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Medicare Payment "Fix" Results in Gains for APRNs

Wednesday, April 15, 2015   (0 Comments)
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Medicare Payment "Fix" Includes Key Provisions for Nurses
APRNs Included in Incentive Program, Gain Ability to Order Medical Equipment
(ANA Email Press Release: 4/15/2015)

SILVER SPRING, MD – ANA applauds Senate passage of H.R. 2, the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act. This legislation protects seniors' and children's access to care and repeals the Medicare sustainable growth rate formula used to calculate Medicare payment rates to health care providers. H.R. 2 includes key provisions that enhance nurses' roles as providers and improve their ability to provide timely services to Medicare beneficiaries. The bill is now headed to the President's desk for signature.

The legislation expands the range of health care providers permitted to document the face-to-face encounter with Medicare patients required to write a prescription for durable medical equipment by including nurse practitioners and clinical nurse specialists. This change improves access to services and will allow Medicare patients to receive needed equipment, such as portable oxygen systems and hospital beds, sooner.

The law also includes nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists in the new Merit-Based Incentive Payment System, which is based on quality, value and accountability standards. The incentive payment program replaces the "Sustainable Growth Rate" (SGR) payment formula, which was intended to control Medicare spending by tying physician payment changes to measures of overall economic growth.

"The provisions affecting nursing in this bill recognize that nurses provide high-quality, efficient and cost-effective services that are valued and needed by Medicare patients, many of whom rely on APRNs for their primary care needs," said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. "Nurses embrace the opportunity to meet health care incentives and improve the health care experience for some of the nation's most vulnerable citizens."

ANA is also pleased that the legislation:•
•  Extends federal funding of CHIP, which covers more than eight million children and pregnant women in families that earn income above Medicaid eligibility levels, for two years.
•  Provides $287.4 million to the National Health Service Corps Fund (NHSC) and Teaching Health Centers.
•  Includes $7.2 billion in additional funding for federally funded Community Health Centers (CHC).
•  Extends funding for the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) programs through September 30, 2017. The MIECHV program provides funding support for evidence-based home visiting programs like Nurse-Family Partnership.

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