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|  |  ANA Applauds Introduction of Legislation Aimed at Expanding Medicaid Coverage of Advanced Practice Nursesi-Newswire August 19, 2005 The American Nurses Association (ANA) today commended Sen. Daniel Inouye (D-HI) for his leadership efforts to expand Medicaid coverage of advanced practice registered nurses (APRNs) through the introduc tion of the Medicaid Advanced Practice Nurses and Physician Assistants Access Act (S. 1515). (I-Newswire) - This proposed legislation, introduced in the U.S. Senate on July 27, 2005, will increase patients' access to essential heath care services while helping to control Medicaid spending. A companion bill, H.R. 2716, was introduced in the U.S. House of Representatives on May 26, 2005, by Reps. John Olver ( D-MA ), Sherwood Boehlert ( R-NY ), Lois Capps, RN ( D-CA ) and Steven LaTourette ( R-OH ). ANA President Barbara Blakeney, MS, RN, hailed the introduction of the bill, stating that it would "level the playing field for ARPNs in the delivery of badly needed health care services, particularly in rural and other underserved areas." Current federal law requires fee-for-service Medicaid to cover health care services provided by some APRNs, including pediatric nurse practitioners, family nurse practitioners and certified nurse midwives ( CNMs ). Some states have opted to also cover the services of certified registered nurse anesthetists ( CRNAs ) and clinical nurse specialists ( CNSs ) - mainly because these practitioners are willing to provide services in physician shortage areas. However, under the Balanced Budget Act of 1997 ( BBA, P.L. 105-33 ), states also have the option of excluding APRNs as Medicaid providers in primary care case management and managed care . In addition, the BBA provides only a vague reference to the types of providers who must be included in managed care panels. Plans must show only that they provide access to "a sufficient number, mix, and geographic distribution of providers" - thus leading to the potential further exclusion of APRNs. The Medicaid Advanced Practice Nurses and Physician Assistants Access Act ( H.R. 2716/S. 1515 ) would remove these barriers to practice. H.R. 2716/S. 1515 would alter Medicaid law in the following three respects: * Fee-for-service Medicaid would be expanded to include direct payment for services provided by all nurse practitioners ( NPs ), CNSs and physician assistants ( PAs ). * All NPs, CNMs and PAs would be recognized as primary care case managers. * Medicaid managed care panels would be required to include NPs, CNSs, CRNAs, CNMs and PAs. "Numerous studies have shown that APRNs provide cost-effective, high quality care, yet many Medicaid plans reimburse APRNs at a fraction of the physician fee schedule," said Blakeney. In addition, she noted, APRNs often are willing to provide services in rural and inner-city areas where access to physicians is limited. "APRNs increase access to health care and decrease preventable acute care admissions and emergency room visits," Blakeney added. "By including the provisions of the Medicaid Advanced Practice Nurses and Physician Assistants Access Act in Medicaid reform, Congress would not only ensure that Medicaid patients receive care in a timely and cost-efficient manner, they would help ease health care shortages in rural and other underserved areas - while also guaranteeing APRNs adequate reimbursement for high-quality patient care." The ANA is the only full-service professional organization representing the nation's 2.7 million registered nurses through its 54 constituent member nurses associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public. American Nurses Association
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