Reps. Greg Walden (R-Ore.) and Allyson Schwartz (D-Penn.), along with 19 other co-sponsors, introduced bipartisan legislation Wednesday to ensure that seniors and disabled citizens have timely access to home health services under Medicare.
The Home Health Care Planning Improvement Act of 2013 will allow physician assistants (PA), nurse practitioners (NP), clinical nurse specialists, and certified nurse midwives to order home health services for Medicare beneficiaries.
“This common-sense bill will reduce unnecessary and duplicative burdens on health care providers and patients in need of home health services,” Walden said. “Particularly in rural areas like central, southern, and eastern Oregon where physicians are scarce, these clinicians play an increasingly important role in the delivery of primary health care services. Not only are they serving on the front lines of primary care, but also in many areas they are the only option readily available.”
“We have a responsibility to provide America’s seniors with high quality, cost effective health care. A key part of that is ensuring they have timely access to health care services in the privacy, comfort and security of their own homes,” Schwartz said. “These highly-skilled health care professionals play a central role in the delivery of primary care, particularly in medically underserved areas, and are crucial to coordinating team-based care.”
Currently, Medicare recognizes PAs, NPs, clinical nurse specialists, and certified nurse midwives as authorized providers who are able to perform many services for Medicare beneficiaries, including ordering nursing home care and prescribing medicine.
However, they are not able to order less costly and less intrusive home health care services. Even in states such as Oregon that have explicitly expanded their laws to allow other medical providers to order home care, Medicare will still not certify payment for these services until a physician signs the order.
Those seniors and disabled citizens who see these medical professionals as their primary care providers often need an extra office visit with an unknown physician in order to get the care they need. In such situations, this impediment merely amounts to extra administrative and paperwork burden, and creates an unnecessary step that fails to recognize current training and scope-of-practice guidelines.
As a result, patients in need of home health care services are either placed in more expensive health care settings, or experience a delay in receiving the care they need. This legislation will relieve that burden for our most vulnerable citizens.
If enacted, this legislation could produce significant savings for Medicare, with one study estimating that the plan would save over $100 million over ten years.
In the rural eastern Oregon town of Enterprise, Theresa Russell serves as the only permanent primary care provider in her clinic, Olive Branch Family Health.
As an NP, current law allows her to treat patients in home health settings, but she must wait for a physician’s signature to do so. In rural towns like Enterprise, that wait time can stretch for a week, or sometimes even a month.
This commonsense, bipartisan change in the law would allow NPs like Theresa to make the decision and speed rural health delivery to seniors, Walden's office said.
“Under current law, NPs not being able to order home health for Medicare patients results in delay for the patient and interruptions in continuity of care,” Theresa Russell said. “This also leads to increased cost of care when a patient of mine needs to be seen by an additional provider.
“Studies have shown that the expanded use of these professionals can result in dramatic decreases in expensive hospitalizations and nursing home stays,” said Val Halamandaris, President of National Association for Homecare and Hospice. “We appreciate the outstanding leadership [Reps. Walden and Schwartz] have shown in helping make home and community based services more readily available to our nation’s elderly population and those with disabilities.”
This bill is supported by prominent national health care groups, such as the National Association for Home Care and Hospice, the American Nurses Association, the American Academy of Physician Assistants, the American College of Nurse Midwives, and the American College of Nurse Practitioners.
Besides Reps. Walden and Schwartz, the bill was introduced with 19 other co-sponsors, including Oregon Reps. Peter DeFazio, Kurt Schrader, and Suzanne Bonamici.
For the full text of the bill, please click here.