AANA Federal Government Affairs
HOTLINE
Number 2007-14 -- Week of Monday, July 23, 2007


In This Issue:


* SCHIP Legislation to Contain CRNA SGR Fix
* Prepare for CRNAdvocacy at AANA Annual Meeting
* House Passes Labor-HHS-Education Appropriation Bill: Restores Advanced Practice Nurse Education Funding
* Veterans Secretary Resigns
* Ask the Experts: Medicare Payment & Policy Q&A for CRNAs
* Amendments




>> SCHIP Legislation to Contain CRNA SGR Fix


On Sunday (July 22nd), House Democrats announced that they will unveil draft legislation within the next several days that would reverse a scheduled cut in Medicare payments to CRNAs, physicians and other Part B providers, and provide a modest increase in fees for each of the next two years. CRNAs and other Part B providers are scheduled to receive a 10 percent reduction in Medicare Part B reimbursement beginning January 1st, 2008 unless Congress acts to reverse the cut. In a letter to the leaders of the House and Senate Medicare-writing committees July 3rd, AANA President Terry Wicks, CRNA, MHS,
requested that the legislation provide relief from Medicare cuts.

The legislation, for which important details have yet to be released, would also increase the State Children’s Health Insurance Program (SCHIP) funding by $50 billion over five years and make revisions to Medicare (New York Times, 07/23). The House legislation, called the Children’s Health and Medicare Protection Act, would increase tobacco taxes and cut Medicare payments to private Medicare Advantage plans to reauthorize and expand SCHIP.

The package is tentatively slated for consideration in the House Energy & Commerce and House Ways & Means Committees Wednesday and Thursday this week. Depending on the details of the legislation, CRNA grassroots action may be necessary. Stay tuned!

Read more, http://www.nytimes.com/2007/07/23/washington/23health.html?hp (requires free registration)

Visit the House Ways & Means Committee, http://waysandmeans.house.gov

Visit House Energy & Commerce Committee, http://energycommerce.house.gov




>> Prepare for CRNAdvocacy at AANA Annual Meeting


Attendees to the AANA Annual Meeting should prepare for opportunities to advocate for the nurse anesthesia profession – all from the central coordination point of the AANA Federal Government Affairs / CRNA-PAC Booth located near the Registration area.

The AANA Federal Government Affairs / CRNA-PAC Booth will be the place to:

· Pick up a custom Call the Congress card made especially for you to call your U.S. Representative and U.S. Senators, urging them to reverse the 10% Medicare payment cuts affecting all Part B providers including CRNAs;

· Sign and deposit a letter to the Centers for Medicare & Medicaid Services, urging the agency to finalize its proposal to increase the value of anesthesia work by 32%, and to increase the anesthesia conversion factor by up to 25% in 2008;

· Pick up your tickets to the CRNA-PAC Presidential Club Honor Dinner and CRNA-PAC “Night in the West” reception; and,

· Learn more about how to strengthen your profession’s voice in Washington, and to make a contribution to CRNA-PAC.




>> House Passes Labor-HHS-Education Appropriations Bill: Restores Advanced Practice Nurse Education Funding

On Thursday (July 19th), the House voted 276-140 to approve a fiscal year 2008 Labor-HHS-Education spending bill (HR 3043, H Rept 110-231) (that reverses the proposed elimination of funding for advanced practice nursing education programs – a reversal that had been requested by AANA and other nursing organizations.

The President’s 2008 budget proposed “zeroing-out” any money for advanced nursing education. The AANA and CRNAs have been working throughout 2007 to restore these important funds. With the panel’s restoration of current levels the bill sent to the full House would provide roughly $57 million for CRNAs and other advanced practice nursing programs, and $165 million in total for nursing education, up from the President’s original 2008 budget request of $105 million and last year’s appropriation of nearly $150 million.

The $607 billion bill, which includes $151.5 billion in discretionary funds, exceeding FY 2007 discretionary spending by $7 billion and topping President Bush’s FY 2008 spending request by $10.6 billion. The bill fell just short of the two-thirds majority of votes that would be necessary to override President Bush's expected veto. House Minority Leader John Boehner (R-OH) expressed confidence that the Republicans would be able to sustain a veto.

