HomeRegulatory Updates

Update on the Proposed APRN Regulatory Model

In recent years, the advanced practice registered nurse (APRN) role has expanded rapidly in terms of numbers and capabilities, yet no uniform APRN regulation model currently exists across the United States. Thus, each state independently determines such important parameters as legal scope of practice, roles that are recognized, criteria for entry into advanced practice, and minimum certification requirements. These inconsistencies adversely have affected access to care for patients and created a significant barrier for APRNs who wish to move from state to state.

In 2004, a national panel, the APRN Consensus Work Group, was formed and charged with developing a uniform regulatory model for advanced practice nursing. In 2006, representatives of the National Council of State Boards of Nursing Advanced Practice Advisory Panel joined the APRN Consensus Work Group in joint dialogue to work toward a future consensus model for APRN regulation. The draft recommendations of the work group have recently been released. On May 16, 2008, a special session was held at the ONS 33rd Annual Congress in Philadelphia to discuss these recently completed recommendations. Presenters in the session provided a brief overview of the history of APRN regulation, review the demographics of oncology APRNs, and discuss the implications of the new model for oncology APRNs.

Because of the importance of APRNs caring for patients now and in the future, it is vital that the education, accreditation, certification, and licensure of APRNs be effectively aligned to ensure patient safety while expanding patient access to APRNs. APRNs, as well as educators and employers, planning are encouraged to review this information to learn more about this important report that may significantly affect their profession in the near future and for years to come.

Learn more about the proposed regulatory model. Final Version (AUG 09). 

View the slides presented during a special session at the 33rd ONS Annual Congress.

Centers for Medicare & Medicaid Services
The Centers for medicare and Medicaid Services Physician Quality Reporting Initiative Measure Finder Tool (Version 1.0) is designed to help eligible professionals and their coding/billing staff to quickly search for applicable measures and their detailed specifications. This tool will allow users to search for applicable measures based on a single code or a combination of codes.


The Use of Erythropoiesis Stimulating Agents in Cancer and Related Neoplastic Conditions
The Centers for Medicare and Medicaid Services is seeking public comment on their proposed determination that there is sufficient evidence to conclude that erythropoiesis stimulating agent (ESA) treatment is not reasonable and necessary for beneficiaries with certain clinical conditions, either because of a deleterious effect of the ESA on their underlying disease or because the underlying disease increases their risk of adverse effects related to ESA use. Click here to read more of CMS proposed decision.

ONS Response to CMS Proposed Decision

US Food and Drug Administration Health Advisory

Commentary on the CMS Proposed Ruling from Other Organizations

  • National Comprehensive Cancer Network: Cancer and Treatment Related Anemia
  • American Society of Hematology: Statement on Medicare Proposed National Coverage Policy on Erythropoiesis-Stimulating Agents
  • American Society of Clinical Oncology: Proposed National Coverage Policy on Erythropoiesis Stimulating Agents
  • The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that three new educational resources have been posted on the CMS website.

    The following items are available for download on the PQRI Educational Resources web page:

    Coding for Quality—A Handbook for PQRI Participation
    This handbook is a resource provided to facilitate PQRI implementation for successful reporting.

    2007 PQRI Code Master
    This Excel spreadsheet provides a sequential list of all ICD-9-CM (I9) and CPT® (CPT4) codes with associated CPT II exclusion modifiers that are included in the 2007 PQRI.

    2007 PQRI Fact Sheet
    This Fact Sheet provides an overview of the 2007 Physician Quality Reporting Initiative.

    To access the new and all available educational resources, visit http://www.cms.hhs.gov/PQRI and scroll down to the “Downloads” section and click on the “Coding of Quality- A Handbook for PQRI Participation”, the “2007 PQRI Code Master”, and the “2007 PQRI Fact Sheet” links.


    New Frequently Asked Questions (FAQs) on the 2007 Physician Quality Reporting Initiative (PQRI)

    The Centers for Medicare & Medicaid Services (CMS) has posted new Frequently Asked Questions (FAQ) related to the Physician Quality Reporting Initiative. These include questions related to instances when Medicare is the secondary payer.

    You can access these FAQs by visiting the PQRI webpage at http://www.cms.hhs.gov/PQRI/ and scroll down to the “Related Links Inside CMS” section and click on the link titled “All PQRI FAQs”.


    PQRI Question of the Week

    Question: Why should I participate in Physician Quality Reporting Initiative (PQRI)?

    Answer: Eligible professionals will have the opportunity to use participation in the PQRI program to improve the care of the patients they serve through the evidence based measures that are based upon clinical guidelines.

    Participating in PQRI is a way to prepare for future pay-for-performance programs.

    Finally, the 1.5% bonus incentive is new money being made available to reward participating professionals.

    Reference: http://www.cms.hhs.gov/PQRI.