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About The Issue

ANA Government Affairs strongly supports the Home Health Care Planning Improvement Act 2015 (S. 578, H.R.1342). This bipartisan legislation would amend the Medicare law to allow advanced practice nurses (APRNs) – a group that includes nurse practitioners, clinical nurse specialists and certified nurse midwives – to sign home health plans of care and certify Medicare patients for the home health benefit.

For nearly two decades, Medicare has recognized the autonomous practice of APRNs caring for patients requiring home health. While APRNs satisfy Medicaid’s face-to-face requirement needed before home health can be authorized, APRNs are prohibited from signing home health plans of care and certifying Medicare patients for the home health benefit. By prohibiting APRNs from signing home health plans and certifying home health benefits, ill patients are faced with the burden of red tape and limited access to physicians that could delay the home health care that they need. These delays in care not only inconvenience patients and their families, but they also result in increased cost to the Medicare system because patients are unnecessarily left in more expensive institutional settings. The Home Health Planning and Improvement Act would eliminate this barrier, and ensure that APRNs to are recognized for services they are currently providing.

In order to meet our nation’s healthcare needs, an integrated, national healthcare workforce that looks beyond physicians must be put into action. 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 playing an increasing role in American health care delivery by practicing independent of physicians in most states, and their work must be supported. 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

Savings Estimate
Cumulated Estimated
Medicare Savings

5-Year Estimate (2015-2019)
$82.5
10-Year Estimate (2015-2024)
$252.6 million
Alternate Model: 10-year estimate with no change in proportion of certifications/recertifications to Medicare claims
$107 million

 

Latest News

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 legislation would amend a section of the Medicare law to allow advanced practice registered nurses (APRNs) – a group that includes nurse practitioners (NPs), clinical nurse specialists (CNSs)and certified nurse midwives (CNMs) – to conduct a face-to-face encounter with Medicare beneficiaries and certify each patient’s eligibility for home health benefits.

ANA strongly supports the Home Health Care Planning Improvement Act 2015 (S. 578, H.R. 1342).

Resources

Fact Sheet - Home Health Care Planning Improvement Act

Senate Bill 578

Health Care Planning and Improvement Act