Breaking Advocacy News: Restrictive Novitas LCD will not be Implemented

Dear AANA Members,

 

In early July I wrote to the AANA membership about the latest anti-CRNA activities of Novitas Solutions, a Medicare Administrative Contractor (MAC). At the time, Novitas had just released a final draft local coverage determination (LCD) which, if implemented on August 16 as scheduled, would establish policy that would not recognize nurse anesthesia education and preparation, resulting in denials for CRNA reimbursement for facet joint injections in 11 states, the District of Columbia, the Indian Health Service, and the Department of Veterans Affairs. Worse, the LCD would have a terrible impact on chronic pain patients, especially those in medically underserved areas, who rely on CRNAs to manage their pain and provide quality of life.

 

Today I am happy to share great news with you about the Novitas LCD!

 

As of this morning (Aug. 16, the proposed implementation date for the LCD), Novitas has posted an official note on its website stating that it is not going to implement the LCD as anticipated. You can view the LCD and official note¬†here. (Please note that first-time visitors to the site need to accept Novitas’ terms and conditions before viewing the LCD. Once you accept, you will be directed to the LCD.)

 

Why, you might ask, did Novitas do a complete about-face less than two months after the final version LCD was released? The answer is simple: The tenacious efforts of the AANA Federal and State Government Affairs staff, staff from other AANA departments, the Board of Directors, and AANA legal counsel made this happen. In particular, our federal advocacy team was instrumental in achieving this result. They tirelessly worked their contacts at the Centers for Medicare & Medicaid Services (CMS), lobbied on Capitol Hill, and exhausted all avenues to exert pressure on Novitas leadership.

 

It is also important to recognize the contributions of our affiliates, the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) and the National Board for Certification and Recertification of Nurse Anesthetists (NBCRNA), who weighed in on this matter with outstanding letters to Novitas.

 

Simply stated, the AANA was not going to allow this LCD to take effect without a fight.

 

However, there is still work to be done. In late August, AANA, NBCRNA, and Novitas leadership will meet in Dallas to begin negotiating a definitive resolution on CRNA reimbursement for pain-management services. During these negotiations, the AANA and NBCRNA will seek provider neutrality for CRNAs and recognition by Novitas of the nonsurgical pain management subspecialty certification (NSPM) as sufficient training for CRNAs to qualify for reimbursement for providing facet-joint injections and other forms of pain management.

 

As always, I will keep you informed of further developments regarding Novitas as they occur.

 

Sincerely,

Bruce A. Weiner, DNP, MSNA, CRNA
AANA President

(This information was provided by AANA)