PAs & Cardiac Rehab Referrals

2017-10-31 | October 31, 2017

Wondering what laws were prohibiting the task from being performed by a PA, a North Carolina PA specializing in cardiology recently reached out to NCAPA after being informed by her institution that she was prohibited from referring patients to cardiac rehab.  NCAPA immediately began researching the issue to see what could be done, and found out that the state regulations for cardiac rehab clinics states that referrals must be from a physician:


(a)    All patients admitted to the program shall have a referral from a physician.

Therefore, the question then became, is this something that is an assumed delegated task for PAs, and therefore something that NCAPA should petition the state regulatory body for PAs to be specifically named in the rule? Or is there a federal regulation that prohibits PAs from referring patients to cardiac rehab facilities?

After bringing the issue to AAPA, they were able to confirm that Medicare policy, which is set by the federal government, currently states that only a physician may order cardiac, intensive cardiac, and pulmonary rehab services.

This issue is on AAPA’s list of PA regulatory barriers that they are working on with Congress, HHS, and CMS. While there is nothing that can be done to remedy this issue on the state level at this time, NCAPA will continue to monitor this issue, so once CMS regulations allow PAs to refer a patient to cardiac rehab facilities, NCAPA will immediately petition the state’s rules to be in line with changes done on the federal level, relieving this regulatory barrier to patient care.


For more information on this issue and other federal regulatory burdens, check out AAPA’s fact sheets:

Top Ten Federal Laws & Regulations Imposing Unnecessary  

Cardiac and Pulmonary Rehabilitation