AANA Federal Government Affairs
HOTLINE
Number 2008-11 -- Week of Monday, May 19, 2008
 
 
 
In This Issue:
 
*  Have You Taken CRNAdvocacy Action on the Teaching Rules?
*  CDC Issues Case Report on Nevada Hepatitis Outbreak
*  Health Information Technology: Privacy Provision Added to Senate Legislation
*  The NPI:  The Number CRNAs Need May 23rd!
*  Follow-Up: AANA Mid-Year Assembly
*  Amendments
 
 
 
 
>> Have You Taken CRNAdvocacy Action on the Teaching Rules?
 
Congress needs to hear from CRNAs today, so that legislators will cosponsor
an AANA-backed equitable Medicare anesthesia payment teaching rules reform
in the House, and urge the Medicare-writing Senate Finance Committee to
include equitable teaching rules provisions in its measure under development
to reverse coming Medicare payment cuts. 
 
If you've already taken action this past week, thank you!  If not, take a
look in your email inbox for a CRNAdvocacy reminder that AANA President
Wanda Wilson, CRNA, PhD, has sent all AANA members and student associate
members for whom we have email addresses.   Your call or letter to Congress
could be the one that makes the difference for CRNA education!
 

 
 
>> CDC Issues Case Report on Nevada Hepatitis Outbreak
 
The Centers for Disease Control and Prevention issued its official case
report on the Nevada hepatitis outbreak, as part of an issue of itsofficial
publication Morbidity & Mortality Weekly Report May 16.
 
"Inappropriate reuse of syringes on individual persons and use of medication
vials intended for single-person use on multiple persons was identified
through direct observation of infection-control practices at clinic A," the
report stated.  "Specifically, a clean needle and syringe were used to draw
medication from a single-use vial of propofol, a short-acting intravenous
anesthetic agent. The medication was injected directly through an
intravenous catheter into the patient's arm. If a patient required more
sedation, the needle was removed from the syringe and replaced with a new
needle; the new needle with the old syringe was used to draw more
medication. Backflow from the patient's intravenous catheter or from needle
removal might have contaminated the syringe with HCV and subsequently
contaminated the vial. Medication remaining in the vial was used to sedate
the next patient."
 
Following the recent outbreak, AANA President Wanda Wilson CRNA PhD has
communicated to AANA members about the importance of adhering to AANA
standards of practice and infection control guidelines.  President Wilson
and senior AANA personnel also met with top officials of the CDC to discuss
and develop strategies for ensuring safe injection practices among all clinicians. 
 
"This outbreak highlights the importance of surveillance and investigation
in detecting viral hepatitis transmission in health-care settings," the
report stated.  "Prevention of transmission in these settings requires
understanding and adherence to recommended infection-control practices..
Better surveillance, education, and oversight are needed to detect and
prevent bloodborne pathogen transmission in ambulatory and other health-care
settings."
 
Read the report from CDC at,
http://www.cdc.gov/mmwR/preview/mmwrhtml/mm5719a2.htm. 
 
 

 
>> Health Information Technology: Privacy Provision Added to Senate Legislation
 
On Wednesday (May 14th), Senate Judiciary Committee Chairman Patrick Leahy
(D-VT) announced that sponsors of a bill (HR 1693) that would promote the
use of healthcare information technology (HIT) have agreed to include an
amendment the Senator proposed to help protect patient privacy.  The AANA
has continued to monitor HIT and advocate for patient privacy and patient
safety.  Senate Health, Education, Labor and Pensions (HELP) Committee
Chairman Edward Kennedy (D-MA) and ranking member Mike Enzi (R-WY)
introduced the legislation last October.  Senator Leahy had raised concerns
that the bill, which would extend the medical privacy rule issued after the
passage of the Health Insurance Portability and Accountability Act (HIPAA)
to electronic medical records (EMR), did not include adequate privacy
protections (CQ Today, 5/14).  The rule allows some healthcare providers to
distribute medical records for marketing purposes (CongressDaily, 5/15).
Under the amendment, providers could not distribute medical records for
marketing purposes, and patients would have the right to request electronic
copies of their records (CQ Today, 5/14).  The amendment also would require
Health and Human Services (HHS) to develop recommendations for Congress on
privacy and security and establish a patient notification system in the
event of a breach of their medical records. Senators Kennedy and Enzi plan
to introduce the amended bill this week.  In June, Senator Leahy plans to
hold a hearing on the privacy protections in the legislation (CongressDaily, 5/15).
 
Visit the Senate Judiciary Committee, http://www.senate.gov/~judiciary/
 
Visit the Senate HELP Committee, http://help.senate.gov/
 
View the bill, http://thomas.loc.gov
Click "Bill Number"
Enter "HR 1693"
 
 
 

>> 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
 

 
 
>> Follow-Up:  AANA Mid-Year Assembly
 
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.  Now's the time to follow-up
strong, to ensure legislators and their staffs have the best possible
impression of CRNAs and our agenda on Capitol Hill.
 
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.
 
Following up is crucial to our advocacy activities the rest of the year.
 
*  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.  
*  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. 
 
 
 
 
>> 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
       National Defense Authorization Act for Fiscal Year 2009 (HR 5658).
       Meanwhile, the Senate will continue work on the Flood Insurance Reform and
       Modernization Act of 2007 (S 2284).
 
*  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).
 
*  A key advisory panel to the Food and Drug Administration has
       recommended the agency approve the marketing of the new sedation drug
       fospropofol (Aquavan C), and that the labeling of the drug indicate it is to
       be administered by persons expert in general anesthesia.  The action by the
       FDA's Anesthesia and Life Support Drugs Advisory Committee is scheduled to
       be posted by the agency in the form of its May 7 meeting transcript within
       the next few days.  The next step is for the agency to execute the approval.
       Extensive background briefing information used to inform the FDA advisory
       committee on its recommendation on fospropofol is available at
       http://www.fda.gov/ohrms/dockets/ac/08/briefing/2008-4354b1-00-FDA-index.htm. 
 
*  Congress is on recess during Memorial Day week, so you can see your
       legislators at home!  Use the background information from the story "Follow
       Up: Mid-Year Assembly" as your guide to advancing CRNAs' issues.  Let us know how
       your meeting goes by clicking this link and note where the meeting took place.
       
*  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 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 2008 American
Association of Nurse Anesthetists.