AANA Federal Government Affairs
HOTLINE
Number 2008-09 -- Week of Monday, April 28, 2008

 In This Issue:

*  AANA Mid-Year Assembly: Over 600 CRNAs & Students Take Nurse Anesthesia Message to Capitol Hill
*  Senate Finance Chairman Lays Out Plan for Medicare Part B Reimbursement Fix
*  The NPI:  The Number CRNAs Need May 23rd!
*  Amendments

 

>> AANA Mid-Year Assembly: Over 600 CRNAs & Students Take Nurse Anesthesia Message to Capitol Hill

During the AANA Mid-Year Assembly (MYA) (April 13th – 16th), more than 600 CRNAs and student nurse anesthetists  came to Washington, DC, to educate Members of Congress on Nurse Anesthesia issues.  Attendees heard educational presentations from AANA Washington staff and experts from the Alston & Bird law firm health policy practice, from CRNA-friendly anesthesia teaching rules reform supporters Representatives Michael Burgess, MD (R-TX), and Xavier Becerra (D-CA), from senior Medicare-writing Senate Finance Committee staff, and from epidemiologist Dr. Michael Jhung of the Centers for Disease Control & Prevention. The three-day meeting helps CRNAs and student nurse anesthetists become more informed on federal issues affecting their practice, education, and Medicare reimbursement, and provides AANA members an opportunity to advocate for nurse anesthesia issues on Capitol Hill directly. 

The AANA also extended its highest public policy honor, the National Health Leadership Award, to Senator Max Baucus (D-MT), chair of the Medicare-writing Senate Finance Committee, for his leadership in advancing strong Medicare and rural health programs, his attention to equitable reform of the Medicare anesthesia payment teaching rules, and his open door to CRNAs from Montana and around the country. 

The messages CRNAs brought to Congress:

    • Reverse the coming Medicare payment cuts on CRNA and physician services, estimated to be 10.6% come July 2008 and another 5% in January 2009;
    • Restore funding for nursing and nurse anesthesia education, which was cut by the Administration’s 2009 budget proposal; and,
    • Reform Medicare anesthesia payment teaching rules for both CRNAs and anesthesiologists equally, not favoring one provider over another.

 

Some 250 members of the AANA participated in a benefit for CRNA-PAC at President Washington’s historic Mount Vernon estate, with the PAC’s Presidential Club donors riding to Mount Vernon in style aboard the historic Presidential Yacht Sequoia.  The meeting also marked the celebration of the recent move of the AANA Washington, DC, Federal Government Affairs Office to new space at 25 Massachusetts Ave., NW, Suite 550, on Capitol Hill near Washington Union Station. 

  • Did you complete your lobby visit report form for every visit?   An online lobby report form is available to you by clicking this link .  Please fill out a form for every visit you made.  If more than one AANA member reports on a visit, all the better – more viewpoints provide us a fuller perspective on your meeting, and AANA DC uses this information on our advocacy work all year long.
     
  • Have you evaluated AANA Mid-Year Assembly ’08?  Though AANA Meetings & Programs takes your evaluation of every AANA Mid-Year Assembly activity, AANA DC would like your views on what Meetings & Programs staff can’t evaluate – such as the degree you thought the whole program prepared you for your meetings on Capitol Hill, and your perspective on our new “two-track” Sunday educational program.  Please click this link to complete and submit your evaluation.  
     
  • The Mid-Year Assembly slide deck and background and advocacy materials are all available online at www.aana.com/federalissues.aspx. 

 

>> Senate Finance Chairman Lays Out Plan for Medicare Part D Reimbursement Fix

On Friday (April 11th), Senate Finance Committee Chair Max Baucus (D-MT) outlined a package of Medicare legislation that would delay for 18 months a 10% Medicare physician payment cut that is scheduled to take effect July 1st.  CRNAs will be directly affected by the cuts if Congress does not act to reverse the scheduled cuts. 

