Angela Golden AANP Co-President American Association of Nurse Practitioners

1. The following slides were part of the presentation at the 25th annual Southwest Regional NP Symposium Angela Golden AANP Co-President American Association of Nurse Practitioners

2. DME • July 1st – require PHYSICIAN documentation • WAIT WAIT – letter writing and visits with Medicare by provider groups • Now delayed to October 1st • provision in the Affordable Health Care Act • Will require physicians to document that a newly required face to face encounter (in the prior 6 months) occurred with the patient for certain types of DME • The encounter can be done by an NP • http://www.capwiz.com/aanp/issues/alert/?alertid=62722811

3. Home Health AGAIN • S. 1332: Home Health Care Planning Improvement Act of 2013 • Sen. Susan Collins [R-ME] • Schumer, Charles [D-NY] • In finance committee and no one from Arizona is on this • Why is this year different • Senate subcommittees are asking for information from NPs • AANP has two lobbyists now and increased staff for federal level • BUT WE NEED YOU • http://www.capwiz.com/aanp/issues/alert/?alertid=62779806

4. Incident to – beware!!! • "Incident to" • rules are unchanged • continue to be limited to services • strictly as a follow up to the physician’s plan of care • MEDICARE IS LOOKING AT THIS FOR FRAUD • YOU ARE RESPONSIBLE FOR WHAT YOUR BILLERS ARE SENDING IN • Specifics • limited to the office setting • physician must still be on site • cannot be with a new patient • or with an old patient with a new problem • In its 2012 work plan, Office of Inspector General intends to determine whether incident-to claims have a higher error rate than ordinary ones

5. Miscellaneous - CMS • Attending in Home Health and Hospice Care • NPs are authorized to serve as "attending physicians" in hospice and home health care. • Authorized to re-certify patient eligibility for hospice care. • Hospital Admitting Physical Examinations • The physician counter signature requirement for hospital admitting physical examinations conducted by nurse practitioners has been eliminated.