Reimbursement Committee

Purpose

To encourage positive changes with reimbursement for services provided by PAs and to serve as a resource on reimbursement issues for PSPA members.

COMMITTEE GOALS

  1. Serve as a resource for the Board of Directors and membership on matters that relate to reimbursement.
  2. To educate the membership of current reimbursement legislation/policies concerning Medicare/Medicaid and other third-party payers.
  3. To establish liaison with third-party payers and government agencies that influence reimbursement issues.
  4. To work closely with the Government Affairs Committee to make positive changes with reimbursement for services provided by PAs.

COMMITTEE COMPOSITION

  1. The committee shall consist of a chairperson appointed by the President and approved by the Board of Directors.
  2. The committee shall consist of PSPA members appointed by the chairperson.
  3. The treasurer will serve as the Board Advisor to the committee.
  4. The treasurer and president are ex-officio members of the committee.

COMMITTEE CHAIR JOB DESCRIPTION

  1. Be a PSPA member in good standing.
  2. Be aware of current reimbursement legislation/policies concerning Medicare, Medicaid, and other third-party payers.
  3. Serve as a contact for members concerning third-party payment issues.
  4. Appoint committee members.
  5. Appoint one member of the committee to serve as the vice-chair. The vice-chair’s responsibility will be to assist the chair with all the functions of the committee as well as be prepared to take over the committee in the unlikely event that the chairperson is unable to complete the functions of the committee.
  6. Submit a written, quarterly committee report to the Board at least 2 weeks prior to each Board of Directors’ meeting.
  7. Monitor and submit updates to reimbursement section on website at timely intervals.
  8. Estimated time needed to fulfill duties of this position is 4-6 hours per month in addition to the Board of Directors’ meetings.
  9. Attend at least three (3) Board of Directors’ Meetings per year.
  10. Make policy recommendations to the Board of Directors’ when appropriate.
  11. Submit at least 2 articles per year to the PSPA NEWS.
  12. Submit a proposed budget to the treasurer prior to requested deadline.
  13. Submit a yearly committee report for the PSPA membership.
  14. Oversee all expenses by the committee.
  15. Participate in the development of the PSPA Action Plan.

COMMITTEE MEMBER JOB DESCRIPTION

  1. Be a PSPA member in good standing.
  2. Be aware of current reimbursement legislation/policies concerning Medicare, Medicaid, and other third-party payers.
  3. Participate in committee activities, complete assigned tasks, and report progress regularly to chairperson by verbal, written or electronic means.
  4. Maintain communication with the committee chair on a monthly basis.
  5. Estimated time needed to fulfill duties of this position is 2-4 hours per month.
  6. Expenses for committee business are reimbursable if approved by the committee chairperson.

 COMMITTEE GUIDELINES

  1. Shall abide by all PSPA and AAPA bylaws and policies.
  2. Any member of the committee representing the Society to an outside group may not act on behalf of the Society without the approval of the Board of Directors.
  3. Budget, disburse and account for those funds allocated to the committee for the administrative function of the committee.

COMMITTEE PROCEDURES

  1. Monitor reimbursement for medical/surgical services provided by PAs by all carriers and governmental agencies.
  2. Gather information about reimbursement problems in Pennsylvania.
  3. As designated by the committee chair, committee member to attend AAPA Reimbursement meeting as needed.
  4. Offer site visits to all PA programs to discuss billing issues.
  5. Provide reimbursement update at annual PSPA Conference.

RESIGNATIONS

A 2-month notice of resignation is requested of the chairperson. It is also recommended that the outgoing chairperson supply the names of two physician assistants that could step into the position, if possible. The resigning chairperson should submit all files and copies of the correspondence regarding the committee’s activities to the new chairperson or to the Board Advisor for the committee.

Approved 1/13/01; Reviewed/Revised 11/1/22

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