The measure would prevent the cuts until January 2010 and increase payments by 1.1%.  The bill would cost the U.S. Treasury about $8.4 billion over five years; halting the cuts without the increase would cost about $8 billion.  The measure would use so-called “balloon financing,” which means CRNAs and physicians would face a Medicare payment cut of 21% in 2010 if the measure contains a pay increase and Congress fails to enact further Medicare payment reform by that time.  The cut would be 20% without the fee increase (CQ Today, 4/11). 

Senator Baucus said that he would not allow the large pay cut to take place in 2010 and that next year he would address the Medicare physician pay funding mechanism more broadly.  Baucus also said that he wants to increase Medicare payments to primary care physicians and link reimbursements to quality of care as provisions of the Medicare package, which he plans to have on the Senate floor by mid-May (CongressDaily, 4/11).  Such a proposal was telegraphed by the government’s Medicare Payment Advisory Commission (MedPAC), which has expressed concern that Medicare and the nation face a shortage of internists and family practitioners.  (CQ HealthBeat, 4/11

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

Visit the MedPAC, http://www.medpac.gov/

Read more, http://www.orlandosentinel.com/services/newspaper/printedition/sunday/orl-docs1308apr13,0,5820333.story

 

>> The NPI:  The Number CRNAs Need May 23rd!

For over a year CRNAs have been required to include their National Provider Identifier (NPI) on all Medicare claims in the primary provider fields.  However, the Centers for Medicare & Medicaid Services (CMS) continues to be concerned about the low percentage of claims being submitted with an NPI alone in the primary provider identifier fields. 

According to the Medicare agency, if your claims are being successfully processed with NPI/legacy pairs, and most are, now is the time for CRNAs to begin sending a small batch of claims with NPI alone.  If the claim is processed and you are paid, you should continue to increase the volume of claims sent with only your NPI.  Please keep in mind that if the Medicare NPI Crosswalk cannot match your NPI to your Medicare legacy number, the claim with an NPI-only will be rejected. If the claims are rejected, go into your NPPES record and validate that the information you are sending on the claim is consistent with the information in NPPES.  If it is different, make the updates in NPPES and resend a small batch of claims 3-4 days later.  If your claims are still rejected you may need to update your Medicare enrollment information to correct this problem. 

For more information on the NPI, http://www.cms.hhs.gov/NationalProvIdentStand/
To apply for your NPI, https://nppes.cms.hhs.gov/NPPES/Welcome.do

 

>> 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 Genetic Information Nondiscrimination Act as Amended (HR 493).  Meanwhile, the Senate will continue work on the FAA Reauthorization Act of 2007 (HR 2881), sent over from the House.
     
  • CMS is posting a new educational presentation about its Physician Quality Reporting Initiative (PQRI) pay-for-performance program, in which CRNAs can participate.  Its slide presentation for an April 30 program is posted at http://www.ampev1.com/customers/palmetto/043008.pdf.  For more information about CMS’ PQRI program, see http:// HYPERLINK "http://www.cms.hhs.gov/pqri" www.cms.hhs.gov/pqri. 
  • Stay Informed about the Nevada Hepatitis Outbreak.  An outbreak of hepatitis has been linked to an outpatient center near Las Vegas, NV, with AANA President Wanda Wilson CRNA PhD most recently testifying before a Nevada state legislative joint committee on healthcare to describe the profession’s action plan to promote infection control and safe practice.  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).
     
  • 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.   
  • Federal officials reached a settlement with an Allentown, PA, hospital over allegedly improper anesthesia charges submitted to Medicare, according to BNA April 23.  Sacred Heart Hospital and its parent organization made no admission of liability to U.S. Attorneys of the Eastern District of Pennsylvania.  You can read the settlement at http://www.usdoj.gov/usao/pae/News/Pr/2008/apr/sacredheartsettlementagreement.pdf. 
     
  • 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 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.  © 2008 American Association of Nurse Anesthetists.