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Senators Susan Collins(R-ME) and Chuck Schumer (D-NY), along with Representatives Greg Walden (R-OR-2), Ron Kind (D-WI-3) and Danny Davis (D-IL-7) introduced the Home Health Planning and Improvement Act of 2015 (S. 578, H.R. 1342) This bill would amend the Medicare law which has kept advanced practice nurses (APRNs), a group that includes nurse practitioners, clinical nurse specialists, and certified nurse midwives from signing home health plans of care and from certifying Medicare patients for the home health benefit. ANA strongly supports the Home Health Care Planning Improvement Act 2015 (S. 578, H.R. 1342).

About The Issue

ANA Government Affairs strongly supports the Home Health Care Planning Improvement Act 2015 (S. 578, H.R.1342). this bill would amend a section of Medicare law which has kept advanced practice nurses (APRNs), a group that includes nurse practitioners, clinical nurse specialists, and certified nurse midwives from signing home health plans of care and certifying Medicare patients for the home health benefit.

These health care professionals now coordinate the majority of skilled care for home health patients, and this outdated prohibition has led to delays in health care delivery. These delays in care not only inconvenience patients and their families -- they result in increased cost to the Medicare system when patients are unnecessarily left in more expensive institutional settings. The Home Health Planning and Improvement Act would eliminate this barrier, permitting APRNs to be recognized for services they are currently providing.

In areas where access to physicians is limited, this prohibition has led to delays in home health services. Moreover, the delays in care inconvenience patients and their families, and can lead to increased costs to the Medicare system when patients are unnecessarily left in more expensive institutional settings or are readmitted when discharged without the needed support at home. Medicare has recognized the autonomous practice of APRNs for nearly two decades, and these health care professionals now provide the majority of skilled care to home health patients. As the demands for home care increases, the supply of qualified health care providers decreases. The inability of APRNs to certify home health plans of care often leads to delay in care for home health patients.

In order to meet our nation’s healthcare needs, an integrated, national healthcare workforce that looks beyond physicians must be put into action. APRNs are playing an increasing role in American health care deliver; practicing independent of physicians in most states.

The ability of APRNs to provide high quality, cost-effective care has been widely recognized by patients and the health care community and is supported by significant peer-reviewed research and critical analysis.

APRNS are willing to provide services in areas where access to physicians is limited; including underserved urban and remote rural areas. At least sixty-six percent of NPs practice in primary care settings and twenty percent practice in remote rural or frontier settings.

ANA strongly supports the Home Health Planning and Improvement Act (S. 578,  H.R. 1342) which would: Allow 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.

Ensure seniors and disabled citizens have timely access to home health services under Medicare. In a 2011 study conducted by Dobson DaVanzo and Associates has determined this fix will have a cost SAVINGS for Medicare.

Savings Estimate
Cumulated Estimated
Medicare Savings

1-Year Estimate (2011)
$6.3 million
5-Year Estimate (2011-2015)
$80.4 million
10-Year Estimate (2011-2020)
$273.1 million
Alternate Model: 10-Year Estimate with no change in proportion of certification/recertifications to Medicare claims
$124.3 million

 

Resources

Senate Bill 578

Health Care Planning and Improvement Act