Related Experiment Videos
Medicaid payment for nonphysician practitioners: an access issue
1Institute for Health and Aging, University of California, San Francisco.
Health Affairs (Project Hope)
|January 1, 1994
Summary
Medicaid payment policies expanded for advanced practice nurses in the 1980s, but state adoption varies. Some states still lag in covering nonphysician services, despite federal mandates for improved access to care.
Area of Science:
- Health Policy
- Nursing Practice
- Healthcare Access
Background:
- Congressional mandates in the 1980s aimed to increase healthcare access for Medicaid beneficiaries.
- These mandates required states to cover services from specific advanced practice nurses.
- This spurred policy changes for nonphysician practitioner reimbursement in many states.
Purpose of the Study:
- To examine the evolution of state Medicaid payment policies for nonphysician practitioners.
- To assess the extent to which states have adopted policies expanding coverage for advanced practice nurses.
- To identify disparities in state-level implementation of federal mandates.
Main Methods:
- Analysis of state Medicaid payment policies related to nonphysician practitioners.
- Review of legislative and regulatory changes following federal mandates.
- Comparison of state policies with professional practice act allowances and Medicare regulations.
Main Results:
- State Medicaid policies for nonphysician practitioners are often more flexible than Medicare policies.
- Not all states have fully embraced policy expansions, with coverage varying significantly.
- A few states have not yet implemented the 1989 federal mandates regarding coverage.
Conclusions:
- Federal mandates have influenced state Medicaid payment policies for advanced practice nurses.
- Variability exists in state-level adoption and implementation of these policies.
- Gaps remain in ensuring comprehensive coverage for nonphysician practitioner services in some states.