AANP Health Policy Update 12-16-2013
December 16, 2013
Members of Congress Finalizing Letter to Voice Support for VHA's Decision to Recognize NPs as Licensed Independent Practitioners (LIPs) Nursing Caucus Co-Chairs, Reps. Lois Capps (CA-D) and David Joyce (OH-R), will be sending a letter this week to Veterans Affairs Secretary Eric Shinseki urging the Veterans Health Administration (VHA) to move forward with their plan of recognizing NPs as LIPs nationwide. This would allow NPs and other APRNs to work to their full scope of practice and give the VHA the flexibility to utilize all providers within the health care team throughout the country, maximizing resources and providing optimal care.
Please contact your Members of Congress TODAY and ask them to sign this important letter by clicking here.
Agreement on Budget Deal Includes Three Month Sustainable Growth Rate (SGR) Patch On Tuesday, December 10, the Chairs of the House and Senate Budget Committees, Congressman Paul Ryan (R-WI) and Senator Patty Murray (D-WA), came to a bipartisan agreement that sets spending levels for the next two years and mitigates some of the spending cuts established by sequestration. The agreement puts the federal budget at $1.012 trillion in 2014 and $1.014 trillion in 2015 – up from the $967 billion required by sequestration. The $63 billion provided in sequester relief was divided equally among defense and non-defense programs and is provided through a mix of targeted spending cuts and revenue enhancements (higher federal worker contributions to the pensions and higher airline ticket fees) which total $85 billion over 10 years. So the package will, in the end, reduce the deficit by $20 to $23 billion. This agreement was passed by the House of Representatives on Thursday, December 12, and is expected to be passed by the Senate this week.
A three month SGR patch was included in the budget agreement which will postpone a nearly 24% cut in Medicare pay for providers from January 1 until April 1, and instead give providers a 0.5% raise during that time period. This delay buys time for lawmakers to consider the different pieces of bipartisan permanent SGR repeal legislation that has passed all three committees of jurisdiction.
With the passage of this agreement, it is expected that Congress will be able to avoid a government shutdown in January when appropriations for the rest of fiscal year 2014 must be passed.
Permanent Sustainable Growth Rate (SGR) Repeal Bills Passed by Two Committees On Thursday, December 12, the House Ways and Means and Senate Finance Committees passed similar bills to permanently repeal the Medicare SGR formula. The current SGR formula produces annual cuts of more than 20% in Medicare payments for provider services that must be fixed on a yearly basis. The bills passed by the two Committees are very similar with both bills being provider neutral, making NPs eligible to receive value based purchasing payments during the first year they are available and allowing NPs to receive chronic care coordination payments. Two major differences in the bills are that the Ways and Means Committee bill provides a 0.5 percent increase to provider fees for three years followed by a freeze in the fees for the following seven years, while the bill passed by the Senate Finance Committee would freeze provider fees from 2014 – 2023. The Senate Finance bill also includes a provision that would allow NPs to supervise cardiac and pulmonary rehab in critical access hospitals.
Now that all three committees of jurisdiction have passed permanent SGR repeal legislation, together, they will work one piece of legislation and find a way to pay for the bill. The Congressional Budget Office (CBO) earlier this month estimated that the repeal of the SGR would cost $116.5 billion over 10 years.
AANP 2014 State Policy Priorities AANP's top policy priorities for 2014 are: 1) Modernizing State Licensure Laws to allow for full practice authority for NPs; 2) Signature Recognition to allow NPs to "Treat the Paperwork" that reflects the care they provide; and 3) Full Participation in Insurance Marketplaces and Plans to promote sustainable practice.
2014 State Legislative Sessions Gearing Up As many as 15 states are now accepting pre-filed bills for their upcoming legislative sessions, as 41 states prepare to convene their 2014 legislative sessions in January. Your AANP State Health Policy Office is working with local stakeholders to introduce and track bills of interest to your patients and your practice. In addition to Full Practice Authority legislation, it is expected that bills allowing for broader signature authority and referring capabilities will be introduced in many state legislatures. We will also work to ensure that any bills regulating Medical Homes, Telehealth, or other aspects of health care utilize provider neutral language to allow patients full and direct access to NP services. Please contact firstname.lastname@example.org regarding any proposed state bills of interest to the NP community.
Insurance Issues? New Multi-State Reimbursement Alliance "Report an Issue" Form Revealed AANP would like to hear from you regarding how patients are accessing NP care through the health insurance marketplaces. Are you participating in the insurance exchange plans? If so, can your patients find you and sign up to be on your panel? Are these plans listing you as a primary care provider? Are patient copays and reimbursement rates for primary care NP services the same as copays for primary care physician services? Are barriers to credentialing with the insurance marketplace plans keeping you or your practice from participating? Section 2706 of the Patient Protection and Affordable Care Act provides for a level playing field within the insurance marketplace. AANP's policy teams have the opportunity to provide feedback to the federal and state exchange regulators about how the exchange insurance plans are doing in this area, and we need your assistance. Please share your experiences by reporting an issue here.
AANP 2014 Health Policy Conference Registration Open AANP invites you to join your colleagues at the 2014 Health Policy Conference, March 30 – April 1. At this conference, participants will learn about the current health care policies, legislation, and practice issues that are critical to advancing the nurse practitioner role. Attendees will not only hear from those creating policy in Washington D.C., but on Tuesday, April 1, attendees will have the opportunity to meet with their Members of Congress and their staff to discuss the important role that nurse practitioners play in the health care system. If you would like more information or would like to register for the conference, please use this link.
Your Voice AANP's Federal Health Policy Office has established a new email email@example.com to collect your stories and personal experiences with federal barriers to practice. We urge you to share your stories with us as they help to create a compelling narrative on Capitol Hill.
Happy Holidays! This will be the last legislative update of 2013. The legislative update will resume on January 6, 2014.
Federal Policy Team Members: MaryAnne Sapio, VP Federal Government Affairs Debra Swan, Associate VP Federal Government Affairs Jan Towers, Sr. Policy Advisor Clark Princell, Director PAC & Grassroots
State Policy Team Members: Tay Kopanos, VP State Health Policy Brittany Dawn McAllister, State Health Policy Specialist
The Voice of the Nurse Practitioner®