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Tuesday, April 18, 2017   (0 Comments)
Posted by: Becky Carroll
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The WOCN® Society In Action is a members-only public policy and advocacy newsletter that is published four times a year to highlight the most pressing issues related to WOC health care and the Society's advocacy efforts.
Finding Power in Our Roots
 
The Society's public policy and advocacy updates and activities will be highlighted at the 49th Annual Conference in Salt Lake City.

Join Kate Lawrence, MSN, RN, CWOCN, the Society's public policy and advocacy coordinator, and Chris Rorick, MPA, the Society's director of government relations, for their session (PP311) Public Policy and Advocacy: Finding Power in our Roots, Sunday, May 21, 2017, 3:10 pm, to hear the current state of affairs and how each of us can impact change in the WOC nursing profession.
Lymphedema Treatment Act

The Lymphedema Treatment Act (H.R. 930/S.497) has been reintroduced in the 115th Congress. This would amend Medicare statute to pay for compression garments, bandages and supplies to reduce lymphedema-related swelling and prevent recurrence. Compression therapy is considered the gold standard for the treatment of lymphedema and the treatment and prevention of venous leg ulcers (VLUs), also known as stasis ulcers.
 
The Society strongly supports the Lymphedema Treatment Act, as this legislation reflects the vision and core tenets of the Society as a means to support cost-effective, evidence-based prevention and treatment of complex wound conditions such as VLUs and lymphedema. The Society prepared a white paper on Medicare coverage of compression therapy.

Please send an e-letter to members of Congress urging support for the Lymphedema Treatment Act. We have provided a sample letter for you to easily contact members of Congress.
Nursing Workforce

Health & Human Services (HHS) Secretary Tom Price recently testified before the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies on the President's "skinny budget" proposal, which recommended that health professions and nursing workforce programs (Title VIII Nursing Workforce) be cut by $403 million dollars and the National Institutes of Health (NIH) be cut by $5.8 billion dollars, or 20 percent.

During the hearing, members of Congress pointed to the NIH being the front line of the U.S. healthcare operations, arguing a $6 billion cut would be devastating to the nation's well-being. Rep. DeLauro (D-CT), Rep. Lowey (D-NY) and Rep. Roybal-Allard (D-CA) spoke against the extreme cuts saying they would not support the cuts proposed to the nursing community, particularly the training programs. Chairman Tom Cole (R-OK) also echoed this concern.

Rep. Davis (R-IL) and Rep. Bonamici (D-OR) circulated a "Dear Colleague" urging Members of the House to support Title VIII Nursing Workforce Development Programs in FY 2018. Davis and Bonamici are asking the Appropriations Committee to allocate $244 million for the Nursing Workforce Development Programs in Title VIII in a letter that notes nurses are "essential members of any healthcare team" and "comprise the largest population of the healthcare workforce."
 
Title VIII programs have helped build the supply and distribution of qualified nurses needed in all healthcare settings. Title VIII programs bolster nursing education at all levels, from entry-level preparation through graduate study, and provide support for institutions that educate nurses for practice in rural and medically undeserved communities.

Earlier this year, Rep. Joyce (R-OH) introduced H.R. 959, "Title VIII Nursing Workforce Reauthorization Act of 2017," and over 25 Members have signed on as co-sponsors to the Bi-partisan bill, which aims to amend Title VIII of the Public Health Service Act to extend advanced education nursing grants to support clinical nurse specialist programs, and for other purposes.
Bladder Health Month

A Congressional Resolution to officially recognize November as National Bladder Health Month has been introduced. About 30 patient and provider groups, including the Society, committed to move the Resolution forward. The resolution was introduced in by Rep. Eliot Engle (D-NY) in April and can be read in its entirety here. Please contact your Representative and encourage them to support H. Res. 67.
Palliative Care Meeting

Society President Carolyn Watts, MSN, RN, CWON, committed to participate in a Palliative Nursing Summit to be held in May in the nation's capital. The Summit will convene national nursing leaders to develop a shared nursing agenda and action plan focused on the following three aspects of palliative care:
  • Communication and Advance Care Planning.
  • Coordination of Care.
  • Pain and Symptom Management.
The goal is to unite and activate nurses in leading and transforming primary palliative care so patients and families can have access to quality primary palliative care and referrals to specialty palliative care whenever and wherever they need it.
Medicare Competitive Bidding

In March 2016, President Obama released his FY 2017 budget, which proposed that inhalation drugs, all prosthetic and orthotics, and ostomy, tracheostomy and urological supplies be listed as products subjected to competitive bidding. The Society expressed serious concerns with this proposal and in response to the flawed policy approach, the Society's leadership developed an advocacy action plan to keep ostomy products excluded from Competitive Bidding. The Society will continue to fight to exclude these program the program in the future. 

