OAAPN and Ohio GAPNA are pleased to announce that Ohio Medicaid has agreed to rescind the January 1st, 2014 APRN reimbursement rule that eliminated the Medicaid share of payment for APRN visits with beneficiaries who are eligible for Medicaid and Medicare coverage (dual eligible). (The dual eligible population consists primarily of the poor elderly, the disabled and the mentally ill, generally the sickest patients. Many dual eligible patients are in LTC facilities and in assisted living; 60% of the average skilled nursing center’s patients are dual eligible.) The original Medicaid decision to eliminate the Medicaid portion of dual eligible provider payments, a cost-cutting measure, did not affect physicians. In response to this policy, and out of concern for reimbursement equity and access for the poorest and the most ill of Medicaid/Medicare beneficiaries, OAAPN and GAPNA joined forces. We requested and received an immediate meeting with Medicaid to articulate the effect this policy could have on Ohio’s elderly and disabled patients.
On March 31st, Medicaid met again with OAAPN and GAPNA and announced they had rescinded this policy. Ohio’s Department of Medicaid and Medicaid Director John McCarthy were quick to respond to our concerns; they were concerned about the impact this policy had on patient care and APRN services. The decisions about whether the policy will include retroactive pay and when the policy will be effective have not been made. We will keep you posted with any updates.
OAAPN and Ohio GAPNA are grateful to Ohio Medicaid for their immediate and thoughtful resolution of this issue.
For more information, contact:
Christine Williams for OAAPN, firstname.lastname@example.org
Sandy Jorgensen for GAPNA, email@example.com
Ohio Gerontological Advanced Practitioner Associations
Ohio Association of Advanced Practice Nurses