House Bill Would Expand APRN Home Health Authority
Representative Allyson Schwartz (D-PA) introduced the Home
Health Care Planning Improvement Act (H.R. 6826) with 39 original
co-sponsors on August 1, 2008. This bill is a companion to the Senate
version (S. 1678) introduced on June 21, 2007. This ANA-endorsed
legislation would change Medicare law to grant Nurse Practitioners,
Clinical Nurse Specialists, and Certified Nurse Midwives the ability to
order home health services and to sign home health plans of
care.
Current LawMedical advances have made it
possible for a growing number of patients to receive care in the comfort
of their own homes. Homecare allows many patients the ability to live
normal lives during the course of their therapy, and allows terminally ill
patients precious time with their families and loved ones. In many cases,
homecare is more cost effective than institutionalized care. For these
reasons, the Medicare home health benefit has grown considerably since the
early 1990s. In 2004, 2.8 million Medicare patients received home health
services.
In order to receive home health services, Medicare
beneficiaries must be certified as "homebound." This means that patients
must leave their homes infrequently and only with considerable and taxing
effort. In addition, patients must require at least one skilled nursing or
therapy service, and a plan of care must be developed and submitted to
Medicare. Today, only physicians and podiatrists may sign plans of care or
certify a patient for home health services. Frequently, patients
experience delays in obtaining home health due to the need for discharge
planners and other referring entities to locate a physician to complete
Medicare paperwork. In some cases, these physicians have very little
direct contact with patients who receive the majority of their care
through APRNs. These needless delays in care inconvenience patients and
their families. In addition, delays can result in increased cost to the
Medicare system when patients are unnecessarily left in more expensive
institutional settings.
H.R. 6826 / S. 1678ANA fully
supports the Home Health Care Planning Improvement Act (H.R. 6826/S.
1678). ANA is working to educate Members of Congress about the fact that
advanced practice nurses (APRNs) represent an important and growing
proportion of the health care workforce, often practicing in rural and
other underserved areas, where physicians are scarce. Numerous studies
have shown that APRNs are able to provide care that is at least as high in
quality as that provided by physicians. Current restrictions on the
ability of APRNs to order home health services are anachronistic and
should be removed. You can help us in this effort!
Contact your Congressional
delegation and tell them to support the Home Health Care Planning
Improvement Act!
Erin
McKeon