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June 5, 2005
ANA Hails Introduction of Bill
to Expand Access to Advanced Practice RNs
Medicaid Advanced Practice Nurses and Physician Assistants Access Act
restores previous federal mandate
Silver Spring, MD – The American Nurses Association (ANA) today applauded
Congressman John W. Olver (D-MA) who introduced bipartisan legislation that
would expand patient access to quality health care by requiring states to
offer Medicaid coverage for primary health-care services provided by
advanced practice registered nurses (APRNS).
The Medicaid Advanced Practice Nurses and Physician
Assistants Access Act of 2005, H.R. 2716, introduced in the U.S. House of
Representatives on May 26, would eliminate the option that state Medicaid
plans currently have of denying APRNs as primary care case managers.
Principal sponsors of the bill are Reps. Olver, Sherwood Boehlert, (R-NY),
Steven C. LaTourette, (R-OH) and Lois Capps (D-CA)
ANA President Barbara Blakeney, MS, RN, hailed Rep. Olver’s introduction of
the bill. “In terms of quality of care, patient satisfaction and
cost-effectiveness, APRNs are among the best values in health care,”
Blakeney said. “APRNs are particularly important in providing primary care
services in underserved and rural communities,” she added.
APRNs are registered nurses who have attained advanced education and
expertise and specialize in such medical fields as pediatrics,
anesthesiology, gerontology, neonatology and mental health. APRNs include
nurse practitioners, clinical nurse specialists, certified nurse-midwives
and certified registered nurse anesthetists. However, Medicaid plans in many
states currently recognize only physicians and do not cover primary care
services provided by APRNS. The proposed measure would help to control
Medicaid spending by offering Medicaid beneficiaries more and often
less-expensive primary-care provider options.
“In areas with a shortage of physicians, nurse practitioners and physician
assistants can be more accessible,” Olver said. “Current law, however, often
denies Medicaid beneficiaries access to these health care providers,” he
added. “This bill would go a long way toward improving health care in many
rural and medically-underserved areas of the country, including the 1st
Congressional district of Massachusetts.”
The Medicaid Advanced Practice Nurses and Physician Assistants Access Act of
2005 would restore a previous federal mandate to cover the primary-care
services of nurse practitioners and certified nurse midwives. This mandate
was eliminated by the Balanced Budget Act of 1997, which encouraged states
to move Medicaid recipients into managed care but gave states the option to
exclude APRNs as participants. The bill also proposes to expand Medicaid
fee-for-service coverage to include direct reimbursement for all nurse
practitioners and clinical nurse specialists (instead of only the family
practitioners, pediatric practitioners and midwives who are currently
covered). In addition, Medicaid managed-care panels would be required to
recognize the services of APRNs – including the pain management services
provided by nurse anesthetists and mental health services provided by
clinical nurse specialists – thus clarifying the scope of providers required
by managed care plans to specifically include APRNs.
Blakeney highlighted the fact that the bill would restore Medicaid coverage
for the case-management services of nurse practitioners and certified nurse
midwives. “This is a long-awaited correction that provides both clarity and
just reimbursement for advanced practice nurses in these categories,” she
noted. “The ANA commends Rep. Olver for introducing this much-needed
legislation, and we look forward to working with him to ensure its
enactment.”
Indiana
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