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CMS Delays New DME Rule

 

Throughout the year, ONA and NPO have been updating you on the status of a new Centers for Medicare & Medicaid Services (CMS) rule that would require that a physician approve many nurse practitioners’ durable medical equipment (DME) orders.

In response to this rule, many of you contacted your Congressional Representatives and asked them to repeal or delay this rule indefinitely. Thanks to your efforts and the work of our national partners, including the American Nurses Association and the American Association of Nurse Practitioners, on September 9, CMS announced it will delay active enforcement and full compliance with this rule until an unspecified date in 2014.

The rule was previously scheduled to take effect on July 1, 2013 and has been postponed twice.

Nationally, NPs have independently ordered DME since 1997. Revoking this authority and requiring NPs and other providers to get a physician’s signature for many DME orders creates unnecessary costs and causes unnecessary delays for patients and providers.

ONA and NPO will continue to work with CMS, our national partners, and Congress to permanently remove barriers to NP practice, including the physician signature requirement for NPs’ DME orders.

Thank you for your advocacy.


Previous Action Alert: Prevent New Barriers to Nurse Practitioners’ Medicare Practice

Starting October 1, Medicare will require nurse practitioners and clinical nurse specialists to have a physician approve many NP and CNSs’ durable medical equipment (DME) orders.

This new rule will require providers to have a physician document that an NP or CNS had a face-to-face visit with a Medicare patient within six months of certain DME orders.

The effect is that physicians must now approve many nurse practitioner and clinical nurse specialist DME orders for Medicare patients, including certain hospital beds, wheelchairs, and oxygen systems, as well as prosthetic devices, orthotics and prosthetics.

Nationally, nurse practitioners have independently ordered DME since 1997.

This new rule will add unnecessary medical costs and delays for patients and providers and erode nurses’ scope of practice at a time when we need advanced practitioners working to the full extent of their training and education.

Thanks in part to your advocacy, the Centers for Medicare & Medicaid Services delayed implementation of this rule from July 1 to October 1.

Now it’s time to repeal the new physician signature requirement entirely.


Original NPO Alert:
CMS Ruling on Nurse Practitioners Durable Medical Equipment orders

As part of the Affordable Health Care Act, starting July 1, 2013, providers must conduct a face to face visit with a Medicare patient within six months prior to ordering certain durable medical equipment (DME) for them.

This new rule also requires that a physician document this visit by signing or cosigning a patient’s medical record to corroborate that a face-to-face visit occurred. The effect is that a physician must approve many Nurse Practitioner DME orders for Medicare patients, including certain hospital beds, wheelchairs, and oxygen systems, as well as prosthetic devices, orthotics and prosthetics.

Nationally, Nurse Practitioners have independently ordered durable medical equipment since 1997. Requiring NPs and other providers to get a physician’s co-signature for DME orders creates unnecessary medical costs and delays for patients and providers.

Groups that represent nurses and Nurse Practitioners, including the American Nurses Association (ANA) and the American Association of Nurse Practitioners (AANP), have been working with CMS to change this rule, but have been consistently turned down. ONA is well aware of this issue and will continue working to address it in partnership with ANA and AANP. 
 

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