Legislative Issues Paper-reimbursement for Nurse Practitioners Research Paper

Legislative Issues - repayment for Nurse Practitioners - Research Paper ExampleAccording to Frakes and Evans (2006), in 2003, the federal government spent 13% of its budget on Medicare services. This means that the federal government spent as much as $271 billion on providing health care services to the needy citizens (Frakes and Evans, 2006). As a result of the increasing allocation on health care programs and policies, the federal government has put significant interest in managing and controlling its costs on implementing these health care programs. In doing so, the federal government has used the legislation to control health care costs by creating a regulatory body structure that will regulate resultant costs and prevent fraud within the health industry (Frakes and Evans, 2006). Because of these regulatory policies and programs, health care providers in both long-suffering care and practice are affected (Frakes and Evans, 2006). Of the health care providers that are very much a ffected of the regulatory efforts set by the federal government, the groundbreaking practice nurses (APN) are among them. Nurse practitioners (NPs) and clinical nurse specialists (CNSs) make up APNs (Frakes and Evans, 2006). According to (Hamric, Spross, and Hanson, 2009), the roles of APNs include nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), clinical nurse specialists (CNSs), and ), certified nurse-midwives (CNMs). ... uently, health providers such as docs and registered nurses are reimbursed under the Current Procedural Terminology system which is created by the American Medical Association (Frakes and Evans, 2006). In this system, which was create in 1966, reimbursements for a service are determined through the individual providers relative value scale (Frakes and Evans, 2006). Subsequently, the value scale, according to Richmond, Thompson, & Sullivan-Marx (2000), is thereby established based on the professional liability insurance cost, practice write off, and work done of the provider, and then multiplied by a geographic expense adjustment modifier. Incidentally, under the reimbursement system, APNs can receive reimbursements from the governments Medicare and Medicaid programs, commercial insurers, self-insured institutions, and managed care organizations for the services they provide (Frakes and Evans, 2006). With the Omnibus Budget Reconciliation Acts of 1989 and 1990, APNs are up to(p) to receive reimbursements however, Richmond, Thompson, & Sullivan-Marx (2000) maintain that the limitation of this Act is that reimbursements are confined to those who practice inside skilled nursing facilities and rural areas. Another restriction to the reimbursement rights of APNs is that APNS can reimburse only for services billed as incident to a physicians care but requires that the APN be employed or contracted with the physician (Frakes and Evans, 2006). Through this set-up, physicians enjoy reimbursements at 100% of their rates . Clearly, the disparity between APNs and physicians is manifested through these reimbursement policies. In a study of Ruchlin, Levey, and Muller (1975), they define the function of reimbursement programs. In their study, they use the