Governor John Kasich last week signed House Bill 139 to allow advanced practice registered nurses and physician assistants to admit patients to Ohio hospitals.
The bill was introduced at the request of BakerHostetler client the Council of Ohio Health Care Advocacy and The Cleveland Clinic. Many hospital emergency departments in Ohio are staffed through the night with APRNs and PAs. Though the patients would be physically admitted to the hospital regardless of the time they entered the Emergency Department, they were not admitted by way of the hospital EPIC system until the next morning when the physician arrived. This was resulting in the hospital losing an entire day of reimbursement.
Beginning in May, the APRNs and PAs who meet certain criteria may admit patients to the hospital. APRNs would still be required to collaborate with the physician, and likewise the PA would be supervised by a physician, as is already required by Ohio law. The collaborator/supervising physician would be required to be a member of the medical staff of the respective hospital. The APRN/PA would have hospital privileges and be credentialed by the hospital in order to admit a patient. APRNs/PAs would be required to notify the collaborating/supervising physician prior to admitting a patient. However, prior authorization is not required.
Prior to an APRN or PA admitting patients to hospitals, three things must occur:
The hospital governing body must decide to allow APRNs/PAs to admit;
The collaborating/supervising physician must agree to allow the APRN/PA to admit patients to his or her service; and
The hospital privileging committee must approve the privileging application.
House Bill 139 does not change the APRN or PA scope of practice. These providers diagnose, treat and prescribe medications to their patients as currently authorized by law.
Providers who currently admit patients to Ohio hospitals include physicians, dentists, and podiatrists. HB 139 amends Ohio law to add APRNs/PAs to the list of admitting providers.
House Bill 139 will become effective mid-May 2014.