In July 2016, CMS's Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) held a meeting that focused on obtaining recommendations regarding treatment strategies for patients with lower extremity chronic venous disease.
 
President Trump has not yet released his complete FY 2018 budget. It's worth noting that new HHS Secretary Tom Price has been a vocal critic of CMS Competitive Bidding Program.
Access to Care

The Agency for Healthcare Research and Quality (AHRQ) published a request for scientific information submissions from the public to inform their review of Treatment Strategies for Patients with Lower Extremity Chronic Venous Disease (LECVD). Read more here.

Due to proposed changes to the Medicare Competitive Bidding Program, and other proposals to limit patient access to supplies, the Society has formulated a plan to preserve patient access to care. The current status of Competitive Bidding may be in flux with the change of administration. However, the issue of access to care continues to be an important public policy and advocacy pillar on the Society's Health Care Agenda. The public policy and advocacy team stepped back to analyzed the comprehensive issue and decided that beyond Competitive Bidding there is still important work to do to articulate the importance of specialty care and access to supplies that give patients what they need for proper management and self-care of their disease process.

Recognizing that patient stories could highlight coverage gaps, the Society has partnered with UOAA in a campaign to promote stories that describe the daily struggle of our patients when facing problems with access to care and supplies. Additional information can be found here. In addition, a Society task force has been created to review current literature that discusses quality of life and problems and gains related to access to care and supplies. The outcome of this review will be a formalized statement on the gaps of care noted for patients with based on the recent literature.

The focus on access to care and supplies continues to build strength, with our foundational work Guiding Principles For Sustainable Access to Ostomy Services Technologies and Innovation patient and clinician stories, and literature review and synopsis. Our next steps will be guided by the Fiscal Year 2018 budget process and the development of a communication plan on sharing our consumer driven focus to legislative and regulatory stakeholders.
Technical Expert Panels (TEP)
 
In January 2017, the TEP of Post-Acute care assessment convened for a second time to review gaps in the areas of Post-Acute Care Assessment. Specifically, areas of concern that were discussed included complex care and fistula management due to the involved nature of providing care to patients with fistula.
 
Kate Lawrence, MSN, RN, CWOCN, the Society's public policy and advocacy coordinator, sat for a second time on the panel representing post-acute care settings and the Society. The project is moving to Beta testing based on feedback from the panel.

If any Society members have been involved in TEP panels, please contact info@wocn.org to help update our list of experts.
Disposable Negative Pressure Wound Therapy Payment

Legislation was passed in late 2015 to allow for payment of disposable negative pressure wound therapy (NPWT) devices in the home health setting.  As a result, effective January 1, 2017, CMS will allow home health agencies to bill for disposable NPWT.

The payment would be equal to the payment that currently exists for such devices in the outpatient setting, including the professional services provided. A "disposable device" is defined as "a disposable negative pressure wound therapy device that is an integrated system comprised of a non-manual vacuum pump, a receptacle for collecting exudate, and dressings for the purposes of wound therapy" and ''a substitute for, and used in lieu of, a negative pressure wound therapy durable medical equipment item that is an integrated system of a negative pressure vacuum pump, a separate exudate collection canister, and dressings that would otherwise be covered for individuals for such wound therapy."

Additional information is available from industry resources, including a nationwide webinar.
Medicare Contractors Propose Changes to Wound Care Payments
 
The Society recently submitted comments to two contractors, First Coast Optionand Novitas Solutions, who have proposed concerning changes to wound care policies. The Society provided comments directly to the changes available here: First Coast Option and Novitas Solutions, as well as participated in developing comment through the Alliance of Wound Care Stakeholders
If you have questions regarding any of these issues, please contact:

Chris Rorick, MPH
Director of Government Relations
chris.rorick@bryancave.com
+1 202-508-6354
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