All posts by Amy

CMS Final Rule: NP and PA Preceptor Documentation Updates – Success!

Susanne J. Phillips, DNP, APRN, FNP-BC

Posted By: Susanne J. Phillips, DNP, APRN, FNP-BC on practicingclinicians.com |November 29, 2019

To access original post visit: https://practicingclinicians.com/the-exchange/cms-final-rule-np-and-pa-preceptor-documentation-updates–success-

On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Medicare Physician Fee Schedule final rule, which will positively affect the NP and PA preceptor documentation burden. For those of you providing clinical teaching rotations for advanced practice registered nurse (APRN) and/or PA students, you may be aware that in March 2018 CMS reduced the documentation burden for physician preceptors. This change authorized teaching physicians to verify and sign student documentation components of evaluation and management (E/M) services rather than have to re-document the work themselves. Unfortunately, this created unintended consequences for APRN and PA preceptors and the students they supervise.

In an era where productivity in patient care has been a major driver of reimbursement, the 2018 rule caused many practices to abruptly discontinue precepting APRN and PA students—creating a crisis in NP and PA education. As a result, the American Association of Nurse Practitioners (AANP), the American Academy of PAs (AAPA), nursing, and physician stakeholders worked diligently to mobilize their constituencies and to request changes to the 2020 final rule. Through lobbying efforts and regulatory comments, CMS revised the language, thereby creating documentation requirement parity among all clinician preceptors.

Effective January 1, 2020, APRN and PA preceptors may review and verify medical record documentation entered by other licensed health care providers and members of the health care team, as well as student APRNs and PAs. This update will ultimately improve patient access to high-quality health care.

There are additional changes affecting APRN and PA providers including, but not limited to, updates to Medicare telehealth service reimbursement, E/M services documentation and reimbursement, physician supervision requirements for PAs, and payment for transitional care management services. Click the links in the references below for additional information.

References

VCNP 45th Anniversary Gala and Awards Reception

You are Invited!

Celebrate with your fellow NPs at the 45th Anniversary Gala during the 2019 VCNP Annual Conference.

Join us for an evening of recognition and celebration of accomplishments Nurse Practitioners have achieved. VCNP will recognize members and present association awards. Special prizes will be presented to participants, and the regional baskets will be given away.

 

2019 VCNP Annual Conference registration is open! Register now for the conference and be part of this special event. Registration is not required to attend.

 

For more information, or to register for the 2019 VCNP Annual Conference, click here.

Share your VCNP Memories

Share your VCNP stories and pictures! If you are a photographer on the side and are willing to participate by capturing the evening, please let us know!

 

Share your memories and talents! Send to amy.sales@easterassociates.com

Coastal Virginia VCNP Pharmacology Symposium

Registration is NOW OPEN!

Join us at the VCNP COVA Pharmacology Symposium on

Saturday, November 3, 2018

7:15 a.m. to 4 p.m.

at

The Lake Wright Conference Center

1521 Premium Outlets Boulevard

Norfolk, Virginia 23502

 

Click here to register.

Click Coastal Virginia Pharmacology Symposium Agenda for more information about the event.

Click Coastal Virginia Pharmacology Symposium Agenda to see the program.

 

Questions? Please contact Alysia Pack, VCNP Tidewater Education Chair via email at COVA18TW@gmail.com. Please allow 48 hours for a response.

Questions about HB 793?

HB 793 passed in the General Assembly and was signed by Governor Northam! The next steps involve the Department of Health Professions (including the Boards of Nursing and Medicine) promulgating the regulations for how this bill will be implemented. As this process unfolds, you may have questions about what this bill might mean for you and your practice. Let us know your questions!

 

VCNP has created hotline is for the use of the members of the Virginia Council of Nurse Practitioners, the professional organization representing NPs in Virginia. If you are not currently a member, we sincerely hope you will join us! Sign up today at https://www.vcnp.net/membership-application-and-renewal/  and stay informed about what is happening for NPs in Virginia!

 

If you are a member, please log in and look for the “Questions about HB 793” link in the “Advocacy” section.

HB 793 Update: Contact Senate Education and Health Committee Members NOW!

Contact the Senate Education and Health Committee Members now! It is possible that HB 793 could be heard as early as Tuesday, February 20. This is the stage, with the Senate Sub-Committee and full Senate Committee, at which we will be proposing amendments to HB 793. We want you to know and trust that we will not let Virginia be an outlier. We have the commitment of our patron that we will not move forward with the bill if it remains in its current form. 

 

Tell the Committee members that you support HB 793!

Chairman Newman – district23@senate.virginia.gov – 804-698-7523

Richard Saslaw – district35@senate.virginia.gov – 804-698-7535

Louis Lucas – district18@senate.virginia.gov – 804-698-7518

Janet Howell – district32@senate.virginia.gov – 804-698-7532

Mamie Locke – district02@senate.virginia.gov – 804-698-7502

George Barker – district39@senate.virginia.gov – 804-698-7539

Richard Black – district13@senate.virginia.gov – 804-698-7513

Charles Carrico – district40@senate.virginia.gov – 804-698-7540

Chapman Peterson –district34@senate.virginia.gov– 804-698-7534

John A. Cosgrove – district14@senate.virginia.gov – 804-698-7514

Lynwood Lewis – district06@senate.virginia.gov – 804-698-7506

Siobhan S. Dunnavant –district12@senate.virginia.gov – 804-698-7512

Amanda Chase – district11@senate.virginia.gov – 804-698-7511

David Suetterlein – district19@senate.virginia.gov – 804-698-7519

Mark J. Peake – district22@senate.virginia.gov – 804-698-7522

 

