As vice president of reimbursement and professional advocacy for the American Academy of Physician Assistants (AAPA) with 30 years of staff experience, Michael L. Powe is a highly respected advocate for and champion of the PA profession. He has worked tirelessly on issues such as legislative rights for PAs to practice, Medicare and Medicaid reimbursement for PA services, and countless others to make sure that PAs can work to the best of their ability with compensation. Mr. Powe is a published author and speaker. He is also an adjunct assistant professor at the George Washington University School of Medicine & Health Sciences in Washington, DC. He has received numerous accolades and awards, his most cherished being the John W. Kirklin, MD, Award for Professional Excellence from the American Association of Surgical PAs.
Mr. Powe was born in Chanel, Ohio. After high school, he graduated in 1978 from Ohio State University (OSU) with a Bachelor of Science in Business Administration. Upon graduating from OSU, he worked as a legislative researcher and policy writer in Senator Gaylord Nelson’s office. Mr. Powe represented Senator Nelson on issues addressed by the U.S. Senate’s Small Business Committee and was directly involved in legislative research and writing policy affecting small businesses. In 1982, Mr. Powe went to work in Chase, Maryland for New York Life Insurance Company. There, he worked in health and life insurance sales and as a marketing representative. In 1986, Mr. Powe moved to Springfield, VA to become an insurance broker for Goldchain, Powe & Chapman.
In 1991, Mr. Powe accepted a position at the AAPA as the Government Affairs Administrator. He felt that his prior career experiences blended well with AAPA’s vision for expanding PA recognition. Over the next few years, the Government Affairs Department worked to grow and expand the AAPA’s ability to address multiple legislative issues on the federal, state, and local levels. The department provides input on and helped craft legislative policies, while making sure to consult with PAs.
Over the years, numerous milestones have taken place in the drive for PA recognition and reimbursement. Some of the most notable being:
- In 1993, the Drug Enforcement Administration (DEA) passes rules to allow PAs to register to become authorized to prescribe and dispense controlled substances. The DEA adds the term “mid-level practitioner” (MLP) for PAs and other non-physician prescribers.
- Balanced Budget Act of 1997 which reforms provisions in Medicare and Medicaid and for the recognizes PAs and APRNs as covered providers in all settings at a uniform rate of payment for the first time.
- In 2003, the Centers for Medicare and Medicaid Services (CMS) expand the ability of PAs to have an ownership interest in a practice and be reimbursed by Medicare & Medicaid. With this policy, Medicaid, TRICARE and nearly all private payers cover medical and surgical services delivered by PAs.
- The Patient Protection and Affordable Care Act (PPACA) passes in 2010, adding 30 million persons to the ranks of those who are fully insured. The ACA also creates a Health Resources and Services Administration’s Expansion of PA Training (EPAT) Program, which provides funding for PA education.
- The Medicare Patient Access to Hospice Act of 2017 passes into law a provision that allows PAs to manage and provide hospice care to Medicare patients.
- Medicare Payment Advisory Commission (MedPAC) in 2019 mandates direct reimbursement for all PA and APRN services, eliminating the “incident to” language required for reimbursement at 85% of the prevailing rate.
- In 2020, the Coronavirus Aid, Relief, and Economic Security (CARES) Act includes a CMS waiver so that hospitals can fully utilize PAs and APRNs fully during the COVID-19 pandemic in accordance to their level of training and their state’s emergency preparedness or pandemic plan. Physician supervision is waived and telehealth benefits for reimbursement include PAs and APRNs providing care to eligible beneficiaries during the crisis.
- The Improving Access to Cardiac and Pulmonary Rehabilitation Act is also passed and is scheduled to go into effect Jan. 1, 2024, this act allows PAs and APRNs to supervise cardiac and pulmonary rehabilitation programs for eligible Medicare and Medicaid patients.
Mr. Powe has a sense of pride and accomplishment in having helped a social innovation grow from an idea into the healthcare force it is today. However, he believes there is still more to be accomplished and hopes to continue pushing forward.
Mr. Powe and his wife Luisa – a Physician Assistant- have one son. Mr. Powe’s passions include basketball, travel, hiking and relays. As a younger man, he enjoyed skydiving (10 jumps), hot air ballooning, and bungee cord jumping. After getting married, he decided to be more careful in his leisure pursuits.
Acknowledgments: This Biographical Sketch was prepared by Robert Smith with the help of Mr. Michael Powe. It was submitted to the Society in November 2021. Photographs are courtesy of AAPA and the PA History Society’s Photographic Collection.