AANA Federal Government Affairs
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Number 2008-06 -- Week of Monday, March 10, 2008



In This Issue:

*
CMS Director for Medicare Management Estimates Double Digit Medicare Part B                       
       Reimbursement Cut July 1st
* Nursing School Graduates Rise While Applications to RN Programs Drop
* Senate and House Budget Committees Pass FY 2009 Budget Resolution
* Legislation Would Make it Easier for Career Military Nurses to Transition to Teaching
* Amendments



>> CMS Director for Medicare Management Estimates Double Digit Medicare Part B Reimbursement Cut July 1st


The Center for Medicare and Medicaid Services (CMS) estimates that Medicare payments to physicians will decline by 10.6% below current levels on July 1st and by 15.4% below current levels on January 1st, 2009, under the current payment formula.  CRNAs will be directly affected by this cut, and the AANA continues to work with members of Congress to fix this reimbursement inadequacy.  The estimates were released on Friday (March 7th), in a letter from Jeffrey Rich, Director of the CMS Center for Medicare Management, to the
Medicare Payment Advisory Commission (MedPAC).  The cuts reflect an increase in the volume of services provided by physicians that exceeds growth targets.  

Congress is working on a Medicare package that would block the cuts.  One plan by the Senate Finance Committee would block all cuts in 2008 and 2009.  Rich in the letter also outlined steps CMS is taking to improve quality and efficiency, including:

  • Continuing and expanding the Physician Quality Reporting Initiative, which pays physicians an additional 1.5% of their billed charges for reporting quality-of-care data;
  • Implementing “structural measures,” which include purchasing and using electronic health record systems;
  • Intensifying efforts to collect and share data on physicians’ comparative costs to improve efficiency; and
  • Testing pilot programs, which currently include one that pays for efficiency in treating chronic conditions and another that develops medical homes for beneficiaries.

Rich in the letter wrote, ‘The real issue is how Medicare can rapidly transform itself from a passive payer for services into an active purchaser of high-quality care by linking payment to the value of care provided” (CQ HealthBeat, 3/3).

Visit for CMS, http://www.cms.hhs.gov/

Visit the Center for Medicare Management, http://www.cms.hhs.gov/CMSLeadership/06_Office_CMM.asp

Visit the Medicare Payment Advisory Commission, http://www.medpac.gov/

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




>> Nursing School Graduates Rise While Applications to RN Programs Drop



Admissions to nursing schools at all levels rose 5 percent, but the number of applicants declined 8.7 percent from 2005-2006, according to a new report from the National League for Nursing (NLN), with impacts on the workforce pool available to apply to nurse anesthesia educational programs.

One out of three qualified applicants were turned away from programs because of a lack of capacity, with baccalaureate programs turning away 20 percent and associate degree programs turning away 32.7 percent of their applicants.  In addition, because 43 percent of pre-licensure nursing graduates were over the age of 30 in 2006 and 16 percent were over the age of 40, the volume of graduates may be increasing but the length of time graduates will spend in the workforce is reduced by their delay in entering the profession. The NLN will begin its next survey this month to evaluate the 2006-2007 academic term.

Read the Executive Summary of NLN Nursing Data Review Academic Year 2005-06, http://www.nln.org/research/datareview/executive_summary.pdf




>> Senate and House Budget Committees Pass FY 2009 Budget Resolution


On Thursday (March 6th), the Senate Budget Committee voted 12-10 along party lines to pass a $3 trillion fiscal year 2009 budget resolution that would provide more in spending for healthcare for children and veterans and other domestic programs than President Bush has requested (CongressDaily, 3/7).  The AANA is working on Capitol Hill in 2009 to reverse anticipated cuts to the Medicare program and to nurse workforce development funding critical to CRNAs.

The Senate budget resolution includes $18 billion more in spending for domestic programs than President Bush has requested (CQ Today, 3/6).  Before approval of the budget resolution, the committee passed several amendments, two of which would reserve funds for pediatric dental care and promote healthcare information technology (HIT) (CongressDaily, 3/6). 

