2014
       
       
       
       
       
       
       
       
       
       
       SENATE JOINT MEMORIAL 14-005
       
       
       BY SENATOR(S) Crowder, Aguilar, Balmer, Brophy, Cadman,
       Grantham, Guzman, Harvey, Heath, Herpin, Hill, Hodge, Jahn, Johnston,
       Jones, Kefalas, Kerr, King, Lambert, Lundberg, Marble, Newell,
       Nicholson, Renfroe, Rivera, Roberts, Scheffel, Schwartz, Steadman,
       Tochtrop, Todd, Ulibarri, Zenzinger, Carroll;
       also REPRESENTATIVE(S) Hullinghorst, Becker, Buckner, Court,
       Duran, Exum, Fischer, Garcia, Gerou, Ginal, Hamner, Kraft-Tharp,
       Labuda, Lee, McLachlan, Mitsch Bush, Navarro, Pettersen, Primavera,
       Rankin, Rosenthal, Salazar, Schafer, Singer, Stephens, Swalm, Vigil,
       Ferrandino.
       
       
          CONCERNING MEMORIALIZING CONGRESS TO ENACT
       LEGISLATION ALLOWING CERTAIN NONPHYSICIAN HEALTH
       CARE PROFESSIONALS TO CERTIFY AND AMEND HOME
       HEALTH PLANS OF CARE. 
       
       
          WHEREAS, Nurse practitioners (NP), clinical nurse specialists
       (CNS), certified nurse midwives (CNM), and physician assistants (PA)
       are playing an increasingly important role in the delivery of our nation's
       health care, especially in rural and underserved areas in states like
       Colorado; and
       
          WHEREAS, These nonphysician health care professionals practice in
       settings where they are usually very familiar with individuals and
       particular cases, and allowing these health care professionals to certify
       home health services to Medicare beneficiaries would be
       most appropriate; and
       
          WHEREAS, In addition, these nonphysician health care professionals
       are usually readily available to expedite the processing of paperwork,
       ensuring that home care services begin promptly without interruption and
       that home care agencies will be reimbursed in a timely manner; and
       
          WHEREAS, Colorado law authorizes these nonphysician health care
       professionals to complete and sign physical exam forms and other types
       of medical certification documents; and
       
          WHEREAS, NPs and PAs can certify Medicare eligibility for skilled
       nursing facility services; and
       
          WHEREAS, The federal government has also recognized the growing
       role of PAs and NPs; for example, the federal "Balanced Budget Act of
       1997", Pub. L. 105-35, allows Medicare to reimburse PAs and NPs for
       providing physician services to Medicare patients, including surgery,
       consultation, and home and institutional visits; and
       
          WHEREAS, The Centers for Medicare and Medicaid Services now
       allows PAs and NPs to sign certificates of medical necessity, which are
       required to file a claim for home medical equipment under Medicare, and
       since 1988, certificates of medical necessity have been authorized to
       provide maternity-related services to the relatively small population of
       disabled women of childbearing age who are Medicare-eligible; and
       
          WHEREAS, The Institute of Medicine, in its 2010 study, The Future
       of Nursing: Leading Change, Advancing Health recommended that NPs
       and CNSs be allowed to certify eligibility for Medicare home health
       services; and
       
          WHEREAS, Despite the expanded role of PAs and NPs in the
       "Balanced Budget Act of 1997", the Centers for Medicare and Medicaid
       Services continues to prohibit PAs and NPs and other nonphysician health
       care professionals from certifying home health services to Medicare
       beneficiaries because, according to the Centers for Medicare and
       Medicaid Services, the Medicare statute requires "physician" certification
       on home health plans of care; and
       
          WHEREAS, The "Home Health Care Planning Improvement Act" was
       first introduced in the 110th Congress and would have permitted NPs,
       CNSs, CNMs, and PAs to certify Medicare home health plans of care; the
       legislation has been re-introduced in each Congress since then, and in the
       current 113th Congress, the legislation exists as S.1332/H.R.2504, with
       the bipartisan cosponsorship of Colorado Representatives Mike Coffman,
       Cory Gardner, Ed Perlmutter, and Jared Polis; now, therefore,
       
          Be It Resolved by the Senate of the Sixty-ninth General Assembly of
       the State of Colorado, the House of Representatives concurring herein:
       
          That we, the members of the Colorado General Assembly, call upon
       the United States Congress to enact the existing bipartisan legislation that
       would allow nurse practitioners, certified nurse specialists, certified nurse
       midwives, and physician assistants to certify and make changes to home
       health plans of care.
       
          Be It Further Resolved, That copies of this Joint Memorial be sent to
       Colorado's Congressional delegation, Governor John Hickenlooper, the
       Centers for Medicare and Medicaid Services, the National Association for
       Home Care and Hospice, the Home Care Association of Colorado, the
       Colorado Department of Health Care Policy and Financing, the Colorado
       Department of Public Health and Environment, the Colorado Medical        Society, the Colorado Nurses Association, the Colorado Society for
       Advance Practice Nurses, and the Colorado Academy of Physician
       Assistants.
       
       
       
       
       
       ____________________________  ____________________________
       Morgan Carroll                       Mark Ferrandino
       PRESIDENT OF                    SPEAKER OF THE HOUSE
       THE SENATE                        OF REPRESENTATIVES
       
       
       
       
       
       
       ____________________________  ____________________________
       Cindi Markwell                        Marilyn Eddins
       SECRETARY OF                CHIEF CLERK OF THE HOUSE
       THE SENATE                        OF REPRESENTATIVES