Legislation to Permit Home Health Certification by APRNs Re-Introduced in the Senate


Yesterday, Senators Susan Collins (R-ME) and Ben Cardin (D-MD) re-introduced S. 445, the Home Health Care Planning Improvement Act . This legislation would allow nurse practitioners (NPs), clinical nurse specialists (CNSs) and certified nurse midwives (CNMs) to certify their patient’s eligibility for home health care services. ANA strongly supports S. 445.

Current Medicare policy prevents these advanced practice registered nurses (APRNs) from providing appropriate care for their patients. Medicare has recognized the autonomous practice of these APRNs for nearly two decades, as they provide the majority of skilled care for home health patients. While these health care professionals are authorized to perform face-to-face assessments of a patient’s needs, a physician must certify their assessment. This legislation appropriately removes that burdensome requirement and ensures more timely access to home health services under Medicare.

While the date has not yet been set, ANA is working with House champions to introduce companion legislation. Last Congress, this legislation garnered 52 cosponsors in the Senate and 206 in the House. We will continue to advocate for passage of this important legislation and urge you to help advance this bill by contacting your Members of Congress.

Town halls, Boehner’s return, and an ACA replacement


Town Halls:

This week, Members of Congress across the country held town halls during this week’s district work period. These town halls largely focused on the Affordable Care Act (ACA) and the future of healthcare. Congressional Republicans, who hope to have the ACA repealed later this spring, faced throngs of constituents concerned over the uncertain future of the law. One of the most pointed moments came on Tuesday, when Senator Chuck Grassley (R-IA) was confronted by a farmer in his state who protested that he wouldn’t be able to afford health insurance if it weren’t for the law’s healthcare subsidies.  Other constituents pleaded with the Senator, who chairs the Senate Judiciary Committee, to simply reform the law rather than repealing it. Polls have recently shown the law’s growing popularity.

Boehner’s Back:

On Thursday, former Speaker of the House John Boehner (R-OH) predicted that Congressional Republicans would not fully repeal and replace the ACA. Boehner insisted that changes would be made to the law, but that the structure would largely stay the same. He alleged that in his 25 years in Congress, “Republicans never, ever, one time agreed on what a health care proposal should look like.”

Next Week:

Congress is back in session next week. On Wednesday, the House Education and Workforce Committee are having a hearing on “Legislative Proposals to Improve Health Care Coverage and Provide Lower Costs for Families,” and on Thursday the House Committee on Energy and Commerce will have a hearing “Examining FDA’s Generic Drug and Biosimilar User Fee Programs.”

ACA Replacement Leak:

On Friday, a leaked draft bill from the House Energy & Commerce committee on an ACA replacement bill was making the rounds in Washington. The bill, dated February 10th, would phase out federal funds by 2020 for those states that expanded Medicaid. The draft also eliminates federal subsidies for individuals to obtain coverage, while adding a tax credit that would increase based on an individual’s age. The tax credit, which has been a longstanding Republican healthcare idea, would do away with income-based thresholds and would range between $2,000 and $4,000. The draft legislation is expected to go through several iterations before it’s sent to markup in mid-March. ANA’s Government Affairs and Health Policy teams will continue monitoring healthcare legislation; stay tuned for updates on Capitol Beat.

This week in Washington – New Legislation on Pre-Existing Conditions, and Trump Appointees for CMS and Labor


Confirmation Updates

The Senate Finance Committee held it’s hearing on Seema Verma’s nomination to become Administrator for the Centers for Medicare and Medicaid Services (CMS). Verma has deep ties to Indiana, Vice President Pence’s home state, where she worked with his predecessor (Gov. Mitch Daniels) to transform the state’s Medicaid program into the current Healthy Indiana Plan that emphasizes health savings accounts.  The more contentious moments of her hearing focused around conflict of interest issues. Verma, who until recently ran a consulting firm (SVC), worked to reform Kentucky’s Medicaid expansion program to include a work requirement for beneficiaries. Disclosures also showed that Verma was consulting on healthcare reforms with nine other states, while also having health industry clients that would in turn be impacted by state reforms. Verma is expected to be confirmed in the coming weeks.

Following Andrew Puzder’s withdrawal from consideration to run the Department of Labor, President Trump nominated Alexander Acosta to become Secretary of Labor. Acosta is currently a Florida law school dean, and was previously a National Labor Relations Board member and Assistant Attorney General for civil rights under the President George W. Bush. Though Puzder’s nomination was plagued with scandals over allegations of domestic violence and a failure to pay taxes after employing an undocumented nanny, Acosta’s nomination is expected to win swift confirmation.

The Senate Judiciary Committee set March 20th as the hearing date for President Trump’s Supreme Court nominee, Neil Gorsuch. Committee Chairman Chuck Grassley (R-IA) said that hearings will last three to four days, which is in-line with past Supreme Court confirmations.

Legislative Update

On Thursday, Chairman of the House Energy & Commerce Committee Greg Walden (R-OR) introduced the Pre-Existing Conditions Protection Act of 2017. The bill aims to preserve the popular provision memorialized in the Affordable Care Act (ACA), which protects Americans with pre-existing conditions from discrimination when seeking health insurance coverage. The Chairman’s bill seeks to temper growing fears over ACA repeal efforts Congressional Republicans are hoping to repeal the ACA sometime later this year.

Congressional Recess

Next week, Congress will be in recess for a week-long district work period. If you plan on attending a town hall or want to engage with your member, check out our ANA Advocacy Toolkit. You can also learn more about the Republican’s ACA repeal plan with this factsheet.