As you may be aware, nursing leader and ANA member Mary Naylor, PhD, RN, FAAN, was recently appointed to be a commissioner on MedPAC, the Medicare Payment Advisory Commission. MedPAC is charged with advising Congress and CMS (the Centers for Medicare & Medicaid Services) on Medicare and Medicaid policies, including annual payment updates for the Medicare prospective payment systems – such as the Physician Fee Schedule, which covers the reimbursement of APRNs (advanced practice registered nurses).

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Dr. Donald Berwick, a leading figure in healthcare quality research and improvement, has been nominated to lead CMS. Marilyn Tavenner, an RN, has been named principal deputy administrator, and is now acting administrator until Dr. Berwick’s confirmation by the Senate. CMS has also undergone a restructuring designed to better administer the complex new healthcare reform policies under the PPACA.

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On April 15, 2010, President Obama signed legislation temporarily stalling the scheduled 21.3 percent cut in Medicare reimbursement rates under Part B, for advanced practice registered nurses, physicians, and other Medicare providers. The “Continuing Extension Act of 2010” extends 2009 payment rates through the end of May 2010, under the Medicare Physician Fee Schedule, and also applies retroactively to April 1.

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A new Medicare policy went into effect in 2010, requiring physicians to be physically present in order to reimburse care given to patients in hospital outpatient and observation units. The rule is causing severe hardship for nurses and their patients who need to receive chemotherapy, IV therapy, and other treatments in observation and other hospital outpatient units — particularly in rural areas where patients and physicians must travel long distances.

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ANA recently submitted comments urging CMS, Congress, and the Administration to allow APRNs – and all healthcare providers – to qualify for a portion of the billions of dollars in incentives for adopting health information technology/electronic health records systems under the federal Medicare/Medicaid Electronic Health Record Incentive Program.

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The Centers for Medicare & Medicaid Services (CMS) is giving Medicare providers – including APRNs – another year to enroll or update their enrollment in the PECOS system, as a condition of payment for items and services they order for their patients, or referrals they make to other clinicians.

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