About the Issue

ANA Government Affairs strongly supports the Home Health Care Planning Improvement Act 2013 (H.R.2504/ S. 1332). Medicare has recognized the autonomous practice of APRNs for nearly two decades as allowed by the state law, and these nurse see the majority of patients requiring home health.  Unfortunately, a quirk in Medicare law has kept APRNs from signing home health plans of care and from certifying Medicare patients for the home health benefit. A new requirement states that patients see a physician or APRN in a face-to-face meeting before home health services can be authorized.  Current law does allow APRNs to satisfy the face-to-face requirement.  However, it does not allow them to sign the final plan of care. This puts an undue burden on the patient. 

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.


ANA strongly supports the Home Health Planning and Improvement Act (H.R. 2504/ S. 1332) which would:


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