Also on Thursday (March 6th), the House Budget Committee voted 22-16 to pass a FY 2009 budget resolution that includes $22 billion more in spending for domestic programs than President Bush has requested (CQ Today, 3/6).  President Bush responded by threatening to veto any FY 2009 appropriations bill that exceeds his request for spending and does not reduce the number of FY 2008 “earmark” projects by half (CongressDaily, 3/7).  The full House and Senate are considering the budget resolutions the week of March 10.  (CQ Today, 3/6).

Visit the Senate Budget Committee, http://www.senate.gov/~budget/

Visit the House Budget Committee, http://www.house.gov/budget_democrats/





>> Legislation Would Make it Easier for Career Military Nurses to Transition to Teaching


On Wednesday (March 5th), Senator Richard Durbin (D-IL) along with 10 co-sponsors introduced the Troops to Nurse Teachers (TNT) Act of 2008 (S. 2705).  The legislation has been referred to the Armed Services Committee and would provide opportunities for Nurse Corps Officers in the Armed Forces the ability to transition to faculty positions at accredited nursing schools after retirement.  The measure was introduced with a letter of support from a wide range of nursing organizations, including the AANA.

The TNT Act is modeled after the Department of Defense program established in 1994 to encourage retiring military personnel to teach school in high-need parts of the country, focusing on the subjects of math and science. The bill would help alleviate the nursing shortage by increasing faculty in schools of nursing.

Read more, http://durbin.senate.gov/record.cfm?id=257099

View the bill, http://thomas.loc.gov
     Click “Bill Number"
    
Enter “S 2705”




>> 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 The Intelligence Authorization Act of 2008 (HR 2082).  Meanwhile, the Senate will continue work on a resolution addressing the President’s Budget (S. CON. RES. 70).
  • Hepatitis Outbreak Hits Nevada.  An outbreak of hepatitis has been linked to an outpatient center near Las Vegas, NV.  The AANA is closely monitoring and acting upon the situation.  More details are available for AANA members on the AANA Website (http://www.aana.com).
  • A panel of the Food and Drug Administration (FDA) scheduled a review for the anesthesia drug suggamedex, for March 11.  The agency’s anesthesia drugs and devices review panel was slated to consider the findings of a staff memo posted as http://www.fda.gov/ohrms/dockets/ac/08/briefing/2008-4346b1-01-FDA.pdf.  Further information will be circulated to AANA members on this issue as the agency publishes it.
  • Make Plans NOW to Attend the AANA Mid Year Assembly!  This year the AANA Mid Year Assembly will be held April 13th-16th in Washington, DC.  And, for the first time, the CRNA-PAC is hosting its Sunday evening fundraiser in Presidential style – with a twilight tour of President Washington’s Mount Vernon estate and dinner at the historic Mount Vernon Inn.  Tickets are $200 per person and are selling fast, with proceeds to benefit CRNA-PAC.  For more information visit the AANA website at http://www.aana.com.  See what AANA will be advocating at MYA’08 by clicking here.   
  • Mount Vernon Night at Mid Year Assembly!!!  If you haven’t bought tickets for Mount Vernon on Sunday, April 16th, at Mid Year Assembly, make sure you check the registration form when registering for MYA.
  • Federal Political Directors (FPDs) NOW is the time to schedule your meetings for Mid Year Assembly.  Federal Political Directors should now be contacting the appropriate offices to schedule appointments with their Members of Congress, and their staff, for the upcoming Mid Year Assembly.  Any questions, please contact AANA Political Affairs Manager Shari Dexter, sdexter@aanadc.com.  
  • Where are the major U.S. Presidential candidates on healthcare issues?  The Kaiser Family Foundation has combed their websites, statements and speeches and posted it all on www.health08.org.    
  • Make a statement to back CRNA-PAC!  The AANA’s CRNA-PAC is a separate fund, supported by AANA members’ voluntary contributions, that builds AANA and CRNAs’ strength in Washington by supporting legislators friendly and influential to CRNAs’ federal policy issues. For more information, see www.aana.com/crnapac.aspx, or email info@aanadc.com if you have any questions.
  • AANA DC has Moved.  As of December 1st, 2007, our new street address is 25 Massachusetts Ave., NW., Suite 550, Washington, DC 20001.  Our telephone, fax number, and email addresses remain the same. 





>> 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.  © 2008 American Association of Nurse Anesthetists.