2018
Prior to 2019, many NPs billed under a different provider’s National Provider Identifier (NPI) number, often that of their collaborating provider. But in light of the passage of HB 793 during the 2018 General Assembly, as many NPs applied for autonomous practice licensure – with some interested in opening their own practices. VCNP wanted to guarantee that health plans will accept these NPs’ claims and compensate them directly. A simple code change ensured that all NPs would be reimbursed for the services they provide.
2019
In the 2019 Virginia General Assembly Session, both HB 1640 and SB 1178 were introduced to ensure that NPs were able to bill insurance directly through their National Provider Identifier (NPI) numbers. Without this simple code change, patients could have lost their access to needed care due to an inability to utilize their insurance. This legislation involved a straightforward change in the Code of Virginia, § 38.2-3408, Policy providing for reimbursement for services performed by certain practitioners other than physicians. Simply adding Nurse Practitioners to the list of mandated providers requires health plans to recognize and reimburse nurse practitioners’ services.
In 2018, The Virginia General Assembly passed HB 793, legislation that allows nurse practitioners (NPs) with five or more years of clinical experience to apply for autonomous practice licensure. This legislation allowed NPs to practice to the full extent of their education and training, helping build the workforce necessary to meet Virginia’s primary care needs.
This legislation was the next logical step following 2018’s legislation allowing autonomous practice. Without this change, patients could lose their access to needed care because of their inability to utilize their insurance.
Nurse practitioners provide comprehensive, cost-effective, high-quality health care services in diverse settings across the care and age continuum. NPs must receive equitable reimbursement from all payers to promote sustainable practice and access to care.