AANP Legislative Update February 11, 2013
|February 11, 2013|
State of the Union Speech: Obama Likely to Call for Controlling Health Costs In a speech likely to focus on job creation and strengthening the nations’ economic recovery, President Barack Obama is expected to emphasize the need to reduce the growing cost of health care while improving access to more affordable health coverage for Americans. As the administration and state governments rush to implement the 2010 health reform law, the President may touch on strategies for reforming entitlement programs such as Medicare to trim the growth in federal spending by modernizing payment systems and improving the delivery of prevention and primary care. Administration officials have assured advocates that the President will not support cuts in Medicaid as states consider whether to expand eligibility.
The President is also likely to call for reforming immigration laws and strengthening protections to prevent gun violence – both issues that touch on important health care issues. Health advocates have stressed the need to strengthen mental health services as part of efforts to prevent gun-related violence, while the cost of health care services for immigrants is a critical issue for many border areas and regions with heavy concentrations of immigrant populations. Florida Senator Marco Rubio will provide the Republican response to the President’s remarks.
AANP Discusses “Future of Nursing” Report with MedPAC Staff AANP President-Elect Kenneth Miller, PhD, RN, CFNP, FAAN, will join representatives of other nurse practitioner organizations Tuesday in meeting with the professional staff of the Medicare Payment Advisory Commission (MedPAC) to discuss the recommendations of the Institute of Medicine’s 2010 report, “The Future of Nursing: Leading Change, Advancing Health.” The Commission, which advises Congress on a wide range of Medicare coverage and payment policies, is expected to discuss the IOM report at its upcoming April meeting and could make its own recommendations to Congress on addressing legislative and regulatory barriers to nursing practice.
Miller and NP representatives will discuss portions of the IOM report that address long-standing barriers that prevent nurse practitioners from providing care at the full extent of their licensure and clinical preparation. MedPAC could consider recommendations that Congress amend existing Medicare law or instruct the Centers for Medicare and Medicaid Services to revise regulations to enable NPs to certify patients for home health care services, conduct assessments to admit patients to skilled nursing facilities, and provide initial certification for hospice care. The commission may also discuss strategies for improving Medicare programs to expand nurse practitioner education to address workforce shortages.
Congress Ramps Up Efforts to Repeal Medicare SGR Encouraged by a new Congressional Budget Office (CBO) cost estimate, Republicans on two key House committees demonstrated last Thursday that they will work collaboratively to repeal the controversial Medicare “sustainable growth rate” (SGR) payment update. House Energy and Commerce and Ways and Means staff met Friday with AANP and other provider groups to discuss an outline of their plan, and the Energy and Commerce Health Subcommittee will hold a public hearing this Thursday on expanding payment models for providers beyond traditional fee-for-service.
Congressional interest in payment reform received a boost last Tuesday when congressional budget analysts dropped the estimated cost of repealing the SGR from $245 billion over ten years to $138 billion. In its updated budget and economic outlook for 2013, CBO said that the cost of holding payment rates constant for 10 years is much lower primarily because of lower spending for physician services. The revised budget estimate came as Reps. Allyson Schwartz (D-PA) and Joe Heck (R-NV) announced the introduction of their updated SGR repeal legislation, the “Medicare Physician Payment Innovation Act” (H.R. 574), last Wednesday.
White House Renominates Tavenner as CMS Chief The White House last Thursday (February 7) renominated Marilyn Tavenner to be the permanent administrator of the Centers for Medicare and Medicaid Services (CMS). Republicans on the Senate Finance Committee called for confirmation hearings but Chairman Max Baucus (D-MT) declined to commit to scheduling hearings.
Tavenner has headed CMS since December 2011 although she has yet to receive a confirmation hearing. Don Berwick, her predecessor, ultimately resigned after the Senate never confirmed his recess appointment. Senate Republican staff said Tavenner would have to answer questions about her reported $160,000 a year retirement pay from her time as an executive at the Hospital Corporation of America, a large hospital chain that lobbies on Medicare and Medicaid policies. Senator Orrin Hatch (UT), the top Republican on the Finance Committee, said CMS has a lot of work to do yet on implementing the health care law and Tavenner has lots of questions to answer before he will decide whether to support her nomination.
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