PA's working as CRNA/AA?

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Specializes in Transplant/Surgical ICU.

Hello,

I was just wondering if PA's are allowed to pass anesthesia. I was lurking on a website, and a PA stated thae he was an anesthesiologist in Russia prior to moving to the USA, and he was legally allowed to work in the capacity of a CRNA/AA although he was a PA. How does that work?

Thanks

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Hello,

I was just wondering if PA's are allowed to pass anesthesia. I was lurking on a website, and a PA stated thae he was an anesthesiologist in Russia prior to moving to the USA, and he was legally allowed to work in the capacity of a CRNA/AA although he was a PA. How does that work?

Thanks

Its not true. First of all training as a physician overseas has nothing to do with the scope of practice of a PA. The scope of practice is directly related to the supervising physician. The PA can do anesthesia as a PA but they do it in the capacity of a PA. There are a very few PAs that do anesthesia (about 25 in the nation according to the AAPA). There are a few states (two if I remember correctly) that prohibit PAs from doing anesthesia. Georgia licenses AAs under the PA practice act so by the way the law is written it would be difficult if not impossible for a PA to do anesthesia. In the other 45-47 states there is nothing to prohibit a PA from doing anesthesia.

The primary problem with PAs doing anesthesia is reimbursement. Under Medicare rules only Physicians, AAs and CRNA can be reimbursed for anesthesia services. The PA mentioned above still could not bill. The few PAs that are doing anesthesia are generally in areas that billing does not matter (VA, HMO etc.). PAs also work with anesthesiologists in other areas such as pain, critical care and in some hospitals in preop doing H&Ps. There is an Association of PAs in Anesthesia if you want to read more about it:

http://www.paanesthesiaworld.us/

David Carpenter, PA-C

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Specializes in ECMO.

David here is the link

http://gaswork.com/post/91576

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David here is the link

http://gaswork.com/post/91576

Here's my take on it for what its worth:

"I have been legally working in perioperative anesthesia setting as a Physician Assistant in the CRNA/AA capacity.

I am a former Anesthesiologist from Russia. My services are being reimbursed by insurance companies including Medicare.

I have attached my resume and cover letter for your review. "

If you look at the description its about perioperative medicine. There are lots of things that a PA can do in the perioperative environment. H&P's, post operative pain management etc. These are reimburseable by Medicare. If you look at the want list and make the assumption that its similar to what they do now it also may reveal some stuff. Pain, critical care medicine and trauma anesthesia (ie resuscitation in the trauma bay) are all within the purview of the PA and reimburseable. The office based and outpatient anesthesia is interesting. Medicare starting in 2006 allow NPPs and physicians to do "moderate sedation" for procedures. Medicare will reimburse this seperately from the procedure.

So you could work for an anesthesia and do critical care medicine, trauma and pain as well as oupatient sedation and get reimbursed for this. They could even let someone sit on the stool in the OR if credentialled as long as they don't bill. The other possibility is that someone could have been licensed as a AA in the past but I really don't know enough about the AA practice acts to really comment on this. There is a similar situation in the PA and NP world where people were licensed based on equivalent experience without completing formal training programs back in the early 70's.

Bottom line the only people getting reimbursed by Medicare in the OR for anesthesia are physicians, CRNAs and AAs.

David Carpenter, PA-C

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Hello,

I was just wondering if PA's are allowed to pass anesthesia. I was lurking on a website, and a PA stated thae he was an anesthesiologist in Russia prior to moving to the USA, and he was legally allowed to work in the capacity of a CRNA/AA although he was a PA. How does that work?

Thanks

He's playing with fire.

You can't practice as a CRNA without BEING a CRNA, and you can't be an AA without BEING an AA - and that means going through the respective programs and passing the certifying examination.

Furthermore - looking at his gaswork ad - there is no AA program at Cornell, so he's flat out lying from that standpoint.

For the same reasons David quoted, it is nearly impossible for a PA to work as an AA. Medicare and virtually all private insurors will not reimburse for his services. If he or his employer are billing his services as an AA, they are doing so fraudulently.

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He's playing with fire.

You can't practice as a CRNA without BEING a CRNA, and you can't be an AA without BEING an AA - and that means going through the respective programs and passing the certifying examination.

Furthermore - looking at his gaswork ad - there is no AA program at Cornell, so he's flat out lying from that standpoint.

For the same reasons David quoted, it is nearly impossible for a PA to work as an AA. Medicare and virtually all private insurors will not reimburse for his services. If he or his employer are billing his services as an AA, they are doing so fraudulently.

Actually Cornell does have a PA program. The RPA-C is unique to New York so I would guess that he was licensed there at one time as a PA. Also for what its worth he is licensed in New Hampshire and employed by an anesthesia group. Cursory examination of New Hampshire law appears to show that it allows PAs to do anesthesia. However if they have figured out a way to bill for anesthesia by PAs its a new one to me (and the AAPA).

David Carpenter, PA-C

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Actually Cornell does have a PA program. The RPA-C is unique to New York so I would guess that he was licensed there at one time as a PA. Also for what its worth he is licensed in New Hampshire and employed by an anesthesia group. Cursory examination of New Hampshire law appears to show that it allows PAs to do anesthesia. However if they have figured out a way to bill for anesthesia by PAs its a new one to me (and the AAPA).

David Carpenter, PA-C

Right - a PA program, but not an AA program.

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Right - a PA program, but not an AA program.

True but he never claimed to be an AA. He stated that he was a PA working in CRNA/AA capacity. There is nothing in New Hampshire law (or most states practice acts) that prevents this. The second part about reimbursed for services is also probably true. He just can't get reimbursed for anesthesia (which makes the whole statement a bit duplicitous).

David Carpenter, PA-C

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