107th Congress

Certified Registered Nurse First Assistants Reimbursement

Message to Congress ANA supports H.R. 822, which will provide Medicare Reimbursement for Certified Registered Nurse First Assistants (CRNFA's). This important legislation would improve access to high quality surgical care for Medicare beneficiaries and provide a cost effective alternative for the nations' health care delivery system by affording additional flexibility to surgeons, hospitals and ambulatory surgical centers. It would also correct an inequity in the law and provide for fair compensation for CRNFA services.

The Issues Surrounding Certified Registered Nurse First Assistants Reimbursement:

• The Certified Registered Nurse First Assistant is a registered nurse who is a technically skilled, highly educated nursing professional who renders direct patient care as part of the perioperative nursing process and who is recognized and has achieved excellence in patient care through a voluntary professional certification process. CRNFAs provide a patient-centered continuum of care before, during and after surgery.

• When providing first assistant surgical services, the CRNFA practices in collaboration with and at the direction of the surgeon and directly assists the surgeon by controlling bleeding and by providing wound exposure, suturing, and other surgical tasks during the surgical procedure. The surgical first assistant may be asked to provide other advanced assistance such as mobilization of tissue, patient positioning, and directing other team members with specific individual patient needs.

• CRNFAs provide high quality, cost-effective surgical care and perform the same first assisting tasks and duties as physicians, physician assistants and nurse practitioners, who currently receive Medicare reimbursement for first assisting. Reimbursing CRNFA's for their surgical first assisting services would address this fundamental inequity while improving the cost efficiency of surgical care provided to Medicare patients.

• The Medicare Certified Registered Nurse Reimbursement Act of 2001 (H.R. 822) was introduced by Rep. Mac Collins (R-GA) on March 1, 2001. This legislation would provide Medicare reimbursement for the surgical first assisting services of CRFNAs at 13.6% of the surgeon's fee. It has strong bi-partisan support on the committees and jurisdiction and currently has 30 co-sponsors.

• ANA joins with the Association of periOperative Registered Nurses (AORN) to urge support of H.R. 822, which would extend Medicare coverage eligibility to CRNFAs for their surgical first assisting services.

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