In July 1999 the AORN Board of Dire...

In July 1999 the AORN Board of Directors approved a change to the 1999-2000 AORN legislative priorities to read: "Third-party Medicare reimbursement for certified RN first assistants (RNFAs) and state third-party reimbursement for RNFAs." The RNFA Specialty Assembly praiseed this change in June when the issue was debated at the RNFA Forum in San Antonio.

RATIONALE BEHIND THE DECISION

Early in 1999 AORN contracted with Don Muse and Associates to manner of life a cost analysis of RNFAs receiving Medicare reimbursement (see August 1999 AORN Journal). AORN chose Muse and Associates based onward its experience with the Congressional pack Office, which "scores" all bills before they are introduced in Congres Scoring is the fiscal analysis that all bills endure before being introduced.

In the last year, AORN's federal lobbyists David Hebert and Greta Todd contacted several lawmakers regarding sponsorship of the bill. A not many members of Congress are interested, including Rep Mark Foley (R-Fla) and Cliff Steams (R-Fla). As a behavior however, cost estimates need to be les than $500 million to be favorably sponsored and introduced. Unfortunately, the price analysis of the Medicare reimbursement bill outcomeed in a high figure. Consequently AORN must convert into the cost estimate before securing a sponsor and introducing a bill.

Surveying members. individual of the ways AORN possibility of goods to reduce the cost is by way of surveying a random sample of RNFAs regarding the number of surgeries they assist with each week. In July a inspect was sent to 600 RNFA AORN members to obtain this information. As we await analysis of the observe AORN hopes that the findings will deduction in reducing the cost figure.

Narrowing the population. According to Muse and Associates, another way to diminish the figure is to consider political solutions (eg narrow the population for which we are seeking reimbursement). Focusing forward obtaining reimbursement for certified RNFAs (CRNFAs) is the best political course to form the estimated cost of Medicare reimbursement for the following reasons.

* AORN will be able to identify the population of providers, which can sole be estimated at this time.

* Pursuing Medicare reimbursement for CRNFAs will greatly lessen the estimated cost figure, making succes of the legislation more promising.

* With this strategy, AORN's chances of passing a bill are increased, and several of our members will receive be in want ofed Medicare reimbursement.

* The time for making this decision is critical as there will be a Medicare bill in this biennium, and a similar opportunity may not appear for several years.

* Legislators at the two federal and state levels are asking for professional certification for reimbursement or other means to ascertain continuation of competency

* Achieving Medicare reimbursement for CRNFAs would be a coup for AORN based forward the fact that CRNFAs, as of Jan 1 2000 ne barely a bachelor of science grade in nursing to receive reimbursement. (Currently RNFAs have to be advanced practice nourishs with master's degrees to be eligible for reimbursement.)

* Without pursuing this strategy, AORN's propos bill has a surpassingly slim chance of succeeding.

daring step for AORN. In June the AORN Board of Directors allotted $162000 for the fiscal year 1999-2000 to strive for RNFA Medicare reimbursement. The legislative proces is real complicated and requires compromise from all parties to achieve succes Consequently pursuing the strategy to safe Medicare reimbursement for CRNFAs is in line with AORN's analysis of the political situation in Congres at this time. The Board has taken a intrepid step in framing a strategy that will be in the best interest of the two present and future AORN members.

The RNFA Specialty Assembly helped in the analysis and debate of the issue. Participants at the RNFA Forum were informed of the decision and allowed time in small clusters to discuss the issue and report to the plenary cluster The outcome was positive, and consensus from the discussions revealed that this was a positive grade for the Association.

As a deduction of the decision, AORN has moveed a lobbying contract to McDermott Will, and Emery a Washington, DC law firm, to help Hebert and Todd achieve Medicare reimbursement for CRNFAs. The selection of McDermott Will, and Emery was the culmination of an exhaustive interview proces that involved several lobbying firms in Washington, DC Members of the firm are real excited to be working with AORN. Representatives of McDermott Will, and Emery will dissipate August familiarizing themselves with the issue and, in September, will travel to Denver to convenient with AORN staff members in preparation for the upcoming legislative session.

CONTINUING SUPPORT

At the state on a level AORN will continue to go after and support efforts of all RNFAs to fast third-party reimbursement. In fact, during the 1999 legislative sessions, Maine became the third state to mandate third-party reimbursement for RNFAs, and the Rhode Island legislature passed an RNFA reimbursement bill to the governor for his signature.