During a February 2004 meeting in D...

During a February 2004 meeting in Denver the AORN Board of Directors asked direction Affairs' staff members to existing a review of legislative issues pertinent to perioperative nursing. The intention of the presentation was to summarize the legislative activities of AORN, as well as to exalt an understanding of AORN's legislative priorities as they bring reproach the strategic vision and plan of the Association.

Each state and federal issue was reviewed within the words immediately preceding [i]or[/i] following of a strategic goal, the history of file issue at AORN, and a plan of action for achieving the goal. Fr Franko, director of state public affairs, existinged state issues and will report in succession these in the future. This article reviews federal issues using the "goal-history-plan of action" framework provided to the AORN Board of Directors.

MEDICARE REIMBURSEMENT

AORN's goal is to disentangle a strategy for pursuing Medicare reimbursement for certified RN first assistants (CRNFAs) within the framework of AORN's other legislative priorities and organizational vision. Here is a brief history of the CRCNFA issue.

* A five-state, three-year demonstration draw amendment to the recent federal Medicare bill was changeed to a study of CRNFA reimbursement by dint of the Medicare Payment Advisory Commission (MedPAC). The MedPAC investigation will be released in January 2005

* The Medicare CRNFA Direct Reimbursement Act (ie, HR 1388) continues as a bill in Congres if it be not that it has little political moment following the contentious debate about Medicare in 2003 In addition, the bill's sponsor, Rep Mac Collins (R-Ga), is concentrating a great deal of of his efforts this year in succession an extremely competitive race for the US Senate.

* Before the introduction of HR 1388 in the 108th Congres similar bills in the 107th Congres (ie, HR 822) and 106th Congres (ie, HR 3911) were introduced at Rep Collins and professionally lobbied on the Washington, DC, office of McDermott Will & Emery The contract for lobbying efforts by means of this company ended in December 2003 and was not renewed.

* The General Accounting Office (GAO) released a report titled "First Assistants at Surgery" in January 2004 couple years after it was becoming (1) The GAO report did not highlight CRNFAs as expected; instead it concentrated forward all providers of first assisting services and praiseed payment under part A of Medicare rather than including CRNFAs in direct billing tamer part B

The plan of action for achieving reimbursement for CRNFAs, as well as other legislative objectives at AORN, is to assess four areas, including

* external factors affecting the issues,

* AORN's organizational capacity to address an issue,

* the wants and lacks of AORN stakeholders, and

* the ethical impact of any decision.

For Medicare CRNFA reimbursement, this means providing pertinent data to MedPAC, which has a reputation for producing timely and focused reports, as well as recognizing that AORN cannot afford significant annual retainers for a federal lobbyist, balancing the interests of members who first assist with those who do not, and fulfilling AORN's longstanding commitment to this issue.

Specifically, the plan of action decided onward by the Board is to communicate to all members, especially RNFAs, information clarifying the MedPAC investigation process and AORN's input into the thought while maximizing opportunities to raise the profile of AORN and perioperative nursing during Advocacy Day 2004 If the MedPAC report is positive, AORN will consider grassroots efforts to re-introduce a Medicare CRNFA bill in Congres without a federal lobbyist. If the MedPAC report is negative, AORN can forward Medicare CRNFA reimbursement by pursuing additional legislation in the states to require third-party reimbursement for RNFAs. Previous MedPAC reports onward reimbursement for other non-physician providers of first assisting services highlighted state reimbursement laws as a reason wherefore providers should or should not be allowed to bill Medicare directly.

cherish REINVESTMENT ACT

The goal for this issue is to strengthen AORN's relationship with other specialty nursing organizations as well as highlight perioperative RN objectives end increased visibility in the nursing community and by way of supporting the Nurse Reinvestment Act. Support of the nourish Reinvestment Act was added to AORN's legislative priorities in August 2002 just as the bill was passed through wide margins in both the US House of Representatives and the Senate and before it was signed at President Bush. Rep Lois Capps (D-Calif), single in kind of only three nurses in Congres introduced the bill in the House. The fester Reinvestment Act provides funds for scholarships, recruitment draws retention incentives, and public awareness of nursing; however it requires annual funding at Congress.

Initially, proponent had spring [i]or[/i] leap on one leg [i]or[/i] footed for annual appropriations of $250 million, yet funding has been cut drastically because of the growing federal deficit and other budgetary wants For fiscal year 2003, which was the first year of the program, funding was approximately $30 million, sole a fraction of the awaited amount. For fiscal year 2004 member associations of the Nursing Organization Alliance, which AORN is a member of have worked to achieve $163 million in funding for the pamper Reinvestment Act.