AARP Report: Removing Barriers to Advanced Practice Registered Nurses

Report Highlights the Need to Allow
APRNs to Certify Patients for
Home Health and Hospice Services

The AARP Public Policy Institute released a report that explains how removing certain barriers to nursing scope of practice could benefit the health care system. The report argues that access to care would be improved to vulnerable patients if advanced practice registered nurses (APRNs) are able to certify home health and hospice services.

APRNs are registered nurses with advanced levels of education and include nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives. APRNs provide primary care services to patients, especially those in underserved and rural communities. AARP estimates there are over 270,000 APRNs in the United States.

The AARP report acknowledges the increasing role APRNs play in caring for patients. While the report does not calculate proposed savings from removing scope of practice barriers for APRNs, the report recommends that potential costly delays in care can be avoided by allowing APRNs to certify home health plans of care for Medicare beneficiaries, allowing APRNs to conduct and document the required face-to-face requirement and allow nurse practitioners in hospice settings to determine if a patient has a condition that would result in life expectancy of six months or less in order to certify hospice services. Currently, physician certification is required for a patient to receive home health and hospice services, and under home health care, only a physician can document that the face-to-face encounter occurred even if an APRN conducted the encounter.

The National Association for Home Care & Hospice and HCAF recognize the important role of APRNs and has long supported efforts in Congress to advance the Home Health Planning Improvement Act, which would allow certain APRNs and physician assistants to certify Medicare home health plans of care. Additionally, HCAF and NAHC strongly supports allowing nurse practitioners to certify eligibility for hospice services.

HCAF and NAHC continue to encourage home health advocates to ask their members of Congress to cosponsor the Home Health Care Planning Improvement Act and thank those members that have already agreed to cosponsor. Advocates may visit HCAF’s Legislative Action Center to email their senators and representative and to access talking points and background materials.

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