AANA Federal Government Affairs
HOTLINE
Number 2005-17, Week of Monday, July 11, 2005


In This Issue:

* Senators Grassley and Baucus Introduce New Pay-For-PerformanceMeasure, Putting CRNAs on Level Footing with Other Healthcare Professionals
* Labor-HHS-Education Appropriations Now Has to Clear Senate
* HHS Secretary Announces Medicaid Commission Members
* Amendments




>> Senators Grassley and Baucus Introduce New Pay-For-Performance Measure, Putting CRNAs on Level Footing with Other Healthcare Professionals


In a letter dated June 29th, AANA President Frank T. Maziarski, CRNA, CLNC, expressed the AANA support for legislation introduced by Senators Chuck Grassley (R-IA) and Max Baucus (D-MT) that would place CRNAs on a level playing field with physicians and other providers as Congress and agencies develop "value-based purchasing" systems for future Medicare reimbursement.

Meanwhile, on Thursday (June 30th), Senate Finance Committee Chairman Grassley and Ranking Member Baucus introduced the legislation that would link a part of Medicare reimbursements to quality of care (CQ HealthBeat, 6/30). The bill would allow the Health and Human Services (HHS) Secretary to reward providers first when they report quality data and later when they improve quality or meet certain quality thresholds.

The legislation would establish a "value-based purchasing" system for providers such as hospitals, physicians, Medicare Advantage plans, home health agencies and skilled nursing facilities. Under the bill, physicians who report quality data would receive the full update to Medicare reimbursements allowable under current law in 2007 and those who do not report quality data would have their updates reduced by 2%.

The legislation also would establish a national healthcare IT network pilot program that would allow providers to exchange clinical, claims and outcomes data for Medicare and Medicaid beneficiaries, as well as clinical trial results and practice guidelines, to help improve care (American Health Line, 6/30). Senator Grassley has said he likely will combine the bill with legislation that would cancel a scheduled reduction in Medicare reimbursements for physicians by the end of the year (CongressDaily, 7/1).

In his letter to the two Senators President Maziarski wrote, "In the interest of the patients we serve, ensuring that Certified Registered Nurse Anesthetists (CRNAs) are at the table as this initiative moves forward takes on real importance, as its processes touch on the critical issues of anesthesia patient safety, outcomes measures, practice efficiency and reimbursement."

Maziarski also went further by saying, "We also appreciate that the introduction of this legislation is an initial step in the process of using healthcare practice and claims information to improve healthcare quality, enhance efficiency, and accelerate the deployment of healthcare information technology. The bill delegates considerable authority to the Secretary to undertake such tasks. Such broad discretion also demands that Congress exercise sufficient oversight to ensure that the process extends fair consideration to healthcare providers such as nurse anesthetists. The involvement of nurse anesthetists is critical to maximizing the chances that VBP initiatives succeed, especially as they relate to anesthesia services."

Visit the Senate Finance Committee, http://finance.senate.gov/




>> Labor-HHS-Education Appropriations Now Has to Clear Senate


Nurse anesthesia educational funding was kept safe from cuts at an early point of the congressional budget process, as the House Appropriations Committee (June 16th) approved by voice vote the Labor, Health, Human Services, Education and Related Agencies draft bill for fiscal year 2006 (HR 3010, H Rept 109-143). The full House adopted the measure June 22 on a bipartisan 330-82 vote.

But now it is the Senate's turn to mark-up their bill, which is scheduled to get under way July 13.

The House bill included $57.6 million for advanced education nursing funding and at least $3 million for CRNA educational funding, which had been requested by AANA and supported in testimony AANA's Louise Hershkowitz, CRNA, MSHA, delivered to the panel this spring. CRNA educational program directors also made statements to legislators supporting CRNA educational program funding. The amounts the panel provided for CRNA education in 2006 are comparable to this year's levels, an important step considering that many other programs in this budget-sensitive bill sustained big cuts.

View Highlights of the House bill, http://appropriations.house.gov/index.cfm?FuseAction=PressReleases.Detail&PressRelease_id=491&Month=6&Year=2005




>> HHS Secretary Announces Medicaid Commission Members


On Friday (July 8th), Health and Human Services (HHS) Secretary Mike Leavitt announced 13 voting members and 15 nonvoting members of a federal Medicaid commission that will be charged with recommending short- and long-term reforms to the program. The committee, created as a result of negotiations over the fiscal year 2006 federal budget, will be required to submit two reports. The first, which must be submitted by September 1st, will include recommendations on how to reduce Medicaid spending growth by $10 billion over the next five years. The second report, due December 31st, 2006, will include recommendations for stabilizing Medicaid over the long term, focusing specifically on "how to expand coverage to more Americans while still being fiscally responsible; ways to provide long-term care to those who need it; a review of eligibility, benefits design and delivery; and improved quality of care, choice and beneficiary satisfaction," said Leavitt (Memphis Commercial Appeal, 7/9). Don Sundquist, the former Republican governor of Tennessee and member of Congress who now works as a lobbyist and consultant, has been appointed to lead the panel (Tennessean, 7/9). Angus King, a former independent governor of Maine, was named vice chair (New York Times, 7/9).

Read more, http://www.commercialappeal.com/mca/midsouth_news/article/0,1426,MCA_1497_3914788,00.html

Also see, http://tennessean.com/apps/pbcs.dll/article?AID=/20050709/NEWS0204/507090348/1001/ARCHIVES

And, http://www.nytimes.com/2005/07/09/politics/09commission.html




>> Amendments


* The House and Senate will be in session this week. The House will be taking up the Occupational Safety and Health Review Commission Efficiency Act of 2005 (HR 740), while the Senate will be focusing on the Department of Homeland Security Appropriations Act of 2006 (HR 2360), sent over from the House, and presidential nominations.


* Emails to Congress Skyrocketing. Ever since September 11th emails to Members of Congress have risen dramatically. As the primary source of communication now, understaffed offices are finding it hard to keep up.

Read more, http://www.washingtonpost.com/wp-dyn/content/article/2005/07/10/AR2005071001011.html

* CMS to Post 2006 Part B Physician Update for Public Comment. CMS is rumored to be posting its 2006 Part B physician update any day now for public comment. The update will most likely include changes to Part B reimbursement for healthcare providers including anesthesia professionals.

* Higher education legislation affecting accreditation may arise in the House Education and Workforce Committee as soon as the week of July 11th. In conjunction with the Council on Accreditation (COA) and other specialized accreditors, AANA has been working to oppose harmful changes in the Higher Education Act (HEA).

* Register for the Spy Museum Reception and Tour! For those of you attending the AANA Annual Meeting in Washington, DC, this year, make sure you register for the International Spy Museum Reception and Tour. The event will be held Tuesday, August 9th (8pm-10pm). Proceeds will benefit the CRNA-PAC. See the Meetings page at http://www.aana.com for more details.

* 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, Senior Director. C 2005 American Association of Nurse Anesthetists.