U.S. Reps. Greg Walden (R-Ore.) and Allyson Schwartz (D-Penn.), along with 25 co-sponsors, introduced bipartisan legislation to ensure that seniors and disabled citizens have timely access to home health services under Medicare.
The Home Health Care Planning Improvement Act, H.R. 2267, will allow physician assistants (PA), nurse practitioners (NP), clinical nurse specialists, and certified nurse midwives to order home health services for Medicare beneficiaries.
Currently, Medicare recognizes NP's and PA's as authorized providers who are able to order nursing home care for Medicare beneficiaries. However, they are not able to order less costly and less intrusive home care services. Even in states 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. This legislation will relieve that burden for our most vulnerable citizens.
"This bill will reduce unnecessary and duplicative burdens on providers and seniors in need of home health services," Rep. Greg Walden said. "Particularly in rural areas like central, southern, and eastern Oregon where physicians are scarce, nurse practitioners, physician assistants, clinical nurse specialists, and certified nurse-midwives are essential components of the health care delivery system. 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 health care, and a key part of that is ensuring they have access to timely home health care services," Rep. Allyson Schwartz said. "These valued health care professionals play a central role in the delivery of primary care, particularly in medically underserved areas, and are essential to the coordination of team-based care."
Eleven Republicans and 17 Democrats, including the rest of the Oregon House delegation, have already signaled their support for the legislation.
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 often stretches as long as one month. This commonsense, bipartisan change in the law would allow NPs like Russell to make the decision and speed rural health delivery to seniors.
"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.
"Thanks to Congressman Walden's leadership, this bill will eliminate unnecessary administrative burden for physicians and improve access to care for seniors," said Cheryl Olson, division director of Providence Home Services.
"This bill will eliminate barriers that currently exist to home health care services for the patients that urgently need them," said Susan Schrand, MSN, CRNP and Executive Director of the Pennsylvania Coalition of Nurse Practitioners. "Nurse practitioners care for thousands of patients across Pennsylvania and the nation each day, and are perfectly suited to make this determination."
"This legislation is long overdue and welcome news for thousands of nurses who have had expanded roles in the care of Medicare patients, but who have had their hands tied by CMS in their ability to certify home health services for patients," said Val J. Halamandaris, president of the National Association for Home Care and Hospice. "This legislation will ensure that important care to these Medicare beneficiaries is not interrupted."