Thanks to ALL who took action on DME, we're able to announce that this
legislation became law on April 16, 2015!
On April 16, President Obama signed into to law H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015. The law replaces the flawed Medicare Sustainable Growth Rate (SGR) formula for provider reimbursement with an improved payment system that rewards quality, efficiency, and innovation. Include nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists in the new Merit-Based Incentive Payment System. Lastly, it removes the barrier to practice in Medicare, allowing APRNs to order durable medical equipment and document the required face to face encounter.
About The Issue
For the past five years Congressman Jim McDermott (D-WA), the Ranking Member on the Ways & Means Committee Health Subcommittee, introduced legislation to eliminate the physician signature for ordering durable medical equipment (DME) -- ensuring that APRNs would be able to continue to order oxygen, home blood glucose monitors, and numerous other durable medical equipment (DME) items without a physician’s signature. Section 6407 of the ACA established a face-to-face encounter requirement for certain items of DME. The law requires that a physician must provide documentation that a physician, nurse practitioner, physician assistant or clinical nurse specialist has had a face-to-face encounter with the patient. CMS has twice postponed implementation of this rule. While the face-to-face encounter is an important tool to combat fraud and abuse in the DME context, it is important to recognize the role that advanced practice registered nurses play in many instances.
Rep. McDermott along with ANA advocated to have this important legislation included in H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015.
*Replaces the Medicare Sustainable Growth Rate (SGR) formula for Medicare provider payment with an improved payment system that rewards quality, efficiency and innovation.
*Creates an incentive payment program, referred to as the Merit-Based Incentive Payment System (MIPS), which includes nurse practitioners, clinical nurse specialists and certified registered nurse anesthetists.
*Expands who can document the face-to-face encounter required for Medicare durable medical equipment prescriptions to include advanced practice registered nurses (APRNs) and physician assistants, as allowed by state law.
*Extends a 2 year reauthorization for the Children's Health Insurance Program (CHIP) - CHIP covers more than 8 million children and pregnant women in families that earn income above Medicaid eligibility levels. Authorization for this vital program is set to expire September 30.
*Offers a 2-year extension of funding for Community Health Centers (CHC), the National Health Service Corps Fund (NHSC) and Teaching Health Centers.
ANA applauds Congress for working together to eliminate the SGR, protect CHIP and preserve funding for key public health programs.