News From Capitol Hill
Both the House and Senate are in recess for the Thanksgiving Day holiday and are scheduled to return to Capitol Hill on Monday, December 2. As reported in last week’s Government Affairs Update, Congress was working to reach a short-term spending package to keep the federal government funded before the current Continuing Resolution (CR) was due to expire on Thursday, November 21. Prior to their departure, both the House and Senate passed a short-term CR to extend current funding through December 20, 2019. The President signed the bill, avoiding a government shutdown. Upon their return, congressional leaders will continue working to reach an agreement on a full fiscal year 2020 spending package. Please stay tuned to the Government Affairs Update for additional information.

AANP Health Policy Agenda Posted and Conference Keynote Speaker Announced
We are pleased to announce that the 2020 Health Policy Conference Draft Program Agenda  has been posted, and we are excited to share that Donna Brazile, veteran Democratic political strategist, syndicated columnist and Fox News contributor will be the Keynote Speaker!

Donna Brazile, a campaign staffer, presidential campaign manager and Democratic party official, is an expert in political strategy. She taps into her Washington circles to provide insights often overlooked by outsiders and offers a well-rounded view of the upcoming 2020 election. Author of the best-selling memoir “Cooking with Grease: Stirring the Pots in American Politics,” her witty style and innovative political strategies have earned her the respect of colleagues as well as adversaries.

Inspired by participation in a successful political campaign at age 9, Donna Brazile holds a lifelong, fiery passion for political progress. She was honored to become the first African American to manage a presidential bid, leading Al Gore’s campaign in 2000. Her analysis of today’s issues and unique take on the policy issues in Congress led her to be named one of the 100 Most Powerful Women by Washingtonian, Top 50 Women in America by Essence and O Power List remarkable visionary by The Oprah Magazine. Brazile is an adjunct professor at Georgetown University, a syndicated newspaper and magazine columnist and an on-air contributor at Fox News. She is also the founder of Brazile & Associates LLC, a general consulting, grassroots advocacy and training firm based in Washington D.C.

A native of New Orleans, Brazile continues to work toward the full recovery of the city, and she encourages young people of all backgrounds to vote and to strengthen the system from within by running for public office. Since 2000, she has appeared at more than a hundred higher education institutions across the country, speaking to young people about diversity and issues in our current political system.

On Monday, March 9, Donna Brazile’s keynote address will offer her insight into Washington politics, the 2020 elections and the legislative landscape. We encourage you to register now , as space is filing up quickly.

Ohio's Better Access, Better Care Act Heard in Committee
On November 19, House Bill 177 , known as the Better Access, Better Care Act, had its fifth hearing in the House Health Committee. During the hearing, questioning frequently centered on the cost incurred by advanced practice registered nurses (APRNs) for a standard care arrangement. No vote was held on the bill. If enacted, this bill would retire the requirement for an APRN to maintain a standard care arrangement with a physician in order to practice.

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!