With the Affordable Care Act (ACA) now signed into law, it moves into the regulatory arena. Laws rarely contain enough specific language to guide their implementation completely. It is the responsibility of the federal administrative agencies to fill in the details of new or amended laws with rules and regulations. Regulations/rules are used to clarify definitions, authority, eligibility, benefits, and standards. Their development is shaped not only by the law but also with the ongoing involvement and input of professional associations like ANA, other providers, third party payers, consumers and other special interest groups. ANA is especially vigilant regarding ACA actions that impact nursing, particularly those that offer the chance to overcome longstanding barriers to nursing practice.
- CMS: Accountable Care Organizations: Request for Information (November 17, 2010)[PDF]
ANA believes nurse-led care coordination, inclusive leadership structures, and a continued focus on patient choice are key in creating the Accountable Care Organization. ANA urges CMS to include these aspects as they develop demonstration projects for this element of the ACA.
- HHS: Covered Preventive Services (September 17, 2010)[PDF]
ANA supported the HHS rules on preventive services that will be required by law to be at no cost to the insurance customer. Covered services include any ACIP recommended immunization, and any USPSTF A or B graded service. ANA pointed out one potential problem with the billing practices for these services.
- CMS: Home Health Payment System Changes (September 14, 2010)[PDF]
In its yearly update of payment regulations and rules for home care delivery, ANA urged CMS to consider the ability of APRNs to delivery care autonomously. ANA also urged CMS to allow APRNs to certify for both home care and hospice care.
- CMS: Outpatient & Ambulatory Surgical Center Proposed Rule (August 31, 2010)[PDF]
ANA advised CMS to support more realistic direct supervision requirements, offered support for inclusion of preventive services, offered support for NQF measures for hospital quality reporting, and encouraged mandatory quality reporting for ambulatory surgical centers.
- CMS: Physician Fee Schedule Proposed Rule (August 24, 2010)[PDF]
ANA concentrated on the inclusion of APRNs in many elements and services that are on the reimbursement schedule for Medicare Part B, and supported comments by the RUC regarding its valuation methodology.
- CDC: Prevention of Seasonal Influenza in Healthcare Settings (July 21, 2010)[pdf]
Comments to CDC in preparation for proposed new guidance which will update and replace previous seasonal influenza guidance and the Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings.
We encourage ANA members, CMAs, and organizational affiliates to submit comments on agency decisions. Some resources are provided below to help you with that process.