Licensure Bill

Licensure in Pennsylvania

The Pennsylvania Academy of Nutrition and Dietetics (PAND) has been working with the support of our lobbyist and the Academy of Nutrition and Dietetics to enhance the current licensure statute in the Commonwealth of PA for Registered Dietitian Nutritionists. 

Pennsylvania is one of 18 states that has licensure of title only. With an enhanced regulation we could achieve practice exclusivity. This means that a license is required to provide MNT or to practice dietetics, subject to any exemptions. 

After years of hard work, an amendment to the original act of May 22, 1951 (P.L.317, No.69), known as the Professional Nursing Law, was introduced by Representative Thomas Mehaffie (District ___) into the PA House Professional Licensure Committee in 2020. PAND’s licensure team continues to negotiate the language in this bill to promote our members as credentialed experts to support our communities in optimizing health through food and nutrition, and to fully protect the residents of the Commonwealth from unqualified providers.

Every member’s voice is needed.

Why do we need enhanced licensure in PA?

An advanced degree alone does not provide assurance of the ability to translate knowledge into practice. Dietetics and Medical Nutrition Therapy are made up of complex nutrition services that should be provided by qualified individuals with the education, training, and professional experience necessary to ensure safe and effective care of the residents in the Commonwealth of PA.Licensure enables those consumers to easily identify qualified providers of those nutrition services and Medical Nutrition Therapy.This amendment also ensures our ability to collaborate and integrate with other licensed health providers to improve a consumer's journey across the continuum of care and improve clinical outcomes.

Licensure enables Pennsylvania RDs/RDNs and Certified Nutrition Specialists (CNSs) to operate at the height of their scope of practice…

Most 3rd party payers, including the Centers for Medicare and Medicaid Services (CMS) recognize the RD[N] as the “professional best qualified to assess a patient’s nutritional status and to design and implement a nutritional treatment plan in consultation with the patient’s interdisciplinary care team. In order for patients to receive timely nutritional care the RD[N] must be viewed as an integral member of the interdisciplinary care team, one who, as the team’s clinical nutrition expert, is responsible for a patient’s nutritional diagnosis and treatment in light of the patient’s medical diagnosis.”

Supporting Literature

The Legal Nexus of Consumer Protection and Dietetics Practice

By: Pepin Tuma, JD
https://www.jandonline.org/article/S2212-2672(20)30451-2/fulltext

 

Consumer Protection Through Professional Regulation

By: Wendy Phillips, MS, RD, CD, FAND and Pepin Tuma, JD

https://www.jandonline.org/article/S2212-2672(19)30507-6/fulltext 

What impact does this have on  the Dietitian?

Licensure is what helps us preserve our role as a medical specialist, and as a practitioner with the ability to bill for medical services. As reimbursement and care coordination continues to evolve, it is imperative that Dietitians remain a part of those conversations, and continue to grow as an essential member of patient care. 

Reimbursement is directly tied to being a licensed practitioner. It is vital Dietitians have a core understanding of their reimbursement landscape. As a profession our ability to grow and expand our impact is directly tied to funding and outcomes. Click below to watch a Reimbursement 101 Presentation by the PAND Nutrition Services Payment Specialist (NSPS), Andrew Wade.

Video

What impact does this have on  the NDTR?

Our suggested updates to the bill include the opportunity for NDTRs to practice MNT under the supervision of an LDN.

Nutrition Services and Reimbursement

Who is a healthcare provider?

“Healthcare provider means a provider of services (as defined in section 1861(u) of the [Social Security] Act, 42 U.S.C. 1395x(u)), a provider of medical or health services (as defined in section 1861(s) of the Act, 42 U.S.C. 1395x(s)), and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business.” As defined by the US Department of Health and Human Services, Office for Civil Rights, HIPAA Administrative Simplification document.

National Provider Identifier

The protection and promotion of optimal health of consumers in the Commonwealth of Pennsylvania relies on a representative workforce of qualified providers. Regardless of your area of practice, all RDNs and NDTRs should obtain a unique National Provider Identifier (NPI) as a means of recognition to payers and external stakeholders. Recognized healthcare providers are able to electronically transmit and receive personal health information (PHI).

Access and download the CMS NPI Toolkit: NPI: What You Need to Know (cms.gov)

Apply for an NPI here: NPPES (hhs.gov)

Taxonomy Codes

Providers must choose one or more taxonomy codes when registering for an NPI. These codes identify the type and/or specialty of healthcare you provide. These codes are reviewed twice per year by the American Medical Association’s National Uniform Claim Committee.

Click these links to access code sets:

National Uniform Claim Committee - Home (nucc.org)

An Easy Way to Find Your Taxonomy Code – NPI Lookup (npi-lookup.org)

Even students can apply for an NPI while in school.
Enter 390200000X Student in an Organized Health Care Education/Training Program to indicate you are a student 

After Graduation and Certification: Upon graduation and the receipt of your certification (and state license if applicable):  Log into your NPPES account.  Remove the 390200000X – Student taxonomy code

Communicating With Members of Congress

Click here to check out the Academy’s tips for the following:

  • Meeting requests
  • Sample phone script
  • Sample email script

Remember, every voice counts!

Engaging Members of Congress

Click here for the Academy’s resources on engaging with your congressional members.

Need more tips? Click here to view a sample phone interaction.


Participate in our session at AME 2023 on April 21st
Pennsylvania Advocacy: Your Voice for Your Profession

State Legislative Tracking Map

Access a list of active state legislation relevant to priority issues, provided by the Academy of Nutrition and Dietetics

We want to hear your thoughts

Click here to complete a survey of opinions. 

We appreciate your feedback and value your voice.

INCIDENT REPORTING TOOL

      “Documenting Stories of Success and Reporting Harm”

The Academy developed the Incident Reporting Tool to support its efforts to protect the public, enhance the quality of nutrition care and promote self-regulation of the profession. The IRT fills a critical gap in supplementing the documentation of noteworthy incidents in the provision of nutrition care services across the country.  Patients, members of the general public and health care practitioners can now easily document examples of successful nutrition care, showing the value of qualified practitioners. In addition, incidents of harm or unethical practice can be submitted using the IRT.  The IRT is very similar to the same tools used across the healthcare continuum by other organizations to document quality care and incidents of harm/unethical care. 

The Academy/CDR Code of Ethics requires reporting cases of harm, and this tool provides a uniform and easy mechanism to do so and complements reports to state licensure boards. The information collected from the Incident Reporting Tool will be used to facilitate stakeholders and policymakers’ understanding of the value of qualified RDN care, including elected leaders, federal and state agency officials, other health care providers and the public. The IRT directly contributes to the Academy’s strategic plan, mission and policy goals, including to "leverage data to demonstrate effectiveness of dietetic and nutrition interventions."

PAND Licensure Contacts

State Regulatory Specialists:

Andrea Barnes, MSCN, RD, LDN, FAND adeleo.barnes@gmail.com

Kara Stromberg, MS, RD, LDN, CDE elliskara1@gmail.com

 

State Policy Representatives:


Nutrition Services Payment Specialists:

Andrew Wade,MS, RDN, LDN, CSSD andrew@casespecificnutrition.com 


Lobbying Representatives
Milliron Goodman