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Change in Federal Law Allows Physician Assistants (PAs) to Provide Hospice Care

May 7, 2018 (SAN DIEGO) – A recent change in federal law that allows physician assistants (PAs) to manage and provide hospice care for Medicare patients is good news for terminally ill patients and families, and highlights the need for effective palliative care education aimed at PAs and other generalist clinicians.

The Medicare Patient Access to Hospice Act, passed by Congress and signed by the President in February, will take effect Jan. 1, 2019. It allows PAs to serve as the attending physician to hospice patients and to provide hospice care within their scope of practice.

The changes mean PAs interested in hospice work will need deeper training. The California State University Shiley Institute for Palliative Care is filling that gap with Primary Palliative Care Skills, a comprehensive online curriculum designed for PAs, nurse practitioners and other primary care providers. The course includes detailed instruction on how to manage the physical, psychosocial and spiritual distress that accompanies life-limiting disease. Actionable tools for prognosis, assessment, advance care planning, care planning, and integrating palliative care into practice are also included.

Every day, PAs engage with patients in meaningful ways about their illness, how to manage symptoms, how to cope, and how to plan ahead. These interactions constitute good primary care; they are also the foundations of palliative care,” said Jennifer Ballentine, Executive Director of the Institute. “Our course will give PAs more depth of knowledge and marketable skills to enter palliative or hospice care, where they are likely to be in high demand, and enhance their care of patients in any setting.”

Under previous Medicare rules only physicians and nurse practitioners could serve as attending physicians in hospice. National healthcare leaders say the addition of physician assistants is welcome and long overdue.

“Hospice providers in communities across the country, especially those in rural and underserved areas, have a difficult time finding enough primary care providers to serve their patients,” Edo Banach, President and CEO of the National Hospice and Palliative Care Organization (NHPCO), said in a news release. “Allowing PAs to serve as the attending physician will relieve the burden and allow for a more seamless delivery of care.”

For more information on the Institute and its evidence-based palliative care education, visit or call 760-750-4006.

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