Chapter 224 and Physician Assistants: Expanding Access to Care

Massachusetts law1 expanded access to primary care by broadening the scope of practice of physician assistants (PAs) and adding them as primary care providers. So, what is Blue Cross Blue Shield of Massachusetts doing?

Credentialing and contracting PAs in 2013

In 2013, we will verify credentials through HCAS and contract with PAs in Massachusetts to expand access to care for our members. There are many aspects of this change in practice scope that we must consider and we want to make sure we do so in a thoughtful manner. We want PAs to have the best implementation experience possible—from the contracting and credentialing process to billing, reimbursement, and access to our technologies—so we have been working together with the Massachusetts Association of Physician Assistants to get valuable input on these topics.

All PAs whose services are billed on a CMS-1500 claim form will have the opportunity to contract with us. At this time, our plan is to have three categories of PAs:

Category:

Description:

PA-PCP PA-PCPs have their own panel of patients and would be listed as a primary care provider (PCP) in our provider directories, so that members could choose the PA as their PCP.
PA (primary care practice) PAs who work in primary care and have elected not to be recognized by Blue Cross Blue Shield of Massachusetts as a PA-PCP.
PA (specialty practice) PAs who work in a specialty care practice.

More information will be shared when plans are finalized

We'll continue to work with the local professional society in Massachusetts, MAPA. When more information is available, we will post an update on this site and will be in contact with PAs. On behalf of our members, we look forward to working with PAs to expand access to care.

1 Chapter 224 of the Acts of 2012, "An Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation."