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Proposed Personal Care Regulations Permit Non-Physician Ordering of Home Care Services

As members know, the federal Coronavirus Aid, Relief, and Economic Security Act (CARES Act) made permanent changes to federal statute permitting non-physician providers, such as physician assistants and nurse practitioners, to order home care services. This change had been a longtime priority of LeadingAge NY, and we were happy to see it occur at the federal level. The Department of Health (DOH), however, maintained that the new provision was not permitted without State recognition.

DOH’s newest version of the proposed personal care regulations includes this major change:

Section 505.14(b)(3) of the regulations have been amended to clarify that a physician signature on the order form is no longer required when an NP or PA conducts the clinical examination. Based on these comments, the Department believes not requiring a physician signature on the order form in these cases is consistent with recent changes in federal law that allows for NPs and PAs, rather than physicians, to order all manner of home care services; federal regulations that grant states discretion as to when to require physician signatures on orders for PCS and CDPAS (42 C.F.R. § 440.167(a)); and the general scope of expansion authority of PAs and NPs in New York State to engage in independent clinical practice without the direct supervision of or collaboration with a physician.

More details regarding the revised proposed regulations, which make significant changes to personal care services and Consumer Directed Personal Assistance Services (CDPAS), are provided in a separate Intelligence article hereComments on this provision and the full proposed regulations are due March 13th and may be submitted here.

Contact: Meg Everett, meverett@leadingageny.org518-929-9342