We are actively working on changing and adding to the legislation to best fit the needs of Virginia NPs. This includes the following key points:
  • A reduction in hours requirements for the Transition to Practice program. This is a top priority for VCNP and its membership. We are working to educate our Senators that five full years of clinical experience requirements is excessive and has not been proven as a barometer for safe practice.
  • Attestation will be a standardized form created by DHP with provisions for exceptions for NPs who may not be able to obtain the physician signature; for example, circumstances due to physician death.
  • There is no provision for grandfathering NPs; however, existing experience will count towards years of experience qualifying for the transition time period. All eligible NPs will need to submit an attestation form to DHP to be able to practice unencumbered by the practice agreement requirement.
  • Endorsement of NPs from other states will be considered under regulations with provisions for NPs from out of state to meet equivalent time requirements attested by a physician or other entity if the physician’s signature cannot be obtained.
  • Removal of APRN titling because the definition excludes those early NPs whose educational programs granted certificates and not a master’s degree.
  • Removal of redundant language from regulations restating provisions for periodic review of records, including site visits.
  • Removal of language that NPs must have graduated from an educational program accredited by Commission on Collegiate Education, as this requirement has been met by virtue of licensure.
  • Collaboration will be defined as to the degree of cooperation necessary to provide treatment and the collaboration is with MDs and other health care providers.
  • Removal of language that NPs practice medicine.
As we are working on amendments, we still need your support! Submit letters via the CareforVA.com website and rally with your colleagues to continue to support HB 793.

2017 VCNP Scholarship Winner – Cindy Fagan

The Virginia Council of Nurse Practitioners (VCNP) awarded a $2,000 scholarship to Cindy Fagan, DNPc, RN, FNP-BC, on Saturday, Nov. 4 during the Virginia Nurses Foundation Gala at The Omni Homestead Resort.

 

Fagan earned her BSN and MSN degrees from Virginia Commonwealth University and is currently a Doctorate of Nursing Practice candidate at the University of Virginia. Her anticipated graduation date is May 2018. Fagan’s nursing career spans 31 years, with 18 of those years spent in the nurse practitioner role.

 

“Cindy’s commitment to the veterans she works with and to her position here at VCNP are inspiring,” said Christine Daley, MN, RN, ANP, president of VCNP. “We look forward to seeing her continue to grow within this profession and this organization.”

 

With roles in primary care, hospitalist, endocrine, and infectious disease, Fagan has varied experience. She is currently settled in the Veterans Health Administration, having spent the past 12 years serving our nation’s veterans at the Hunter Holmes McGuire Medical Center. Fagan also serves as the government relations chairperson for VCNP and has also served as past-president of the statewide organization. Her responsibilities within that role are to advance VCNP’s mission and goals in terms of legislative initiatives including policy development, strategies and tactics, engaging member participation in advocacy activities, garnering stakeholder support, coalition building and coordination of legislative efforts throughout the state.

 

VCNP’s scholarship, which was awarded for the first time in 2010, honors nurse practitioners and their passion for quality health care. To date, VCNP has granted $9,000 in total to scholarship winners. The scholarship is funded through the generous membership participation of the basket raffle that occurs each year at the annual conference. Scholarship applicants must be members of VCNP who are enrolled in a doctoral program in the Commonwealth of Virginia. Applicants also must have completed 50 percent of the required hours of graduate study and exhibit academic excellence and a commitment to advanced practice nursing with strong clinical and leadership abilities.

Governor McAuliffe Issues Proclamation for NP Week 2017

Governor McAuliffe issued a Proclamation recognizing November 12–18, 2017 as NP Week in Virginia. The full text is included below; you may also view it at https://governor.virginia.gov/newsroom/proclamations/proclamation/2017-nurse-practitioner-week/


2017 Nurse Practitioner Week

11/12/2017

WHEREAS, nurse practitioners (NPs) are advanced practice registered nurses (APRNs) who have advanced clinical education and training building upon their initial registered nurse preparation; and

 

WHEREAS, NPs serve as trusted frontline providers of healthcare for patients in our state; and

 

WHEREAS, there are 234,000 licensed nurse practitioners in the United States, and more than 9,700 NPs in Virginia providing primary, acute, and specialty care to patients of all ages and walks of life; and

 

WHEREAS, NPs diagnose, treat, and prescribe medications and other treatments to patients through a caring, patient-centered, holistic model of care; and

 

WHEREAS, citizens have great trust in the high-quality care NPs provide, resulting in more than one billion patient visits annually to NPs across the country; and

 

WHEREAS, five decades of research demonstrates the high quality of care provided by NPs; and

 

WHEREAS, utilization of NPs promotes a more accessible, efficient, cost-effective, and higher quality health care system; and

 

WHEREAS, Virginia is proud to recognize and honor the service of NPs to our Commonwealth;

 

NOW, THEREFORE, I, Terence R. McAuliffe, do hereby recognize November 12-18, 2017, as NURSE PRACTITIONER WEEK in our COMMONWEALTH OF VIRGINIA, and I call this observance to the attention of all our citizens.