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News From Capitol Hill
The House will be busy this week addressing several health-related pieces of legislation, including the youth tobacco epidemic, helping Medicaid offer maternity services, fighting flu, Saving Lives: Vaccine Science and Innovation, workplace violence prevention for health care and social service workers, Alzheimer’s awareness, and tribal veterans health bills. The Senate Committee on Indian Affairs will also address tribal veterans health bills this Wednesday. Additionally, congressional leaders continue to negotiate a short-term spending package before the current continuing resolution expires this Thursday, November 21. At this time, we anticipate that Congress will pass another continuing resolution to fund the federal government through December 20, 2019.
Both the House and Senate will be in recess beginning this Friday, November 22, and are scheduled to return to Capitol Hill on Monday, December 2. Stay tuned to the Government Affairs Update for weekly news.
Cardiac Rehab Bill Introduced in the Senate
On Wednesday, November 13, Senators Capito (R-WV) and Klobuchar (D-MN) introduced S. 2842, the Increasing Access to Quality Cardiac Rehabilitation Act of 2019. This legislation is the Senate companion bill to the House legislation, H.R. 3911, introduced in July 2019 by Representatives Lewis (D-GA) and Smith (R-NE). Both pieces of legislation will authorize nurse practitioners (NPs), clinical nurse specialists (CNSs) and physician assistants (PAs) to order and certify cardiac and pulmonary rehabilitation. Under current law, NPs, CNSs, and PAs are authorized to supervise these programs beginning in 2024 but are not authorized to order that care. The House bill would make these changes beginning in 2020, and the Senate bill would make these changes beginning in 2021. Please use the AANP Advocacy Center to contact your elected officials and urge their support of this legislative priority.
2020 AANP Health Policy Conference
Register now for the 2020 American Association of Nurse Practitioners® (AANP) Health Policy Conference! The Health Policy Conference Committee has planned a robust program, and we are excited to share the agenda, which will be posted this week on the AANP website.
Spaces are filling up quickly, and we don’t want you to miss out on the opportunity to hear from a variety of government and industry experts as they discuss the priorities of Congress and the Trump Administration and their potential impact on NPs and patients. Attendees will develop the skills and insight necessary to advocate effectively at the federal level and will have the opportunity to deliver the NP message to elected officials and their staff on Capitol Hill Day. Register now for the 2020 AANP Health Policy Conference.
Indiana Legislature to Reconvene
The Indiana Legislature is scheduled to convene Tuesday for Organizational Day, marking the ceremonial start of the 2020 legislative session. Last session, NP scope of practice reform legislation made significant progress but ultimately failed final passage. Indiana AANP members can watch their emails for updates of NP bills introduced and under consideration during this new session.
State Election Results
Earlier this month, several states held elections for government office. Many races were very close and required recounts and run-offs.
AANP will continue to monitor any changes to the state legislative landscapes that influence the policy dynamics for pro-patient reforms in 2020. Members can watch their emails for more information about new legislation that could impact NP practice.
Among the final confirmed election results:
- Louisiana incumbent Governor John Bel Edwards (D) maintained his office in a narrow victory.
- Kentucky State Attorney General Andy Beshear (D) defeated incumbent Governor Matt Bevin (R) after a contested recount.
- Mississippi Lt. Gov. Tate Reeves (R) defeated state Attorney General Jim Hood (D) after incumbent Gov. Phil Bryant (R) retired due to term limits.
- New Jersey Democrats maintained majority in the General Assembly.
- Virginia House of Delegates flipped from Republican to Democratic majority.
- Texas voters adopted nine of ten proposed constitutional amendments.
HHS Transparency Requirements
On November 15, the U.S. Department of Health and Human Services (HHS) released a final rule and fact sheet regarding new requirements that hospitals make public a machine-readable file with all hospital standard charges, including payer-specific negotiated charges, as well as a list of “shoppable services” that can be scheduled in advanced. On that same day, HHS also released a proposed rule and fact sheet on a proposal to require health plans to provide consumers with real-time, personalized access to cost-sharing and other information pertinent to their plan benefits. AANP will continue to evaluate both the final hospital transparency rule and the proposed health plan transparency rule for the impact on nurse practitioners and their patients.
