Eye on Nursing

House Nursing Caucus Welcomes New Co-Chair in January 2013

Freshman Congressman Dave Joyce announced on January 16 that he will co-chair the bipartisan House of Representatives Nursing Caucus. Rep. Joyce, an Ohio Republican, will join California Democrat Rep. Lois Capps in leading the caucus, which meets regularly to discuss issues related to the nursing profession. Read the rest of his announcement here.

News in Tennessee

Recently, the Tennessee Action Coalition had success at the end of 2012 and in January 2013 getting the word out about nursing scope of practice  through several publications including an OpEd in the Nashville Tennessean January 2013 titled: "Tennessee Voices: Let Skilled nurses ease health burdens". Other items inlcude an article on scope of practice in The Tennessee Nurse showcasing its work resulting from a survey used to guage progress on the Future of Nursing: Campaign for Action within their state. Read more about the survey and other relevant articles on nursing scope of practice within the state here.

News in Virginia

AARP Virginia sent a letter to the Virginia Board of Nursing, commenting on proposed regulations concerning continuing professional competence for nurses seeking to renew their licenses. To ensure a highly-skilled, qualified health care workforce, AARP Virginia encouraged the Board of Nursing to require competence standards beyond the continuing education requirements currently in place.

News at the Center to Champion Nursing in America, DC

The Center to Champion Nursing in America contributed to a comment letter AARP submitted to the Centers for Medicare and Medicaid Services (CMS) on payment policies under the Medicare Physician Fee Schedule and other proposed revisions to Medicare Part B. The letter expressed support for pain management services provided by certified registered nurse anesthetists and voiced concerns about consumer access to durable medical equipment. The proposed requirement that physicians sign off on an extensive list of items including commonly prescribed items, such as blood glucose monitors and standard wheelchairs may create a barrier for consumers, many of whom routinely receive this needed equipment ordered by nurse practitioners and other advanced practice registered nurses as well as physician assistants. This proposed policy change runs contrary to current Medicare reimbursement practice.

The Center to Champion Nursing in America contributed to a comment letter AARP submitted to the Centers for Medicare and Medicaid Services (CMS) on proposed updates to the Home Health Prospective Payment System (HH PPS) rates and addresses other home health changes, including hospice quality reporting. AARP encourages CMS to allow advanced practice registered nurses such as nurse practitioners to order home health services, which could prevent possible delays in accessing needed care.  Read more here.

The Center to Champion Nursing in America contributed to a letter AARP sent to Senator Conrad (D-ND) endorsing his legislation entitled the "Craig Thomas Rural Hospital and Provider Equity Act of 2011" (S. 1680). Senator Conrad’s bill would also add certified nurse-midwives and clinical nurse specialists to the list of eligible health care providers who can conduct face-to-face encounters with patients to determine eligibility for Medicare home health services. More importantly, the legislation would allow nurse practitioners, certified nurse-midwives, clinical nurse specialists, and physician assistants to certify for home health services for Medicare beneficiaries. Allowing these advanced practice registered nurses to certify home health services could decrease costs, expedite treatment by eliminating the need for physician sign-off, and allow patient-centered health care teams to practice more efficiently.  (July 23, 2012) 

The Center to Champion Nursing in America contributed to a comment letter AARP submitted to the Centers for Medicare and Medicaid Services (CMS) regarding increased Medicaid payment rates for primary care providers. The letter encouraged CMS to include advanced practice registered nurses and physician assistants, who currently provide primary care services across the country, as providers eligible for these increased payments. (June 11, 2012)

News in Connecticut

AARP Connecticut submitted testimony in support of Senate Bill 414, which allows Advanced Practice Registered Nurses (APRNs) to sign forms to authorize needed health care services. This bill would increase consumers’ access to support services by allowing APRNs to sign, certify or give an authorization where a physician is allowed or required to do so.

News in Louisiana

AARP Louisiana offered support for House Bill 951, which proposed to remove a mandatory collaborative practice agreement between physicians and nurse practitioners who practice in medically underserved areas, thereby increasing consumers’ access to health care.

AARP Missouri submitted testimony in support of Senate Bill 679, which proposes to increase consumers’ access to health care by removing the mandated collaborative agreement between physicians and advanced practice registered nurses and instead would allow a written protocol or a standing order.

AARP and members of the Nursing Community sent a letter to the Federal Trade Commission expressing support of their efforts to promote competition, access, and choice in health care through opinions on proposed regulations and legislation affecting Advanced Practice Registered Nurses’ scope of practice.

AARP Virginia submitted a letter in support of a Virginia Department of Health Professions’ study regarding scope of practice for nurse practitioners, the elimination of barriers to practice, and health care access for consumers.