The next step is for the bill to be reconciled in House-Senate conference committee with similar legislation pending in the U.S. Senate.

Read more, http://www.azstarnet.com/allheadlines/192578.php

Visit the House Appropriations Committee, http://appropriations.house.gov/

Visit the House Appropriations Labor-HHS Subcommittee, http://appropriations.house.gov/Subcommittees/sub_lhhse.shtml

Read the House bill and report,
HR 3043 and H Rept 110-231

Read the Senate bill and report,
S 1686 and S Rept 110-89.




>> Veterans Secretary Resigns


On Tuesday (July 17th), Department of Veterans Affairs (VA) Secretary Jim Nicholson announced his resignation. The VA is one of the largest employers of CRNAs in the country. Nicholson was selected by President Bush to head the VA in 2005. At the time of his announcement, no names had surfaced publicly as candidates to succeed him. The position of Secretary of Veterans Affairs is nominated by the President and subject to confirmation by the Senate. Nicholson said his resignation would take effect no later than October 1st (Philadelphia Daily News, 7/18).

Read the VA Press Release,
http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1360

Read more,
http://www.philly.com/philly/health_and_science/20070718_Embattled_VA_chief_quits.html

Visit the VA, http://www.va.gov/



>> Ask the Experts: Medicare Payment & Policy Q&A for CRNAs

AANA’s Associate Director, Federal Regulatory & Payment Policy, Pamela Kirby, JD, is soon posting a new section in the Member Federal Issues area of the AANA Website, at http://www.aana.com/federalissues.aspx (requires AANA member login and password) titled “Ask the Experts,” which will also appear in future editions of the AANA NewsBulletin federal issues column. Under “Ask the Experts,” CRNAs will be able to find answers to basic Medicare and federal payment policy questions CRNAs most frequently ask. To start the series off, we have included one below.

Question: Can CRNAs bill Medicare directly for their services?

Answer: Yes, CRNAs can bill Medicare directly for their services.

Under Medicare Part B, CRNAs can bill Medicare directly for their anesthesia services and can be paid/reimbursed for 100 percent of the physician fee schedule amount for their services, just as can an anesthesiologist and other physicians. (42 Code of Federal Regulations §414.60 – Payment for the services of CRNAs) This means, for example, if Medicare decides that providing a particular anesthesia service is worth $500, the CRNA could bill Medicare for the full $500. CRNAs have billed Medicare directly since 1986, and were the first advanced practice nurses to become Medicare Part B providers. Make sure you or your employer are billing fully for your services.

For answers to frequently asked payment and policy questions, please visit the AANA Federal Issues homepage on the AANA website at http://www.aana.com. For more specific questions please email info@aanadc.com.



>> Amendments


* The House and Senate will be in session this week. Both the House and the Senate will be in session this week with the House considering the Departments of Transportation, and Housing and Urban Development, and related agencies appropriations bill 2008 (HR 2641). Meanwhile, the Senate will continue work on the Higher Education Amendments of 2007 (S 1642).

* Have you asked your U.S. Representative to cosponsor HR 1932? You should have received a CRNAdvocacy Alert from AANA President Terry Wicks CRNA MHS asking you to take action. Check your email inbox!

* How’s Your NPI? In addition to the resources available to CRNAs at http://www.aana.com, the Medicare agency has posted extensive information on applying for, testing, and using your NPI at http://www.cms.hhs.gov/NationalProvIdentStand/. Healthcare professionals can apply for the NPI online at https://nppes.cms.hhs.gov.

* Make Sure You Register for a Night in the West! This event at AANA Annual Meeting in Denver benefits your CRNA-PAC! See your AANA Annual Meeting registration information for more details. Any questions about CRNA-PAC, please see http://www.aana.com/crnapac.aspx, or contact AANA Political Affairs Manager Shari Dexter sdexter@aanadc.com.

* Make Plans NOW to Visit with Your Legislators Over the August Recess! The August recess is an excellent time to visit with your legislator at home. Members will be working from their district offices during the break giving you a fantastic opportunity to get face time with your Representative and Senators!

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. © 2007 American Association of Nurse Anesthetists.