The legislation passed by the Senate April 14 that would permanently remove the sustainable growth rate formula, also allows nurse practitioners and clinical nurse specialists to document the face-to-face encounters with Medicare patients required that are to write prescriptions for durable medical equipment. Previously, nurse practitioners and clinical nurse specialists were required to certify that the order for durable medical equipment was based on a prior face-to-face visit with a Medicare patient as documented with a physician’s co-signature.

"This change improves access to services and will allow Medicare patients to receive equipment, such as portable oxygen systems and hospital beds, sooner," the American Nurses Association said in a statement.


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The law, called the "Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act"also includes advanced practice registered nurses in the new Merit-Based Incentive Payment System. The incentive payment program replaces the Sustainable Growth Rate (SGR) payment formula.

“The provisions affecting nursing in this bill recognize that nurses provide high-quality, efficient and cost-effective services that are valued and needed by Medicare patients, many of whom rely on APRNs for their primary care needs,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “Nurses are more than ready to meet the quality and accountability standards for reimbursement and will continue to improve the health care experience for some of the nation’s most vulnerable citizens.”