Current Law
Medical advances have made it possible for a growing number of patients to receive care in the comfort of their own homes. Homecare allows many patients the ability to live normal lives during the course of their therapy, and allows terminally ill patients precious time with their families and loved ones. In many cases, homecare is more cost effective than institutionalized care. For these reasons, the Medicare home health benefit has grown considerably since the early 1990s. In 2004, 2.8 million Medicare patients received home health services.

In order to receive home health services, Medicare beneficiaries must be certified as "homebound." This means that patients must leave their homes infrequently and only with considerable and taxing effort. In addition, patients must require at least one skilled nursing or therapy service, and a plan of care must be developed and submitted to Medicare. Today, only physicians and podiatrists may sign plans of care or certify a patient for home health services.

Frequently, patients experience delays in obtaining home health due to the need for discharge planners and other referring entities to locate a physician to complete Medicare paperwork. These delays in care inconvenience patients and their families. In addition, delays can result in increased cost to the Medicare system when patients are unnecessarily left in more expensive institutional settings.

S. 1678/H.R. 6826 
ANA fully supports the Home Health Care Planning Improvement Act (S. 1678/ H.R. 6826). ANA is working to educate Members of Congress about the fact that advanced practice nurses (APRNs) represent an important and growing proportion of the health care workforce, often practicing in rural and other underserved areas, where physicians are scarce. Numerous studies have shown that APRNs are able to provide care that is at least as high in quality as that provided by physicians. Current restrictions on the ability of APRNs to order home health services are anachronistic and should be removed.

View CoSponsors of the House and Senate Bills
S. 1648
H.R. 6826