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The Association of periOperative Registered Nurses (AORN) is reporting that the Medicare Payment Advisory Commission (MedPAC) released a mandated report to Congress late last week regarding its study of Part B Medicare reimbursement for Certified Registered Nurse First Assistants (CRNFAs). The concluding paragraph states: Law and regulation do not include criteria for determining which NPPs (non-physician providers) should qualify for separate payment. In the absence of explicit criteria, the (MedPAC) Commission in the past has not recommended the inclusion of additional groups to the list of separately payable NPPs because of concerns about licensure and duplicate payments. CRNFAs would not automatically disqualify from consideration on the basis of licensure, as did other groups the Commission has looked at and they are similar to some of the groups allowed to bill separately in education and experience. If the Congress chooses to add CRNFAs to the list of NPPs eligible for separate payment under Medicare Part B for assistant as surgery services, any additional payments should be offset from existing payments so that the effect of this change would be budget neutral.
AORN is working to identify the most workable strategy for applying the MedPAC report to legislative priorities in 2005. Additional information will be communicated to members soon. To review the entire MedPAC report, go to: www.medpac.gov/publications/congressional_reports/Dec04_CRNFA.pdf