Did you know that many hospitals have special supervision requirements for their outpatient services – including nursing care? Special requirements for “direct” supervision by physicians and other health care providers particularly affect nursing services, observation units, and critical access hospitals (CAHs). ANA has advocated to rescind or improve these requirements, which can affect nurses’ ability to provide IV therapy, chemotherapy, and other nursing care in hospital outpatient and observation units. The Centers for Medicare and Medicaid Services (CMS) recently issued a final rule maintaining the requirement, with minor changes.

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The Centers for Medicare and Medicaid Services (CMS) announced November 29, 2011 that Medicare will cover screening and counseling to help reduce obesity. Medicare beneficiaries can receive these and other approved preventive services from primary care providers (including nurse practitioners and certified nurse midwives) without any cost sharing.

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On December 14, 2011, the Department of Health and Human Services announced $218 million in funding to assist 26 hospital systems in reducing hospital readmissions and preventable medical errors.

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Thirty-two organizations will participate in the Pioneer Accountable Care Organization (ACO) Model, the Centers for Medicare and Medicaid Services (CMS) announced December 19, 2011. The ACO initiative was created in the Affordable Care Act to improve quality and coordination of care for Medicare beneficiaries while decreasing costs, with patients assigned to ACOs on the basis of their primary care physician history.

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In late November 2011, President Obama formally nominated Marilyn Tavenner, a nurse, to head the Centers for Medicare and Medicaid Services (CMS), the key agency within the Department of Health and Human Services which administers and develops policy for Medicare, Medicaid and the Children’s Health Insurance Program.

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ANA held a Congressional briefing on September 27 on Capitol Hill, urging lawmakers to support the bipartisan “Home Health Care Planning Improvement Act of 2011” (H.R. 2267/ S.227). The legislation would remove a federal barrier to practice in Medicare by ensuring that APRNs and PAs can sign home health plans – current law puts an undue burden on the patient, leading to delays in home health services and increased costs for patients. During the briefing ANA also highlighted compelling results from a new study that found implementation of the law will lead to a cost savings of $309 million over ten years for Medicare.

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