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How do I get licensed in Oregon?
For specific information on licensure, or to obtain an application, contact the Board of Medical Examiners at:
Crown Plaza, Ste 620
1500 SW 1st Avenue
Portland OR 97201-5826,
Website is http://www.oregon.gov/omb/pages/index.aspx
They can provide you with copies of the Administrative Rules and Medical Practice Act governing PAs in Oregon.
I am currently licensed in Oregon. May I do history and physicals for a corporation in other states?
If you are licensed in Oregon, you are only allowed to practice in Oregon; there are exemptions for federal facilities.
Who do I notify? What happens then?
Oregon Medical Board: They can list you as “inactive” if you are gone for less than 6 months. You need to send them a letter from your commander.
NCCPA: Notify them with a letter from your commander. He will need to include proof of deployment and then they will give you a grace period for the time period you are gone.
AAPA: Notify them of your change in mailing address, if applicable. They can list you as “inactive” and allow a grace period.
What are the Oregon laws regarding MD supervision? How much does the MD actually have to be on site with the PA?
It really depends on the clinic. A physician must be in the office at least one day every two weeks and must be readily available.
How many supervising physicians can a PA have?
Four. Whoever you are working with at that time is your supervising physician.
Are there specific guidelines for PA supervision which include either time spent with a supervising physician or physical distance from supervising physician?
The BME makes its decision based on the practice description and each specific situation.
What is an “agent” for the supervising physician?
An “agent” is any physician that is either in a partnership or shares call with your supervising physician. As long as this is the case, then they would be considered as “agents” of your supervising physician.
I’m a student, graduating in August and taking my boards in October. How can I work in the meantime?
You need to apply for a Limited Post Graduate License – there is a $75 fee, and it is a little more restrictive than a regular license. This limited license is a temporary license you can use for up to a year. When you do pass the boards, you need to notify the BME and they will roll you over into a regular license.
I read that I cannot register for CME credit until I pass the NCCPA. Is this true?
You cannot get CME credit toward NCCPA until you pass one PANCE exam, which is available 50 weeks each year.
Who do I contact about loan repayment?
Contact the State Scholarship Commission in Eugene, who review such applications and award some monies each year. Their address is: Valley River Office Park, 1500 Valley River Dr, Ste 100, Eugene OR 97401. Phone 541-687-7400.
I am a recent graduate and need information regarding malpractice insurance. Who can I contact?
You have three real choices with regards to malpractice insurance:
- AAPA offers the best deal in town for AAPA members.
- Physician Mutual
- CNA Insurance
Can I do flexible sigmoidoscopies and neonatal circumcision?
PAs can do these procedures as long as they can show training, the procedures are included in their practice description, and they have received approval from the BME. Training can be gained though classes and having your supervising physician observe you doing a number of procedures.
What things should I take care of regarding billing before I start to see patients?
Make sure that you are on the insurance plan. Sometimes you will be under your physician’s number and sometimes under your own number.
Who do I contact to get an Insurance Number?
Insurance # - Check with each insurance company. Most will allow PAs to practice under the Group Number or Supervising Physician Number. (Blue Cross does not credential PAs as providers, so you bill under your MD’s number and include a chart note showing that a PA provided the physician services.)
Who do I contact to get a Medicare (UPIN) Number?
Call Blue Cross/Blue Shield of South Dakota 800-326-0238
Do I need to register with Medicaid to see Medicaid patients?
Medicaid in Oregon is the Oregon Health Plan. You need to belong to different insurance companies.
I work in a multiple MD practice which is not a corporation. How do I handle billings with regards to a Tax ID as each physician uses its own?
The answer is different based on whether you are a salaried employee (W-2) or whether you are an independent contractor.
If you are a W-2 employee, and you work with all three physicians, you would use the appropriate physician’s tax ID when you work with them and they each would need to be listed as your supervising physician. You should have your own Medicare Number, which you can get by contacting Blue Cross/Blue Shield of South Dakota 800-326-0238.
If you are an independent contractor, then you need your own tax ID (W-9). Some insurance carriers require that you have your own number. Have your office check. See if they credential PAs; if so, get your own number . You should have your own Medicare Number, which you can get by contacting Blue Cross/Blue Shield of South Dakota 800-326-0238.
Can the PA see the patient and bill at 100% under the physician’s NPI number for medicare patients?
The MD must see the patient initially AND dictate the first visit. If the PA sees the patient after this, the MD must be in the building to bill under the MD’s NPI #. Use modifier for “incident to”. If a new condition is discovered by the PA, then the MD must see the patient the next visit to make the diagnosis, evaluate and dictate before the PA can bill 100% under the MD’s NPI #. Otherwise, it will be reimbursed under the PA’s NPI, at 85%.
Can I sign a home health evaluation?
The problem resides on a federal level and concerns Medicare only. Under DME guidelines you can already sign with other insurances (Blue Cross, etc.). However, even if we were successful in getting a state law passed similar to the NPs, it would not help us anymore than it has helped them. The AAPA is currently working on this issue at the federal level.
Can a PA cover nursing homes?
You can cover nursing homes under Medicare rules (most insurance companies are the same):
- You get paid 85% for nursing home visits.
- The MD/DO must do the original admittance note and orders – at least sign and see patient.
- The MD/DO also must see the patient every 30 days for the first 90 days then every 60 days thereafter. You can then alternate with the MD/DO.
- You may do up to 18 visits a year for each patient.
- PAs can write, sign and date all progress notes which do not require a physician counter signature.
Workers comp does not allow a PA to be attending and pays at 80%. My office manager just gave me a letter from MHN regarding Oregon HB 3669 in which they state they are going to allows NPs to be attending and are working on changing the fee schedule to 100%. Why were PAs not considered in this bill?
The issue of PAs not being able to treat workers comp is MHN only. PAs can see these patients for at least 30 days and longer if their supervising physician or agent becomes the attending. The original HB 3669 was defeated; however the day before the end of the legislative session, the NPs put through a new bill 3669A and would not allow any amendments whatsoever. Coincidentally, top executives at MHN are all RNs except for the medical director. We already have legislative work occurring to be placed in the law in 2006.
PA vs NP A common question posed to physician assistants is, "What is the difference between a PA and a nurse practitioner (NP)?" There is no easy way to respond because what a PA or an NP does varies by state, specialty, and individual practice. The AAPA Public Relations Committee (PRC) researched both professions and developed a list of resources to help answer the question. In October, an editorial was published in the Journal of the American Academy of Physician Assistants and posted on the JAAPA Web site that offers an overview of what the PRC learned.