Journal of Gerontological Nursing

NEWS 

Interpretation of HCFA Rule Leaves New Mexico Elderly and Poor Without Care

Abstract

Several nurse practitioners (NPs) in rural New Mexico have been laid off their jobs in the wake of a new i nterpretation of Medicare reimbursement law by a fiscal intermediary of the Health Care Financing Administration (HCFA) in that area.

A new "clarification" of a long-standing policy was issued earlier this month by HCFA's fiscal intermediary in the New Mexico area. Employers of these nurses in advanced practice were told they can no longer receive Medicare reimbursement for services currently performed by NPs.

Many of the inequities created by Medicare law would be eradicated if a bill now in Congress were to pass. The bill is the Rural Nursing Incentive Act of 1989. The measure would directly reimburse NPs and clinical nurse specialists under Medicare for providing services in rural areas.

One of the ANA's short-term strategies involves an anticipated final HCFA rule on Medicare and Medicaid: Requirements for Long Term Care Facilities. In the rule, HCFA recognizes the expanded role of the NP in the delivery of long term care services to the elderly by allowing NPs to alternate with the physician in performing the required visits to nursing home residents.

For more information, contact Cathy Koeppen, American Nurses' Association, 4101 14th Street, NW, Suite 200, Washington, DC 20005; 202-798-1800.…

Several nurse practitioners (NPs) in rural New Mexico have been laid off their jobs in the wake of a new i nterpretation of Medicare reimbursement law by a fiscal intermediary of the Health Care Financing Administration (HCFA) in that area.

A new "clarification" of a long-standing policy was issued earlier this month by HCFA's fiscal intermediary in the New Mexico area. Employers of these nurses in advanced practice were told they can no longer receive Medicare reimbursement for services currently performed by NPs.

Many of the inequities created by Medicare law would be eradicated if a bill now in Congress were to pass. The bill is the Rural Nursing Incentive Act of 1989. The measure would directly reimburse NPs and clinical nurse specialists under Medicare for providing services in rural areas.

One of the ANA's short-term strategies involves an anticipated final HCFA rule on Medicare and Medicaid: Requirements for Long Term Care Facilities. In the rule, HCFA recognizes the expanded role of the NP in the delivery of long term care services to the elderly by allowing NPs to alternate with the physician in performing the required visits to nursing home residents.

For more information, contact Cathy Koeppen, American Nurses' Association, 4101 14th Street, NW, Suite 200, Washington, DC 20005; 202-798-1800.

10.3928/0098-9134-19891201-19

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