Whereas, In OBRA ’89, PL 101-239, Section 6405, amending Section 1905(a) (21) of the Social Security Act, Congress requires States to offer the option of direct payment to nurse practitioners, whether or not those practitioners are under the supervision of, or associated with, a physician or other health care provider; and
Whereas, The Medicaid beneficiaries in nursing facilities are among the most frail and most complicated long term care patients, requiring careful, close and coordinated medical supervision; and
Whereas, The management of frail long term care patients with multiple chronic medical conditions, receiving several medications, requires active physician involvement to assure a teamwork approach to long term care; and
Whereas, Federal regulations require each nursing facility resident to have an attending physician, stipulate that the physician must visit the resident at least once every 30 days for the first 90 days and then at least once every 60 days, and restrict nurse practitioners to every other required visit, under the physician’s supervision; and
Whereas, The implementation of a physician supervised plan of care is in the best interest of the long term care patient; therefore be it
RESOLVED, That the American Medical Association pursue statutory and regulatory clarification for physicians to continue their collaborative and supervisory practice with
nurse practitioners, proscribing direct payment to independent nurse practitioners.
Note: Effective August 13, 2024, AMDA - The Society for Post-Acute and Long-Term Care Medicine is now Post-Acute and Long-Term Care Medical Association (PALTmed).