APN   APN REGULATION AND LEGISLATION

Joint Commission adopts standards that include nurse-led clinics as “primary care medical homes” a decision that will provide more choice and access for patients seeking care.

ANA Press Release
Standards & EPs for The Joint Commission Primary Care Medical Home Option

Notice to Nurse Practitioners Who Directly Bill Part B for Treating Medicare Patients. View the memo.

APNs Can Resume Ordering Respiratory Services in Hospitals.  The Wisconsin Department of Health Services Issued a statewide variance allowing licensed practitioners, i.e. APNPs to order Respiratory Therapy services in the hospital. View the memo.

Home Health Legislation Introduced in the House, May 15, 2010.  The Home Health Care Planning Improvement Act H.R. 4993 was reintroduced in the U.S. House of Representatives on April 13 by Congresswoman Allyson Schwartz (D-PA). The Senate companion for The Home Health Care Planning Improvement Act S. 2814 was introduced in November 2009 by Senators Susan Collins (R-ME) and Kent Conrad (D-ND).

The Home Health Planning and Improvement Act would allow physician assistants, nurse practitioners, clinical nurse specialists and certified nurse midwives to order home health services under Medicare in accordance with state law. Medicare has recognized the independent practice of APRNs for nearly two decades, and these health care professionals now provide the majority of skilled care to home health patients. Unfortunately, a quirk in Medicare law has kept APRNs from signing home health plans of care and from certifying Medicare patients for the home health benefit. In areas where access to physicians is limited, this outdated prohibition has lead to delays in health care delivery. These delays in care inconvenience patients and their families. In addition, delays can also result in increased cost to the Medicare system when patients are unnecessarily left in more expensive institutional settings.

To view HR 4993 click here:  http://www.thomas.gov/cgi-bin/thomas

WNA Testifies at APNP Statute Clean-Up Bill.  On March 30, WNA member Mary Schwanebeck and Gina Dennik-Champion, Lobbyist, provided testimony supporting AB 828 at the Assembly Public Health Committee.  The bill passed out of committee with amendments which are approved by WNA. To view the bill go to: http://www.legis.state.wi.us/2009/data/AB828hst.html and click here to view WNA Testimony.

Medicare’s New Physician Supervision Rule Harms Patients.  A new Medicare policy went into effect in 2010, requiring physicians to be physically present in order to reimburse care given to patients in hospital outpatient and observation units. The rule is causing severe hardship for nurses and their patients who need to receive chemotherapy, IV therapy, and other treatments in observation and other hospital outpatient units — particularly in rural areas where patients and physicians must travel long distances. For more information:  http://www.capitolupdate.org/index.php/2010/04/medicares-new-physician-supervision-rule-harms-patients/

Rule Promulgated Clarifying Physician Supervision of APNPs under the Injured Patient and Family Compensation Fund.  WNA served on the Advisory Council of the Office of the Insurance Commissioner that included discussion related to clarification of the supervision requirements of APNPs. The amended language captures the process used for oversight by a medical director for any clinic health care provider.   To view the languages go to  page 277.

Scope of Practice: Who Should Do What to Assure High Quality, Efficient Health Care . . . And How Can States Decide? Click here for details.
Evidence-Based Health Policy Project Briefing; March 3, 2010
State Capitol, 412 East; 8:30-11:00; Scope of Practice: Who Should Do What to Assure High Quality, Efficient Health Care . . . And How Can States Decide?

MedPAC Focuses on Nurses Practitioners & Other Non-Physicians. MedPAC encourages written and verbal comments, and meetings with its staff members. Comments on current agenda items can now be submitted electronically, through MedPAC's website, at http://www.medpac.gov. Payment updates and other issues and recommendations will be discussed fully in upcoming reports to Congress, issued each March and June, and also available through the website. For updates on specific topics go to ANA's Capitol Update at http://www.capitolupdate.org/index.php/2010/01/medpac-focuses-on-nurse-practitioners-other-non-physicians

Medicare Physician/APRN Pay Cut Avoided.
On December 19, President Obama signed into law H.R. 3326, the Department of Defense Appropriations Act, which contains a temporary pay freeze on Medicare Part B reimbursement rates for physicians, advanced practice redgistered nurses, and other nonphysician providers. A 21 percent pay cut was scheduled to take effect in January 2010. The hold is effective only for two months, through February 28, 2010. The American Medical Association is leading efforts to permanently end annual Medicare pay cuts under the Sustainable Growth Rate (SGR) formula. Senate Majority Leader Harry Reid vowed to work on the issue in early 2010, but that was before the Massachusetts Senate election and the ensuring chaos over health care reform.

Medicare: ANA Advocates for Nurses and Patients at MedPAC, RUC and CPT Meetings
Medicare policies touch the lives of many of our patients, and reimbursement issues directly or indirectly affect financial compensation for many staff RNs and advanced practice RNs. Many APRNs are enrolled as Medicare providers, and are directly reimbursed for caring for Medicare patients. ANA GOVA staff had the opportunity recently to advocate for nurses and patients at recent meetings of MedPAC, and the RUC and CPT committees. For more information go to: http://www.capitolupdate.org/index.php/2009/10/medicare-ana-advocates-for-nurses-and-patients-at-medpac-ruc-and-cpt-meetings/

Click here for access to the current WNA Working for You - Late Winter 2010 document.  Details regarding legislation/rules relating to Advance Practice Nurses can been found under Core Issue #1 - Workforce Health, Rights & Safety in the first section - Workforce Advocacy Legislation/Regulation.