WV--DiChiacchio, Toni

Document ID: CMS-2012-0061-0009
Document Type: Public Submission
Agency: Centers For Medicare & Medicaid Services
Received Date: May 14 2012, at 12:00 AM Eastern Daylight Time
Date Posted: May 15 2012, at 12:00 AM Eastern Standard Time
Comment Start Date: May 11 2012, at 12:00 AM Eastern Standard Time
Comment Due Date: June 11 2012, at 11:59 PM Eastern Standard Time
Tracking Number: 8100eb9f
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This is comment on Proposed Rule

Medicaid Program: Payments for Services Furnished by Certain Primary Care Physicians and Charges for Vaccine Administration Under Vaccines for Children Program

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I am deeply disappointed that the improved Medicaid reimbursements will exclude us Nurse Practitioners that are running our own, independent practices without physician involvement. As an NP with my own clinic, I reach out to the underserved and low income more than any other providers. By excluding me from the improved reimbursements you are putting me at a distinct disadvantage. Plus, I contribute a certain amount of my profits annually to care for patients who can't afford care. These patients will suffer too if I can not get the increased reimbursements. 19 states and the District of Columbia now allow NPs to practice completely autonomously. And if ACA is ruled constitutional, you will be short about 30,000 physicians so you will need us desperately to care for Americians. Otherwise, those who argued agains the ACA are going to be proved right...patients will have to wait a year or more to get in with their care provider. The Federal Trade Commission has been commenting on laws that are eliminating NPs from free market competition. This proposed rule is definetly an anti-trust issue and should not be allowed as written.