[Extensions of Remarks]
[Page E935]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


    LEGISLATION PROVIDING MEDICAID COVERAGE OF ALL CERTIFIED NURSE 
              PRACTITIONERS AND CLINICAL NURSE SPECIALISTS

                                 ______


                          HON. BILL RICHARDSON

                             of new mexico

                    in the house of representatives

                         Wednesday, May 3, 1995
  Mr. RICHARDSON. Mr. Speaker, I am pleased to introduce legislation, 
H.R. 1339, that would provide Medicaid coverage for all certified nurse 
practitioners and clinical nurse specialists for services they are 
legally authorized to perform.
  As the need to provide basic medical care to the Nation's medically 
deprived population increases, the need to facilitate access to 
quality, cost-effective primary care provided by nurse practitioners 
also increases. Over 400 studies have confirmed the high quality of 
health care provided by nurse practitioners in a variety of urban and 
rural primary care settings. It is well known that the majority of our 
underserved populations are located in rural and inner city settings 
across the Nation. While nurse practitioners are willing and able to 
provide services in these settings, not all nurse practitioners are 
currently being reimbursed by Medicaid for their services in these 
areas.
  Currently, patients are able to access the care of certain nurse 
practitioners such as family and pediatric nurse practitioners, but 
others such as adult and women's health nurse practitioners are not 
accessible. The legislation I am introducing would enable all nurse 
practitioners, regardless of specialty, to provide care to Medicaid 
recipients.
  Nurse practitioners are particularly capable to provide health care 
to the indigent. Their educational programs emphasize the provision of 
care to patients who have limited financial resources. In a national 
survey conducted by the American Academy on Nurse Practitioners, over 
60 percent of the patients seen by these providers had family incomes 
of less than $16,000 per year.
  Nurse practitioners rate as high in financial efficiency as they do 
in consumer satisfaction. Their ability to focus on preventative and 
curative medical services contribute to the quality as well as the 
cost-effectiveness of the care they provide.
  Nurse practitioners can play a central role in achieving our national 
goal of providing quality, cost-efficient health care for all citizens. 
I am hopeful this legislation will help to eliminate disparities in 
access to care for rural and inner city Medicaid populations by 
providing direct reimbursement to nurse practitioners and clinical 
nurse specialists who have proven their ability to deliver quality care 
in a cost-effective manner.


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