The following slides were part of the presentation at the 25th annual Southwest Regional

NP Symposium

Angela GoldenAANP Co-President

American Association of Nurse Practitioners

• July 1st – require PHYSICIAN documentation• WAIT WAIT – letter writing and visits with

Medicare by provider groups• Now delayed to October 1st

• provision in the Affordable Health Care Act• Will require physicians to document that a

newly required face to face encounter (in the prior 6 months) occurred with the patient for certain types of DME

• The encounter can be done by an NP• http://www.capwiz.com/aanp/issues/alert/?

alertid=62722811

DME

Home Health AGAIN• S. 1332: Home Health Care Planning

Improvement Act of 2013• Sen. Susan Collins [R-ME]• Schumer, Charles [D-NY]

• In finance committee and no one from Arizona is on this

• Why is this year different• Senate subcommittees are asking for

information from NPs• AANP has two lobbyists now and increased staff

for federal level• BUT WE NEED YOU• http://www.capwiz.com/aanp/issues/alert/?

alertid=62779806

Incident to – beware!!!• "Incident to"• rules are unchanged• continue to be limited to services• strictly as a follow up to the physician’s plan of care

• MEDICARE IS LOOKING AT THIS FOR FRAUD• YOU ARE RESPONSIBLE FOR WHAT YOUR BILLERS

ARE SENDING IN• Specifics• limited to the office setting• physician must still be on site• cannot be with a new patient• or with an old patient with a new problem

• In its 2012 work plan, Office of Inspector General intends to determine whether incident-to claims have a higher error rate than ordinary ones

Miscellaneous - CMS• Attending in Home Health and Hospice Care• NPs are authorized to serve as "attending physicians" in hospice

and home health care. • Authorized to re-certify patient eligibility for hospice care.

• Hospital Admitting Physical Examinations• The physician counter signature requirement for hospital

admitting physical examinations conducted by nurse practitioners has been eliminated.