AARP submitted a letter to Members of Congress expressing serious concerns with the House Reconciliation proposal pursuant to the Fiscal Year 2013, including provisions affecting state health insurance exchanges, Medicaid and CHIP provisions, and the repeal of the prevention and public health fund.

Along with partnering national nursing organizations, AARP sent a letter thanking CMS Acting Administrator Marilyn Tavenner for her leadership on the recently-released Graduate Nurse Education (GNE) Demonstration solicitation. The letter also requested a 30-day extension of the proposal deadline to allow additional time for questions and clarification. 

AARP applauds Medicare Graduate Nurse Education Demonstration. In a statement released earlier this week, AARP applauded the CMS Innovations Center's recent release a request for proposals to implement an initiative to produce more advanced practice nurses (APRNs).  The Medicare Graduate Nurse Education demonstration program, established by the Affordable Care Act (ACA), will provide $200 million over four years to create partnerships between hospitals, schools of nursing and community-based providers such as community health centers, and will help to incentivize the production of more highly skilled nurses.

AARP Comments to Marilyn Tavenner, Acting Administrator for the Centers for Medicare & Medicaid Services, about the proposed rule on “Reform of Hospital and Critical Access Hospital Conditions of Participation.”  AARP recommended that the proposed regulation be modified to clearly state that APRNs be eligible for clinical privileges, admitting privileges, and medical staff membership including voting privileges and that hospital policies assure that the process for making these decisions are transparent, objective and timely.  (See PPI publication Removing Barriers to APRN Care: Hospital Privileges for more information). (December 21, 2011)

AARP responded to a Request for Information from the Centers for Medicare and Medicaid Services (CMS), and encouraged clear communication, delivery reform, patient engagement, and quality care measures in the development of ACOs.  In this letter, AARP also encouraged CMS to adopt the Institute of Medicine’s definition of “primary care” so that practices led by Advanced Practice Registered Nurses (APRNs) and Nurse-Managed Health Centers can participate in ACOs.  (December 3, 2011)

AARP New York letter to the Co-chairs, Workforce Flexibility/Change of Scope of Practice Work Group recommending the removal of scope-of-practice barriers for advanced practice registered nurses (APRNs) in New York state. (December 2, 2011)

In a June 2011 comment letter to CMS, AARP expressed concern at the exclusion of Federally-Qualified Health Centers, Rural Health Centers, and nurse-led medical/health homes as eligible providers and suppliers in ACOs, since each of these entities provides primary care, particularly to medically underserved populations. (June 6, 2011)

AARP Comments on the proposed statement of antitrust enforcement policy regarding Accountable Care Organizations participating in the Medicare shared savings program (“Proposed Statement”). (May 31, 2011)

AARP Comments to Don Berwick, CMS Administrator, about the proposed rule regarding the Face-to-Face Requirements for Medicaid Home Health Services.

The law requires that a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or a physician assistant have a face-to-face encounter with the individual before a physician certifies the individual’s  need for home health services. AARP pointed out that this is an extra step for patients whose primary care provider is an advanced practice registered nurse (APRN), leading to increased costs and delays in accessing home health care. AARP believes that APRNs should not just conduct the face-to-face encounter, but be able to order (certify) home health services (i.e. sign the forms authorizing services). AARP has consistently supported legislation that would allow APRNs to certify patients for home health services.  (September 12, 2011)

A Letter of Endorsement: AARP Supports Home Health Care Planning Improvement Act (H.R. 2267), co-sponsored by Representative Allyson Y. Schwartz (D-PA).

A Letter of Endorsement: AARP Supports Home Health Care Planning Improvement Act (H.R. 2267), co-sponsored by Representative Greg Walden (R-OR).

A Letter of Endorsement: AARP supports Home Health Care Planning Improvement Act of 2011, co-sponsored by Senator Susan M. Collins (R-ME).

A Letter of Endorsement: AARP supports Home Health Care Planning Improvement Act of 2011, co-sponsored by Senator Kent Conrad (D-ND).

Letter to CMS: AARP outlines its priorities related to Accountable Care Organizations, including ensuring that nurse-led practices and nurse-managed health clinics are considered providers within ACOs and ensuring that accurate outcomes data is captured, including for care provided by advanced practice registered nurses.

Statement from Nancy LeaMond: AARP Urges Bi-Partisan Support for Home Health Companion Bills 

A Letter of Endorsement: AARP supports Home Health Care Planning Improvement Act of 2010, sponsored by Representative Allyson Y. Schwartz (D-PA 13)

A Letter of Endorsement: AARP supports Home Health Care Planning Improvement Act of 2010, sponsored by Senator Susan M. Collins (R-ME)

Statement from Susan Reinhard: AARP Applauds HHS Investments in Primary Care

Statement from Susan Reinhard: AARP Applauds Medicare Graduate Nursing Education

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