The fight to give nurses more power

[NRSKarenRN, BSN, RN]

CNN Reports:

The fight to give nurses more power

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Help Fight For Nurses In The 112th Congress! Write your Congressman/women to support legislation

S. 56/H.R. 2134: Medicaid Coverage of Advanced Practice Registered Nurses

Advanced Practice RNs in Medicaid

Ask your Members of Congress to cosponsor the Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2011 (S. 56/H.R. 2134). The Medicaid APN Access Act changes federal Medicaid law to improve the recognition of health care services provided by advanced practice registered nurses (APRNs). This bill will increase access to essential health care services and increase state flexibility while removing current legal barriers to advanced practice registered nurses (APRNs).

Background

Current federal law requires fee-for-service Medicaid to cover health care services provided by some APRNs (pediatric nurse practitioners, family nurse practitioners and certified nurse midwives). Some states have opted to also cover the services of certified registered nurse anesthetists and clinical nurse specialists - mainly because these practitioners are willing to provide needed services in primary care provider areas.

The Balanced Budget Act of 1997 made many changes to Medicaid law, and in the process erected new barriers to APRN practice. S. 56/ H.R. 2134 would remove the following barriers:

* Current law requires fee-for-service Medicaid to recognize pediatric and family nurse practitioners, and certified nurse midwives. The Medicaid APN and PA Access Act would change this law to require Medicaid fee-for-service plans to recognize all nurse practitioners, clinical nurse specialists, certified nurse midwives, and physician assistants.

* Current law also gives states the option to recognize family and pediatric nurse practitioners, certified nurse midwives, and physician assistants as primary care case managers in their fee for service program. S. 56/H.R. 2134 would change the law by removing the state option - therefore requiring states that offer case management services to recognize non-physician providers. It would also expand the definition of nurse practitioner to include all NPs.

* Many states have moved their Medicaid population into managed care. Current law only requires that these managed care plans enroll "a sufficient number, mix, and geographic distribution of providers." In reality, many plans do not enroll APRNs. The Medicaid APN and PA Access Act would change the law to require Medicaid managed care plans to include the services of nurse practitioners, clinical nurse specialists, certified nurse midwives, certified registered nurse anesthetists, and physician assistants.

Rationale

Many studies have shown that APRNs provide cost-effective, high quality care. In addition, APRNs are often willing to provide services in rural and inner-city areas where access to physicians is limited. APRNs increase access to health care and decrease preventable acute care admissions and emergency room visits. By supporting S. 56/ H.R. 2134, your Members of Congress would help ensure that Medicaid patients receive care in a timely and cost-efficient manner

S. 227: The Home Health Care Planning Improvement Act

The Home Health Planning and Improvement Act of 2011 (S. 227) would allow advanced practice registered nurses (APRNs) - nurse practitioners (NPs), clinical nurse specialists (CNSs), certified nurse midwives (CNMs) and physician assistants (PAs) - 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 led to delays in health care delivery. Moreover, these delays in care inconvenience patients and their families. Additionally, delays can lead to increased cost to the Medicare system when patients are unnecessarily left in more expensive institutional settings.

[kabfighter]

Man, there is a lot of hate and ignorance in some of the comments. I'm always amazed how people can take our honored title of 'nurse' and make it seem like a disparaging term.

Anyhow, better reimbursement for non-physician providers seems like a no-brainer to me.