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How to champion the cause

Saturday May 17, 2014
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Maryanne Sapio, vice president of federal government affairs at AANP, says NPs are needed to help change the future of healthcare delivery. “Nurse practitioners are the champions we need to advocate for legislation that will modernize the Medicare program to reflect the services and care that nurse practitioners are providing.”

For instance, two legislative proposals currently gaining support in Congress address barriers that, if removed, would enable NPs to practice to the fullest scope of their license.

HR 2504/S 1332 Home Healthcare Planning Improvement

This legislation would allow NPs to order home healthcare services after a face-to-face assessment, eliminating the need for an NP to have a physician document that the assessment has occurred, which increases physician reimbursement costs and potentially delays care due to the two-step process. This bill has been introduced in the U.S. House of Representatives and Senate and is gathering support in both chambers.

HR 3833 Durable Medical Equipment Prescriptive Authority

NPs have possessed the authority to prescribe this equipment for years. But in an attempt to control costs caused by over-prescribing, Congress proposed under the Affordable Care Act to require a physician’s signature, certifying a face-to-face assessment, before NPs can write the orders. This policy was ultimately approved as part of the ACA, but the implementation has been delayed by the Centers for Medicare and Medicaid Services. The delay has allowed time for a legislative proposal that would prevent the implementation of this policy. This bill is currently introduced in the House and is gathering support and waiting further action.

Preparing to speak to a member of Congress to advocate for patients and NPs?

Sapio gave the following tips to make your efforts more effective:

Join a professional organization

While an NP can certainly reach out to congressional members independently, national organizations provide status updates regarding specific legislation; coordinate a strong, cohesive, consistent message, and facilitate in-person meetings with members of Congress.

Remember that you’re the expert

NP advocates should speak confidently regarding their area of expertise and use research and case studies to illustrate the need for ongoing change in healthcare legislation. Sapio said NPs “... are the ones providing care to patients every single day and they see how these federal barriers that remain law are blocking the care they can provide to their patients.”

Educate members of Congress on your everyday challenges

Members of Congress are generally open to hearing from NPs and want to learn about the realities of practice. She recommends assessing baseline knowledge and building from there to educate congressional members about how some of these legislative barriers affect “on the ground” practice.

Try multiple tactics

Attempt an in-person meeting first. If that doesn’t work, a phone call or email can also be effective. At any given time, congressional members are juggling a number of issues. Persistence ensures that a message will be heard.

Ask for help

“Our federal team is also always available, through emails and phone calls,” said Sapio. “Where we can all work together, we will work together to support each other and to bring an issue to the forefront.”

To see what else is trending, visit www.Nurse.com/Nurse-Practitioners.


Meaghan O’Keeffe, RN, BSN, is a freelance writer. Check out her blog at www.ScrubbedIn.Nurse.com. Post a comment below or email specialty@nurse.com.