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Bill Would Expand Home Health Referral Powers to NPs, PAs By Emily Mullin June 28, 2011
Seniors would have faster access to home health services if a new bipartisan bill that allows nurses and physicians’ assistants to approve these services for Medicare patients is passed by Congress.
Current Medicare regulations recognize nurse practitioners and physicians’ assistants as authorized providers that are able to order nursing home care for Medicare beneficiaries. Yet the law does not allow them to order less costly medical services like home health services. Instead, Medicare requires a physician to sign the order for home health services. Even in states that have expanded their laws to allow other medical providers to order home care, Medicare does not certify payment for these services until a physician signs the order.
Nurses and other health professionals have argued that they are just as capable in determining whether a patient should receive home health services.
The Home Health Care Planning Improvement Act of 2011 would allow nurse practitioners, clinical nurse specialists, certified nurse midwives and physicians’ assistants to authorize home health services with Medicare patients.
Healthcare providers and supporters of the bill say the legislation will ensure more timely access to home health services for Medicare beneficiaries. Co-sponsors Reps. Allyson Schwartz, D-Pa., and Greg Walden, R-Ore., introduced the bill in the House on June 21. Schwartz previously introduced the bill in the last two sessions of Congress and Sens. Susan Collins, R-Maine, and Kent Conrad, D-N.D., introduced the Senate companion bill earlier this year.
Dr. Jan Towers, director of federal health policy and professional affairs for the American Academy of Nurse Practitioners, says that advocates for the Medicare change had lobbied for it to be a part of the Patient Protection and Affordable Care Act, signed into law in March 2010. It wasn’t included in the final version of the act, but Towers says healthcare providers don’t anticipate any opposition in getting the bill passed this legislative session.
“Patients sometimes don’t get the care they need because they have to wait for a signature from the physician for these services,” Towers says.
Seniors and disabled individuals often need an extra office visit with a physician in order to get home health services approved. In rural areas of the country that have a shortage of primary care physicians, the ability for a nurse or other healthcare professional to approve home health services would expedite that process for patients.
Val J. Halamandaris, president of the National Association for Home Care and Hospice, said in a statement that the proposed change to current Medicare rules is “long overdue” since nurses and other healthcare practitioners have increasingly larger roles in caring for Medicare patients.
“This legislation will ensure that important care to these Medicare beneficiaries is not interrupted,” he said.
The American Nurses Association said that, if passed, the legislation will help improve access to care for seniors that need it.
“In order to meet our nation’s healthcare needs, an integrated, national healthcare workforce that optimizes utilization of all qualified providers must be put into action,” ANA President Karen Daley said in a statement.
Delays in access to home health services not only create inconveniences for Medicare patients and their families but can result in increased costs to Medicare when patients are unnecessarily left in more expensive institutional settings, such as nursing homes, the group said.
In October 2010, the Institute of Medicine, a nonprofit non-governmental organization, released a study that recommended nurse practitioners and clinical nurse specialists be allowed to certify eligibility for Medicare home health services.
The bill is also supported by AARP, American College of Nurse Midwives, National Association of Pediatric Nurse Practitioners, American College of Nurse Practitioners, American Academy of Physician Assistants, American Association of Colleges of Nursing and the National Organization of Nurse Practitioner Faculties.
Comments(1) for Bill Would Expand Home Health Referral Powers to NPs, PAs
1.
in rural areas like Hawaii we have a very hard time finding MD's willing to admit to nursing facilties. This would help with patinet through put and timely care in the home.
Posted by Michele Potts on Wednesday, June 29, 2011 @ 12:07 AM
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