Nurse practitioners (NPs) have a long history of providing high quality, cost effective care to Medicare patients. They have been safely and independently ordering durable medical equipment since 1997 when Congress authorized NPs to receive direct reimbursement for Medicare Part B services.
Recently, in an attempt to reduce fraud, waste and abuse in the ordering of DME, a provision of the Affordable Care Act required that a face-to-face encounter take place as a condition of payment for certain DME items. Currently NPs are permitted to perform the face-to-face encounter, but the law still requires a physician to document that the face-to-face encounter has occurred. This requirement is even enforced when the face-to-face encounter has been performed by an NP. NPs do not object to the requirement for a face-to-face encounter with the patient for whom they order DME, but it is an unreasonable and costly administrative burden to require that a physician sign off on these DME orders. This additional requirement increases the cost of patient care and leads to unnecessary delays in Medicare patients obtaining the medical equipment they need, especially in parts of the country already designated as a health professional shortage area.
The Centers for Medicare and Medicaid Services (CMS) have delayed this provision already as result of concerns expressed by the nursing community and others until a date sometime later in 2014. While we advocated for this delay, we understand the only way to truly remove this barrier to access for millions of Medicare beneficiaries is through a change in law.
Legislation that would authorize nurse practitioners to document the face-to-face encounters with their Medicare patients to order certain durable medical equipment has been introduced in the U.S. House of Representatives. The WOCN Society is working with others in the nursing community to encourage Members of Congress to support beneficiary access to DME by becoming a cosponsor of H.R. 3833. We need you to urge your Members of Congress to cosponsor H.R. 3833. Click here to contact your representatives today.
If you have any questions or require additional information, please do not hesitate to contact WOCN® Society Government Relations staff, Chris Rorick, at Chris.Rorick@bryancave.com.