April 2018 Newsletter
Signature Authority Update:
Now that House Bill 429 has become a reality, many of you have questions in regards to specific components the bill addressed.

1.  Disability Parking Placards - The revenue department has been notified of the bill passage. It will take a few weeks for the forms to be changed to reflect a signature line for nurse practitioners. Please check their website periodically for the change.

2. The NPAA will be meeting with Alabama Medicaid in May to begin to develop a formal partnership so that our practice and needs align with Medicaid guidelines.

3. Death Certificates - NPAA has been in contact with the Alabama Department of Public Health (ADPH) in regards to signing death certificates. Before CRNPs can sign death certificates, the ADPH must first develop an internal “credentialing” process that will provide for CRNP signature recognition within that organization. Once the process has been developed, the CRNP may download the credentialing forms for completion and submission back to the ADPH. CRNPs should not sign any paper death certificates until notification from ADPH that he/she has been granted this privilege. 
NPAA officers will continue to work on behalf of all Alabama NPs to ensure a smooth transition is accomplished. Your membership has allowed NPAA the opportunity to accomplish many goals aimed at improving the health and welfare of Alabama’s citizens. Thank you for your support!

12th Annual NPAA Conference
"Speaking in One Voice: Fostering Evidence Based Practice"
The Nurse Practitioner Alliance of Alabama (NPAA) will hold its 12th Annual Advanced Nursing Practice Conference on September 14-15, 2018 at the Hyatt Wynfrey Conference Center in Birmingham, AL (located at Galleria Mall). 

The theme for this year’s conference is “ Speaking in One Voice: Fostering Evidence Based Practice .”  The NPAA conference committee has met on several occasions and has been hard at work for our 12 th Annual Conference. We are pleased to announce the format has been revised to include choice of breakout sessions on Friday afternoon and Saturday morning.

Friday morning will begin with group sessions focused on Legislative and Reimbursement issues specific to Alabama. The keynote speaker will be Mr. Frank Harrington, Director of Reimbursement and Regulatory Affairs American Association of Nurse Practitioners. Frank has already been busy consulting on reimbursement issues confronting Nurse Practitioners within Alabama. Other morning presentations will include advance practice issues from BON Director Peggy Benson, optimizing reimbursement coding tips by Lynn Rapsilber and legislative update by NPAA executive committee.

Friday afternoon will offer breakout sessions on topics such as: Structural Heart Disease, dyslipidemia, overactive bladder, men’s health, update on bariatric surgery and sessions on pharmacogenetics and more to come. On Saturday morning there will be the annual opioid prescribing update or optional concurrent sessions. Bayer will offer two hands-on-lab-sessions on IUD insertion. Other sessions will include topics such as erectile dysfunction, diabetes management and more. We hope to offer a finalized agenda in May.

Conference Spotlight on Dr. Lynn Rapsilber
She is owner of NP Business Consultants, LLC educating NPs about the fiscal responsibility we all have to our practices.
What are the major barriers for optimal reimbursement?
Most practitioners are educated in the clinical aspects of becoming an APRN, however, little time is devoted to the business aspects.  In this time where APRNs can transform health care, we need to understand how we are paid to sustain a practice whether employed by or owner of a practice.

Lack of understanding in the reimbursement process can result in missed opportunities to capture revenue or perhaps trigger an audit.

What facilitates reimbursement?
One needs to understand the mechanism of how revenue in a practice is generated. Using E&M coding is important but even moreover with the shift from procedure to value based payment, education is critical so as not to leave money on the table. APRNs cannot ignore this responsibility.

What steps will need to occur to optimize reimbursement?
There are provider issues, practice issues, patient issues and payer issues which have a bearing on the reimbursement process.

How do states with full practice authority fare in the area of reimbursement versus states with restricted practice?
Reimbursement issues are similar across the country regardless of the state practice authority. Those in more restricted states need to be aware of how billing is occurring to make sure there are no barriers to payment.
What recourse does a NP have if they feel they were not fairly reimbursed?
Advocacy, involvement at the state level and national intervention.