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Rural Access to Nurse Anesthesia Services Act

Discussion in 'Anesthesiology' started by ZoidbergMD, Aug 19, 2009.

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  1. ZoidbergMD

    ZoidbergMD

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    Dick Durbin has introduced the Rural Access to Nurse Anesthesia Services Act to the Senate :confused::scared:

    Does anybody know any infromation on this? Will/Has it pass(ed)?
    I tried looking up more info about the details, but I haven't gotten very much (other than it's there)...but it already sounds bad for us
  2. BLADEMDA

    BLADEMDA SDN Gold Donor Gold Donor

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    Durbin Introduces Legislation to Ensure Anesthesia and Surgical Services in Rural Areas are Covered

    Thursday, August 6, 2009​

    [WASHINGTON, D.C.] – Assistant Senate Majority Leader Dick Durbin (D-IL) introduced legislation late last night that would allow services provided by Certified Registered Nurse Anesthetists (CRNAs) to be reimbursed by Medicare. The Rural Access to Nurse Anesthesia Services Act would close existing loopholes to guarantee anesthesiology cost reimbursement for Critical Access Hospitals and enable these hospitals to continue to provide surgical services to residents in rural areas.

    “In my state of Illinois, 51 Critical Access Hospitals provide emergency, primary care, and surgery services directly to 51 rural communities. These hospitals cover over 60 percent of the counties in the state and reach over one million rural residents,” said Durbin. “Without the services of rural nurse anesthetists, many of these hospitals would not be able to offer surgical care. The Rural Access to Nurse Anesthesia Services Act will enable hospitals to offer the highest quality and availability of services to patients in Illinois and around the country.

    While it has been a longstanding policy for Medicare and Medicaid to reimburse Critical Access Hospitals for the cost of services provided by nurse anesthetists, the law was changed 3 years ago. The new policy eliminated reimbursements for a number of hospitals, five of which are in Illinois. Durbin’s Rural Access to Nurse Anesthesia Services Act would restore the ability for Critical Access Hospitals to receive reimbursements for nurse anesthetists.

    Over 1,300 Critical Access Hospitals provide essential health care services to rural and small communities nationwide. Durbin said they are a vital part of the health care safety net to ensure the elderly and disadvantaged have access to both primary and emergency care. Nurse anesthetists are the primary anesthesia providers at rural hospitals and also offer obstetrical, surgical and trauma stabilization services to medically underserved areas.

    Similar legislation was introduced in the House of Representatives earlier this year by Representatives Phil Hare (D-IL) and Timothy Johnson (R-IL). Both the House and Senate bills are supported by the American Hospital Association, the Illinois Hospital Association, and the Illinois Critical Access Hospital Network.
  3. BLADEMDA

    BLADEMDA SDN Gold Donor Gold Donor

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    H.R.2204 - Medicare Access to Rural Anesthesiology Act of 2009

    To amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals. view all titles (2)

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    • Official: To amend title XVIII of the Social Security Act to provide payment under part A of the Medicare Program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals in the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals. as introduced.
    • Short: Medicare Access to Rural Anesthesiology Act of 2009 as introduced.
  4. ProRealDoc

    ProRealDoc Anti-AANA

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    This is long overdue.
  5. IDBasco

    IDBasco Atypical agent

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    Wait, that sounds like they want to pay docs the way they are currently paying CRNAs? Huh? :confused:
  6. Southpaw

    Southpaw ASA Member

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    CRNAs bill 100% the same as MDs. No other midlevel can make this claim. They have it nice. Remember, it doesn't matter how much YOU value the service of an MD, all that counts is how much the decision makers (lawmakers, hospital administration, etc.) value that service.
  7. seinfeld

    seinfeld ASA Member

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    they basically were not paying anesthesiologist enough to make even on providing anesthesia service in rural areas, but they were allowing CRNA to get payed a reasonable wage.
  8. jwk

    jwk AA-C ASA-PAC Contributor

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    This is the "Rural Pass-Through" bugaboo. The ASA has been fighting this for years. As it stands NOW, CRNA's bill under Part B, just like anesthesiologists. Under the Rural Pass-Through regs, a HOSPITAL (certain rural hospitals) can also bill for the CRNA's services under Part A, and "pass through" that additional payment to the CRNA. The regs do NOT offer this same pass-through payment to anesthesiologists, thus providing a financial disincentive for anesthesiologists in rural areas.

    Now - the standard CRNA response to this is "the anesthesiologists don't want to go there anyway". Yet somehow, every time it comes up, the CRNA's have a problem with it and fight it tooth and nail.

    Interestingly, the current law allows the same pass-through for AA's - except AA's can't work in hospitals without an anesthesiologist, so it' a moot point.
  9. jwk

    jwk AA-C ASA-PAC Contributor

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    So Blade, correct me if I'm wrong, but these appear to be two different bills - one relating to CRNA's and critical access hospitals, and one adding anesthesiologists into the rural pass-through.

    What changed about the CRNA law three years ago, or did they simply re-define critical access hospitals and some of them dropped off the list?
  10. IDBasco

    IDBasco Atypical agent

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    I was aware they bill medicare the same, and don't agree with that practice. But that is another topic for another thread. I wasn't aware of the pass through that jwk explained above. That explains why it sounds like doc's pay was what was changing and not CRNA's, when it seemed like it should be the other way around. Now I get it. :)

    Thanks guys.
  11. Southpaw

    Southpaw ASA Member

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    Sorry bro...yeah thanks jwk, I wasn't aware of that issue either. Hopefully the bill will pass and give anesthesiologists/AAs more options with regards to practice location.
  12. BLADEMDA

    BLADEMDA SDN Gold Donor Gold Donor

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    Correct.

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