when a bill is received. In general, we make them aware of this and learn what their concerns are. However, on this bill we had many members who turned to us. They think this could potentially be a big problem. “
Governor Mike Parson signed Executive orders in March 2020 Certain approval requirements for doctors, anesthesiologists, perfusionists, physiotherapists, physiotherapy assistants and medical assistants were temporarily waived.
“Since then … home health officials have been able to use nurses and medical assistants to order the home health services,” said Hudspeth.
MSMA agencies in areas like Kansas City, Rolla, Springfield, and Southeast Missouri have benefited from these assignments, particularly in time-sensitive situations, Hudspeth said.
“(The waiver) allows us to speak directly to the patient’s primary caregiver when we get orders, rather than consulting the doctor who has never seen the patient,” said Hudspeth. “This leads to an improved coordination of care.”