Your Voice is Important! What Legislators Need to Hear. Monday, February 10, 2014 Presented by Kathy Hutto , CNAP Lobbyist Jackson Walker L.L.P . and John Hubbard , CNAP Public Policy Director. Events Leading to SB 406 . 2005-2007 Moratorium
Your Voice is Important!What Legislators Need to Hear
Monday, February 10, 2014
Kathy Hutto, CNAP Lobbyist
Jackson Walker L.L.P.
John Hubbard, CNAP Public Policy Director
Political Reality – Legislature thinks we got a BIG GULP
Look at 2009 and 2011
Leadership wanted continued forward movement and changes to benefit as many practices as possible
Resolution of 90 day issue is near!
7 priorities are more than enough! DO NOT EXPECT OR WANT YOU TO TRY TO DISCUSS ALL 7 TODAY!
Key message is simple.
Ensure that APRNs have the ability to contract directly with insurance providers and serve as their patient’s Primary Care Provider whether or not the delegating physician is in-network or a contracted provider.
Two provisions of current Texas law state that a managed care organization (MCO) may not refuse a request made by an in-network physician and an advanced practice registered nurse (APRN), authorized by the physician to provide care, to identify the APRN as a network provider.
Section 843.312 of the Texas Insurance Code
Section 1301.052 of the Texas Insurance Code
Despite the agreed upon changes in SB 406 Medicaid managed care plans deny credentialing APRNs when the delegating physician is not an in-network provider.
In addition, HHSC is not changing the Uniform Managed Care Contract because HHSC staff think SB 406 does not supersede the in-network requirements for APRNs supervising physicians found in the Insurance Code.
As a result, APRNs willing to serve the Medicaid population are unable to do so, leaving many people unable to find the health care they need. This is especially true of the elderly, people with disabilities and children – the most vulnerable Texans.
The Insurance Code needs to be amended to require APRNs be recognized as PCPs whether the delegating physician is in-network or not.