On September 9, 2013, Centers for Medicare & Medicaid (CMS) announced the postponement of the durable medical equipment (DME) face-to-face signature requirement until an unspecified date in 2014. The postponement of enforcement of the rule happened after hundreds of ANA nurses wrote their members of Congress, coupled with lobbying efforts by ANA’s Washington, DC staff. ANA President, Karen A. Daley, PhD, RN, FAAN also expressed her concerns in a letter to CMS Administrator, Marilyn Tavenner MHA, RN.
In November 2012, Centers for Medicare and Medicaid (CMS) released its Medicare Physician Fee Schedule Final Rule, which included the durable medical equipment (DME) face-to-face encounters rule. Under the new rule for ordering DME; a physician must document that the physician, or a nurse practitioner (NP), a clinical nurse specialist (CNS), or a physician assistant (PA), has had a face-to-face encounter. The encounter with the beneficiary must occur within 6 months before delivery of DME. Beginning with orders for durable medical equipment made on or after October 1, 2013, a physician will have to sign that the face-to-face encounter was completed. Click here for a detailed explanation of the requirements of the rule and a complete list of items.
On the last day Congress was in session before their August work break, Congresswoman Suzanne Bonamici (D-OR) introduced the Protecting Access to Primary Care Act, H.R. 2986. The bill seeks to improve access to primary care for individuals enrolled in Medicaid. The bill will improve reimbursement rates for nurse practitioners, physician assistants, and other primary health care providers. The Affordable Care Act (ACA) presently provides improved reimbursement rates for physicians, but does not similarly increase reimbursement rates for other primary care providers like nurse practitioners and physician assistants.
On April 8, 2013, the American Nurses Association (ANA) provided detailed comments on key developing quality issues, to the Institute of Medicine (IOM) and the Centers for Medicare and Medicaid Services (CMS). ANA has devoted significant time and resources to providing the nursing viewpoint in the development of quality initiatives, as a member of the Measure Application Partnership and a partner in the National Priorities Partnership.
Marilyn Tavenner, MHA, BSN, RN, cleared the first hurdle on her path to being the first Center for Medicaid and Medicare Administrator in six years. On April 23rd, she was approved, by a strong margin, by the Senate Finance Committee. Unfortunately, the last step, a vote by the full Senate, has been held up due to “a hold” being placed on her vote by Senator Harkin (D-IA). Ms. Tavenner was nominated to head CMS by President Obama in early February. Tavenner joined CMS in February 2010 and became acting administrator in December 2011.
On January 1, 2013, new coding and reimbursement policies go into effect for many psychiatric/mental health services. Many services will be paid at higher levels.The new policies recognize the challenges of caring for patients with severe mental illness, multiple co-morbidities and complex medications, in community settings as well as hospitals and other inpatient facilities. his is great news for advanced practice registered nurses (APRNs), psychiatric registered nurses (RNs), and other mental health providers.