ANA Recommends Requiring Health Plans to Include APRNs to Qualify for State Health Insurance Exchanges

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ANA has recommended to the Centers for Medicare & Medicaid Services (CMS) that to qualify for inclusion, health insurers seeking to offer plans on state health insurance exchanges must include at least a minimum number of advanced practice registered nurses (APRNs) in each plan’s network of health care providers. That minimum number would be set in each State equal to 10% of the number of APRNs recorded as independently billing Medicare Part B using the most recent data available from CMS. In 2011 there were 100,585 APRNs participating in Medicare Part B using their own NPI. In Connecticut, the median State with respect to APRN participation in Medicare Part B, ANA’s recommendation would require Exchange plans to include 178 APRNs in their networks.The required minimums range from a low of 16 in Hawaii to a high of 654 in Florida.