Home Health Orders for NPs Under the Maryland Total Cost of Care (TCOC) Model
As noted in previous Government Affairs Updates, the Center for Medicare and Medicaid Services (CMS) approved a waiver that will allow all Medicare-enrolled NPs in Maryland to certify home health services for Medicare beneficiaries beginning on January 1, 2020, as part of the Maryland TCOC Model. The Maryland TCOC Model is the first model tested by the Centers for Medicare and Medicaid Innovation (CMMI) that holds a state fully at risk for the total cost of care for Medicare beneficiaries. CMS has instructed Maryland Medicare Administrative Contractors to begin accepting home health claims submitted by home health agencies with NPs in the attending provider field, as well as claims submitted directly by NPs for certification/re-certification and care plan oversight for home health plans of care.
Access more information regarding the waiver and the Maryland TCOC Model. Additionally, AANP has put together a brief primer on the waiver. AANP is very pleased to see that CMS recognizes that authorizing NPs to fully oversee home health plans of care will decrease costs of care, lower unnecessary utilization and support patient/provider relationships. AANP will continue to work with CMS on expanding this authorization throughout other Medicare and Medicaid programs.
Primary Care First Model Application Portal Open
As mentioned in previous Government Affairs Updates, in April of 2019, the CMMI announced the creation of the Primary Care First Model Option. This is a value-based care model that is focused on primary care providers, including NPs. On Thursday October 24, 2019, CMMI released the Request for Applications (RFA) with the information necessary for providers and practices to determine if they wish to enroll in the model, and CMMI opened the application portal. Practice and providers will be able to apply for the model through that portal until January 22, 2020. The RFA and additional information regarding the model can be found on the CMMI Primary Care First website. We would like to highlight that CMMI has moved back the model start date from January 1, 2020, to January 1, 2021. AANP will provide additional information regarding the model as it becomes available and will be updating the AANP Advanced Payment Models page with additional resources.
CMMI Kidney Care Choices Model Request for Applications
As noted in a previous Government Affairs Updates, on Thursday October 24, 2019, CMMI released the RFA for the Kidney Care Choices Model options, which are focused on improving kidney care for Medicare beneficiaries. Practices that meet the eligibility requirements within the RFA will be eligible to apply for the Model until January 22, 2020. The implementation period for the model will be 2020, and the model performance period will begin January 1, 2021. The application portal and additional information regarding the kidney care model options will be found on the Kidney Care Choices Model website. We would also like to note that CMMI announced in the RFA that it is considering implementing a waiver for NPs participating in these models to certify and recertify home health plans of care. This waiver has not yet been finalized, and we will provide additional information on the model and the waiver as soon as it becomes available.
NP Legislation: Advocating to Remove Federal Barriers
The number of cosponsors continues to increase in both the House and Senate. Keep up the momentum by engaging with your elected officials and their staff!
Visit the AANP Advocacy Center to send your message:
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As always, your Federal and State Government Affairs teams are available to answer any questions. Please feel free to contact us at governmentaffairs@aanp.org or statepolicy@aanp.org.
Federal Government Affairs Team Members:
MaryAnne Sapio, VP Federal Government Affairs
Debra Swan, Associate VP Federal Government Affairs
Jessica Talbert, Director of Federal Advocacy
Nick Rumberger, Director of Operations, Office of Government Affairs
Jan Towers, Senior Health Policy Consultant
State Government Affairs Team Members:
Tay Kopanos, VP State Government Affairs
Jamie Kings, State Policy Analyst
Ashley Shew, State Policy Analyst
Julia Dieperink, State Policy Coordinator
The AANP Government Affairs Update is sent weekly to update and inform our members about AANP activities, initiatives, programs and events. Any reproduction or republication of material contained in this newsletter is strictly prohibited without prior written permission from AANP.
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