AANA Federal Government Affairs
HOTLINE
Number 2004-24, Week of Monday, October 4, 2004


In This Issue:

* Congress Settles on "Continuing Resolution" Budget Until After Presidential Election
* Medicare Might Cover Implantable Defibrillators
* AANA President Sends Letter to Capitol Hill Urging Passage of Patient Safety Legislation
* Amendments


>> Congress Settles on "Continuing Resolution" Budget Until After Presidential Election

On Wednesday (September 29th) Congress approved (H J Res 107) a stopgap continuing resolution (CR) to fund government agencies at fiscal year
2004 levels through November 20th (CongressDaily, 9/30). The CR means for CRNAs that appropriations (such as health funding programs, nurse education programs, certain VA programs, and certain minor aspects of Medicare administration) will not be addressed until after the November 2nd Presidential election. Funding for these programs continues at last year's levels.



>> Medicare Might Cover Implantable Defibrillators

The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule on Tuesday (September 28th) that would expand Medicare coverage for implantable cardioverter defibrillators (ICDs), a move that would increase the number of eligible beneficiaries by one-third, to about 500,000 (New York Times, 9/29). If the proposed rule were to become final the impact on CRNAs would be to boost access to these services for Medicare beneficiaries, increasing the opportunity for CRNAs to be reimbursed for providing the procedures' necessary anesthesia services while possibly reducing demand for anesthesia for more invasive alternatives.

Under the proposal, Medicare would expand coverage for ICDs, which cost between $20,000 and $35,000, to beneficiaries who have mild to moderate heart failure. CMS officials said that Medicare would provide coverage for ICDs for at least 25,000 additional beneficiaries in the first year of the expansion, which the agency says could save as many as 2,500 lives. By 2005, about 77,000 Medicare beneficiaries could have ICDs (Washington Post, 9/29). Medicare currently pays about $25,000 per ICD, but CMS officials said that they might reduce the amount that the program reimburses for the devices (Seattle Post-Intelligencer, 9/28). The rule could take effect by early 2005, according to CMS Administrator Mark McClellan.

CMS Press Release,
http://www.cms.hhs.gov/media/press/release.asp?Counter=1211

For more info, http://www.nytimes.com/2004/09/29/business/29device.html (requires free registration)

Also see http://www.washingtonpost.com/wp-dyn/articles/A58035-2004Sep28.html (requires free registration)



>> AANA President Sends Letter to Capitol Hill Urging Passage of Patient Safety Legislation

AANA President Frank Maziarski, CRNA, MS, CLNC sent a letter to Capitol Hill and Members of Congress urging them to take action on the Patient Safety legislation that has passed both the House and the Senate. On July 22nd the Senate adopted the patient safety reporting legislation (S
720) that AANA has helped advocate this Congress, most recently as our lead item at AANA Midyear Assembly. The House had passed similar legislation (HR 663) in March 2003 with the support of AANA. In his letter, President Maziarski urged Congressional leadership to act upon the legislation before they adjourned for the year. President Maziarski cites the landmark 1999 Institute of Medicine (IOM) report, "To Err is Human," and states, "We held then and hold now that more can be done to improve anesthesia patient safety."

President Maziarski, in conjunction with the AANA DC office, has also launched a Grassroots Action Alert. The action alert is for all CRNAs to get involved by calling their individual Senators and Representative. Tell them that they should support the patient safety legislation that has passed both the House and the Senate.

Look for the Grassroots Action Alert on the AANA website, at http://www.aana.com



>> Amendments

* Both the House and Senate are in session this week, with the House working on (HR 5011) the Military Personnel Financial Services Protection Act. This measure regulates financial investments and life insurance offering from the private sector to military personnel in order to curb fraudulent activities. Meanwhile, the Senate will be debating (S 2845) the National Intelligence Reform Act of 2004. Both the House and Senate are scrambling to finish work by October 8th so legislators can go home and campaign for the November 2nd elections. However, Roll Call and other news outlets suggest it is likely Congress will not complete all its work, especially on budget matters, and is likely to return to Washington in a "lame duck" session, perhaps starting the second week of November.

* A new survey of the nation's acute care hospitals released September 28th found that roughly two-thirds of hospital emergency department (ED) directors are having problems maintaining adequate on-call specialists such as neurosurgeons, orthopedists, and obstetricians. The American College of Emergency Physicians (ACEP) conducted the survey on a grant from The Robert Wood Johnson Foundation. Medical directors from 1,427 hospital emergency departments - 32% of all U.S. acute care hospitals - responded to the survey. On-call shortages have been exacerbated by revisions to federal rules that govern the obligations of physicians and hospitals under the Emergency Medical Treatment and Labor Act (EMTALA), ACEP said. One-third of survey respondents reported additional problems finding specialists for their on-call panels since the revised rules took effect in November 2003, the survey found. Other factors driving on-call shortages include the medical liability crisis and a lack of adequate funding for services provided in the emergency room. To read ACEP's press release, go to http://www.acep.org/3,34081,0.html

* The first Vice-Presidential Debate will be Tuesday (October 5th) at Case Western Reserve University in Cleveland, Ohio. The second Presidential debate will be Friday, October 8th, with the focus on domestic policy.

* For up-to-date Congressional floor & committee schedule information, see http://thomas.loc.gov/



>> For More Information

The AANA Federal Government Affairs Hotline is published for the nurse anesthetist members of AANA each week Congress is in session by the AANA Office of Federal Government Affairs, Washington DC, 202-484-8400, info@aanadc.com, Frank Purcell, Director.

Copyright (c) 2004 American Association of Nurse Anesthetists.

(posted 10-7-2004)