This array of less front than depth...

This array of less front than depth is the third of a three-part series that summarizes issues currented in "Politics: Art of the Possible," an education session at the 1999 AORN Congres In the session, AORN lobbyist David Hebert neared a summary of RN first assistant (RNFA) Medicare reimbursement efforts, an update of federal issues related to managed care and patients' rights, an overview of federal politics and the lobbying proces and a call for grassroots efforts. The following are selected passages from Hebert's comments, as well as from his June 1999 report to the AORN Board of Directors.

RNFA MEDICARE REIMBURSEMENT

AORN has been working to build support for RNFA reimbursement in a less degree than Medicare; however, obtaining reimbursement for any provider is a lengthy process. To this point, AORN's efforts have focused in succession trying to enlist a handful of congres members to sponsor legislation.

Determining charges Knowing that a sponsor forward a key committee might ask the Congressional parcel Office to determine the fiscal validity of reimbursement before moving forward, AORN take downed into an agreement with Don Muse and Associates, a company that has determined the splendor of this legislation over the last five years. Based in succession the findings, it may be difficult obtaining a sponsor in succession a key committee unless the estimated preciousness for reimbursement can be decreased. AORN has asked Muse to perform further analysis, including conducting a review to acquire a more accurate read upon how many surgical procedures are performed through RNFAs.

Mediocre reform. It is possible that Congres may consider Medicare reform in 1999 or 2000 Rep Bill Thomas (R-Calif), chair of the House Ways and Means Health Subcommittee, and Sen John Breaux (D-La) are eager to keep up substantive Medicare reform. Both serv forward the recent Bipartisan Commission onward the Future of Medicare, which failed to report a favorable reform plan. equal if Sen Breaux and Rep Thomas decide to instigate forward to create a plan, however, they will have to convince their respective leaderships that it is viable, given the politics of the situation. It has been widely reported in Washington that neither Senate Majority Leader Trent Lott (R-Miss) nor House Speaker Dennis Hastert (R-Ill) is eager to consider a bill that is likely to gain President Clinton the political high ground

Technical corrections bill. A more probable scenario involves Congres considering a technical corrections bill for Medicare that addresses a certain quantity of of the severe cuts in hospital and nursing hearth reimbursement that have passed in previous pack agreements. This scenario would be an opportunity to introduce smaller noncontroversial items related to Medicare, as well. It is not likely that a technical corrections bill would be a vehicle to actuate RNFA Medicare reimbursement.

As AORN works to bring the projected costs of this legislation, more resources ne to be dedicated to growing and empowering the grass lower parts to gain a sponsor upon a key committee. Even with Washington representation, we ne to enhance our grassroots representation in first note of the scale legislative districts and states to generate congressional interest in this issue.

PATIENTS' BILL OF RIGHTS

AORN has supported efforts for a patients' bill of rights act in managed care. There continues to be, of course, many different interests in this issue. The legislation, which also is supported by way of the American Nurses Association (ANA) and the American Association of feed at the breast Anesthetists (AANA), has been a top priority among the Democratic leadership and certain Republicans--mostly physician legislators.

Activity in 1999 Early in the year, alone the Senate Health, Education, Labor, and Pension (ie, HELP) Committee acted. The committee, which is chaired by way of Sen Jim Jeffords (R-Ver), supported a bill that had been previously approved from the Senate leadership. The bill is unassuming in nature and was oppos through the Democrats on the committee. All Democratic amendments, including an amendment at Sen Jeff Bingaman (D-NM) that prohibits health care plans from discriminating against health care professional participation, have been defeated onward a party line vote of 10 to eight.

The House mercantile relations Committee planned two more hearings for June before continuing with subcommittee and abounding committee markup (ie, the part of the proces in which bills actually start to rouse forward) in July. The House Education and Workforce Committee began consideration of eight bills introduced by the agency of Rep John Boehner (R-Ohio) during the week of June 14 1999 The legislation amends solitary the Employee Retirement Income Security Act (ie, ERISA) and does not affect other health plans. It is designed to address mainly access issues as requested by way of business organizations such as the US Chamber of exchange and the National Federation of Independent Businesses. Democrats and the Republican physicians upon the House Commerce Committee do not consider it to be positive legislation.

Unclear timing. It is unclear whether patient rights legislation will be passed by means of Congress this year. Republicans are accusing the Democrats of holding the issue for nearest year's election, and Democrats are arguing that the Republican majority is dragging its feet to prorogue consideration indefinitely. Unless the House and Senate consider the legislation by way of September, there will be no action in 1999; and, nearest year, with an election looming, serious consideration is unlikely.