Nebraska: Providers fight to allow practitioners to prescribe

Friday, January 24, 2014

OMAHA – Providers rely on nurse practitioners to prescribe HME in many rural areas where physicians are hard to come by—but Nebraska providers have no such recourse.

“As our regulations sit, only MDs and DOs can write prescriptions for DME under the Medicaid benefit,” said Ed Erickson, general manager at North Platte, Neb.-based Great Plains Homecare Equipment. “It’s very important that any mid-level practitioner be able to write orders for this equipment to prevent delays. There’s a real bottleneck here.”

If a physician goes on vacation, for example, it could add weeks to the process. That puts providers and patients on hold.

The current regulation is based on misinterpreted information from CMS, Erickson said.

“They’ve based this on egregious information from Medicare as to who can write orders—what Medicare was referencing applies to home health and they’ve blanketed it onto the DMEPOS side of things,” he said. 

Unfortunately, it doesn’t look like that’s going to change anytime soon.

The Nebraska Department of Health and Human Services (DHHS) held a public hearing Dec. 19 to discuss proposed changes to Medicaid regulations. Stakeholders from both HME and nursing used the hearing to push for mid-level practitioners to be allowed to sign orders for HME, but they didn’t get far. 

Still, Erickson says providers in Nebraska won’t give up. 

“We could approach a statute change, but that’s a burdensome process,” he said. “It appears we will go at least another year with the current restrictions.”