Medicare Bill Passed by House Would Seek Expanded Use of Nurses’ Services (3/27/15)

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March 27, 2015

Adam Sachs, 301-628-5034
Jemarion Jones, 301-628-5198


Medicare Bill Passed by House Would Seek Expanded Use of Nurses’ Services
APRNs Would Gain Ability to Order Medical Equipment after Meeting with Patient

SILVER SPRING, MD – A bill passed by the U.S. House March 26 would alter the Medicare payment system to provide incentives for quality, efficiency and innovation, and would include certain registered nurses as part of the incentive payment program. The bill also would include certain nurses under health care provider eligibility requirements for prescription orders of durable medical equipment for Medicare patients.

The proposed new incentive payment program, the Merit-Based Incentive Payment System, would include services provided by advanced practice registered nurses (APRNs) -- nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists. The payment program would replace the “Sustainable Growth Rate” (SGR) payment formula, which is intended to control Medicare spending by tying physician payment changes to measures of overall economic growth. Nurses are directly affected by the SGR: Nearly 40 percent of Medicare Part B health care providers are APRNs, who are paid a fraction of Medicare’s physician reimbursement for services.

“We are pleased that Congress is recognizing that APRNs have the knowledge, ability and credentials to increase access and improve services for Medicare beneficiaries, and that they should be reimbursed fairly for achieving incentives, saving costs and improving Medicare’s efficiency,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN.

The Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) would expand 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. The proposed change would permit nurse practitioners and physician assistants to qualify for the in-person encounter to validate the order of equipment, as allowed by state law. This change would improve access to services and allow some Medicare recipients to receive needed equipment sooner.

The bill also would provide a two-year funding extension for:

  • The Children’s Health Insurance Program (CHIP), which covers more than eight million children and pregnant women in families that earn income above Medicaid eligibility levels.
  • The roughly 1,300 federally funded urban and rural Community Health Centers (CHC) and National Health Service Corps Fund (NHSC) and Teaching Health Centers, whose main mission is providing primary care.

ANA will continue working with other nursing and health care consumer organizations and with its grassroots network of nurses to advocate passage of the bill in the Senate.

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ANA is the only full-service professional organization representing the interests of the nation's 3.1 million registered nurses through its constituent and state nurses associations and its organizational affiliates. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.