Onsite Physician Requirement

Dear Iowa RHC Clinics,

Unfortunately, the proposed site visit rule (ARC 1909C) was delayed by the 10 member legislative rules review committee to the end of the next legislative session May 2016. So the requirement for a physician to visit the PA staffed remote site clinic every 2 weeks will remain in effect until then. And the medical society is making a major effort to overturn the proposed rule in the legislature. The PA Regulatory Board has the option of withdrawing the proposed rule, and rewriting rule. Or the board can keep with the current proposed rule while trying to educate the legislature about its merits.

In the meantime requests to waiver the requirement can be made to the PA Board listing special circumstances. Several such requests have been granted by the PA board recently.

Please let your legislator know of the importance of having flexible rules to keep medical care in rural areas. 29 other states allow physicians to decide how frequently to visit a PA staffed remote clinic. Many national physician associations recommend regulatory flexibility like the proposed PA visit rule allows. Federal rules now allow physicians to determine PA clinic visit frequency. Nurse practitioners have no physician visit requirement.

The rule improve has a good chance of passing eventually if we all make the effort to educate our legislators about the importance of flexible rules like this visit regulation to keeping care in rural Iowa. Thanks to all who helped move it this far. Please let us know if there are questions or suggestions.

Ed Friedmann, PA
Redfield Rural Health Clinic