Home Care Legislation Gains Bipartisan Support

New bipartisan legislation introduced recently that would allow physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives to order home health services for Medicare beneficiaries is gaining support. 

U.S. Representatives Greg Walden (R-Ore.) and Allyson Schwartz (D-Pa.) are now joined by 23 other co-sponsors, up from 19 at the time of the bill’s introduction. The Home Health Care Planning Improvement Act of 2013 (H.R. 2504) was introduced in late June.

“This common-sense bill will reduce unnecessary and duplicative burdens on health care providers and patients in need of home health services,” Representative Greg Walden said. “Particularly in rural areas like central, southern, and eastern Oregon where physicians are scarce, these clinicians play an increasingly important role in the delivery of primary health care services. Not only are they serving on the front lines of primary care, but also in many areas they are the only option readily available.”


Medicare already recognizes Pas, NPs, clinical nurse specialists, and certified nurse midwives as “authorized providers” who can perform many services for Medicare beneficiaries, including ordering nursing home care and prescribing medicine. However, they’re not able to order home health care services, which are often less costly than other care settings.

Even in states that have explicitly expanded their laws to allow other medical providers to order Medicare, according to the National Association for Homecare and Hospice (NAHC), Medicare won’t certify payment for home health until a physician signs the order.

What can happen is that seniors who see nurse practitioners of physician assistants, etc., as their primary care provider may need an extra office visit with an unknown physician in order to get the sign-off on home care services.


Many times, this amounts to extra administrative and paperwork burden along with creating an unnecessary step that doesn’t recognize current training of these medical professionals and their scope of practice, says NAHC, and can even delay care delivery.

The new legislation would help solve those issues and could even save Medicare more than $100 million in the next 10 years, according to one study

“Studies have shown that the expanded use of these professionals can result in dramatic decreases in expensive hospitalizations and nursing home stays,” said Val Halamandaris, President of National Association for Homecare and Hospice in a statement. “We appreciate the outstanding leadership [Reps. Walden and Schwartz] have shown in helping make home and community based services more readily available to our nation’s elderly population and those with disabilities.”

Written by Alyssa Gerace 

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