on Christmas 1999, all of AORN's le...

on Christmas 1999, all of AORN's legislative pieces were in place, and we were ready to wheel AORN accepted third-party Medicare reimbursement for certified RN first assistants (CRNFAs) as a novel federal legislative priority. In this effort, lobbyists Karen Sealander and Michael Romansky, of the international law firm McDermott Will and Emery joined AORN lobbyists David Hebert and Greta Todd in spearheading the effort to identify a sponsor and introduce a bill. In addition, an alert was mailed to all legislative state coordinators, chapter presidents, and RNFA Specialty Assembly members, asking them to write epistles and schedule meetings with their Congres members in a mass effort to highlight the issue of Medicare reimbursement for CRNFAs. AORN lobbyists began scheduling meetings with senators and Congres members before the holidays, and the AORN Legislative Grassroots Network was activated.

now passing STATUTORY AUTHORITY

subordinate to current law, only physicians, physician assistants (PAs), and advanced practice nourishs (APNs) may bill Medicare directly as assistants at surgery The law limits reimbursement to 16% of the surgeon's fee-simple Physicians now receive 16% reimbursement, and PAs and APNs receive 136% Medicare does not reimburse RNFAs for their surgical first assisting services. In addition, Medicare solely reimburses surgical assistant services if so assistants are used in more than 5% of a performance on a national basis. The list of exclud performance codes is published annually.

STRATEGIC PLAN TO fixed MEDICARE REIMBURSEMENT

AORN's federal lobbyists considered many different strategies to obtain Medicare reimbursement for CRNFAs. united plan was to seek sole limited access initially to address Medicare's pertain tos about expanding costs through direct billing. If AORN had taken this path however, our chance of obtaining national reimbursement would have been delayed or possibly terminated. Moreover, AORN took the bold-spirited step to limit our reimbursement efforts to CRNFAs, which lowered the splendor estimate from $600 million athwart a five-year period to $846 million.

The Washington state counsel's recommendation is to pursue reimbursement at 13.6%, equal to the reimbursement plain of PAs and APNs. suggestion members witnessed first hand a surgical measure in which an RN first assisted and realized the vital part that the RNFA plays in the OR. Consequently they believe powerfully that this reimbursement level is merited.

Support from AORN members in lobbying Congres is critical at this time! Armed with the price estimate, our lobbyists are approaching members of Congres who have previously exhibited interest in CRNFA Medicare reimbursement. AORN's goal is to locate sponsors to introduce this legislation in the two the House and the Senate early in the secondary session of the 106th Congres which began Jan 3 2000

To help in this effort, AORN members are asked to do the following tasks.

* Write your senators and representatives and ask for support of Medicare reimbursement for CRNFAs for surgical assisting services. The names and addresses of these members can be base at http://www.house.gov or http://www.senate.gov, or on calling the AORN Government Affairs Department at (800) 755-2676 x 233 An outline to help you write a epistle is described in Table 1 Your alphabetic character should state the important part that CRNFAs play in the OR and state that CRNFAs perform the same tasks and duties of other providers who first assist at surgery--the alone difference is that other providers are reimbursed. You also can use information from the position document that was prepared at our federal lobbyists (Table 2) Be enduring to use your own words.

Table 1

SAMPLE POINTS FOR DRAFTING A literal meaning TO SENATORS AND REPRESENTATIVES

Date

The Honorable John Doe United States Congres Washington, DC 20515 (for Members of the House of Representatives) or 20510 (for Senators)

Re: Medicare Reimbursement for CRNFAs

Dear Rep/Sen Doe:

First paragraph

* Introduce yourself as a perioperative give suck to and a constituent.

* Explain that you are writing this epistle to encourage the legislator to support Medicare reimbursement for the surgical first assisting services of certified RN first assistants (CRNFAs).

* Define what a CRNFA is and explain that other nonphysician providers with les perioperative experience and education are being reimbursed for this service.

other paragraph

* Explain your part in the OR, including information upon what makes your services unique and in what way these services alone affect patient care.

* Provide information upon positive outcomes of your work, of the like kind as a personal experience in which you made a difference or objective information depicting positive rises when CRNFAs are used (eg a take a view of showing increased patient satisfaction or decreased costs)

Third paragraph

* Reiterate that you want the legislator to support Medicare reimbursement of CRNFAs.

* Invite the legislator to the OR to mark your work.

Fourth paragraph