Nurses are invited to take a short online survey that will influence PSNA’s member benefits, guide our strategic plan and focus on better meeting the needs of Pennsylvania’s nurses. Complete it for a chance to win a $25 gift card. We thank you for your participation! Click here.

PSNA joined the American Nurses Association (ANA) today in issuing the following statement attributable to ANA President Karen A. Daley, PhD, RN, FAAN:

“The ANA and PSNA are extremely disappointed that the nation’s elected leaders have failed to find common ground to avert the so-called “sequester.” Consequently, painful cuts in health care spending will hurt vulnerable Americans seeking care and lead to widespread job losses.

Reducing the nation’s deficit on the backs of seniors who need care and professionals who dedicate their lives to providing health care services and conducting research is reckless and should be unacceptable to anyone. Although the sequester was meant to spur action to address fiscal issues in a thoughtful way, we are now facing a situation where cuts in Medicare funding will result in the elimination of hundreds of thousands of health care jobs. Allowing these cuts to go forward is the equivalent of malpractice. The nation’s lawmakers have chosen inaction with a full understanding of the painful consequences for their constituents.

We call upon our nation’s elected leaders to do the right thing and formulate a balanced solution that strengthens the nation’s health care system and the economy instead of weakening it.”

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In September 2012, ANA, along with the American Hospital Association (AHA) and the American Medical Association (AMA), warned that the 2 percent sequester of Medicare spending is projected to cause a loss of 766,000 nursing and other health care jobs and a corresponding decline in quality of care for patients.

ANA represents the interests of the nation’s 3.1 million registered nurses.

PSNA will hold its annual Summit, “Bullying: Are You the Aggressor, the Bystander or the Target,” on Tuesday, May 21, 2013 at DeSales University, Center Valley. This event was originally scheduled to be in November 2012 and has been rescheduled due to Hurricane Sandy. PSNA is pleased to host keynote speaker Cheryl Dellasega, PhD, RN, CRNP at this year’s event. 

“Nursing is viewed as the most trusted and caring profession,” said PSNA Chief Executive Officer Betsy M. Snook, MEd, BSN, RN.  “Yet nurse-on-nurse bullying is a reality. Not only does it affect morale and professional self-esteem, but it jeopardizes patient care. Dr. Dellasega’s session ‘Spite in White’ equips nurses with tools to recognize relational aggression and promote change.”

For more than 25 years, Dr. Dellasega has been working as a researcher, counselor, teacher and nurse practitioner. She is the author of six books including When Nurses Hurt Nurses, a book about recognizing and overcoming the cycle of bullying. As a professor of humanities in the College of Medicine and professor of women’s studies at The Pennsylvania State University, Dr. Dellasega is actively involved in medical education, conducts research on psychosocial issues and leads community outreach efforts. She has appeared as an expert on national and local television and radio shows and in print including: The Today Show, Good Morning America, The Gayle King Show, Redbook, The Philadelphia Inquirer and Girl Scout Leader.

This year’s Summit also features a series of continuing education sessions on issues ranging from standards of a healthy workplace, post-traumatic stress disorder and creating a respectful work environment.  Attendees can earn up to 5.7 contact hours from the Summit with additional contact hours awarded for the practice showcase.

 Online registration is now open with pricing available for PSNA members, non-members and nursing students.  Please visit www.panurses.org/summit2013 for a schedule of events, session details and to register.

PSNA and PSNA District 16 will host a Town Hall meeting on April 18, 2013 at Millersville University. Join us at 6:00 pm to discuss topics including safe staffing, whistle blower protection, APRN scopes of practice and violence against health care workers. Featured speakers include Senator Lloyd Smucker, Rep. Bryan Cutler, Rep. Keith Greiner, PSNA CEO Betsy Snook and PSNA Director of Govt Affairs Kevin J. Busher. Click here for the District 16 Town Hall announcement to download and share with colleagues.

The American Nurses Association (ANA) commends the White House for its decision to nominate Marilyn Tavenner, MHA, BSN, RN, to permanently head the Centers for Medicare and Medicaid Services (CMS). Tavenner, a former Intensive Care Unit (ICU) nurse, has served as chief executive officer of the Hospital Corporation of America (HCA) and was Virginia’s secretary of Health and Human Resources under then-Governor Tim Kaine.

“Marilyn is more than prepared to head the Centers for Medicare and Medicaid Services (CMS), an agency that touches the life of every American through the Medicare, Medicaid, and children’s health insurance programs, promotes quality standards, and develops policy innovations intended to expand patient access to high quality health care,” says ANA President Karen A. Daley, PhD, RN, FAAN. “We at ANA believe that her expertise and experience will provide CMS with the leadership needed to guide our health care system during this time of great change. We urge a swift confirmation process so that CMS can continue its work to improve the health care of individuals and families nationwide.”

Tavenner joined CMS in February 2010 and became acting administrator in December 2011.

Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius today released a new report showing that for every dollar spent on health care-related fraud and abuse investigations in the last three years, the government recovered $7.90. This is the highest three-year average return on investment in the 16-year history of the Health Care Fraud and Abuse (HCFAC) Program.

The government’s health care fraud prevention and enforcement efforts recovered a record $4.2 billion in taxpayer dollars in Fiscal Year (FY) 2012, up from nearly $4.1 billion in FY 2011, from individuals and companies who attempted to defraud federal health programs serving seniors and taxpayers or who sought payments to which they were not entitled.  Over the last four years, the administration’s enforcement efforts have recovered $14.9 billion, up from $6.7 billion over the prior four-year period.  Since 1997, the HCFAC Program has returned more than $23 billion to the Medicare Trust Funds.

These findings, released today in the annual HCFAC Program report, are a result of President Obama making the elimination of fraud, waste and abuse, particularly in health care, a top priority for the administration.

The success of this joint Department of Justice and HHS effort was made possible by the Health Care Fraud Prevention and Enforcement Action Team (HEAT), created in 2009 to prevent fraud, waste and abuse in the Medicare and Medicaid programs and to crack down on individuals and entities that are abusing the system and costing American taxpayers billions of dollars.  These efforts to reduce fraud will continue to improve with new tools and resources provided by the Affordable Care Act.

“This was a record-breaking year for the Departments of Justice and Health and Human Services in our collaborative effort to crack down on health care fraud and protect valuable taxpayer dollars,” said Attorney General Holder.  “In the past fiscal year, our relentless pursuit of health care fraud resulted in the disruption of an array of sophisticated fraud schemes and the recovery of more taxpayer dollars than ever before.  This report demonstrates our serious commitment to prosecuting health care fraud and safeguarding our world-class health care programs from abuse.”

“Our historic effort to take on the criminals who steal from Medicare and Medicaid is paying off: We are gaining the upper hand in our fight against health care fraud,” said Secretary Sebelius. “This fight against fraud strengthens the integrity of our health care programs and helps us fulfill our commitment to our seniors.”

About $4.2 billion stolen or otherwise improperly obtained from federal health care programs was recovered and returned to the Medicare Trust Funds, the Treasury and others in FY 2012.  This is an unprecedented achievement for the HCFAC Program, a joint Justice Department and HHS effort to coordinate federal, state and local law enforcement activities to fight health care fraud and abuse. 

The administration is also using tools authorized by the Affordable Care Act to fight fraud, including enhanced screenings and enrollment requirements, increased data sharing across the government, expanded recovery efforts for overpayments and greater oversight of private insurance abuses.  

Since 2009, the Justice Department and HHS have improved their coordination through HEAT and increased the number of Medicare Fraud Strike Force teams to nine. The Justice Department’s enforcement of the civil False Claims Act and the Federal Food, Drug and Cosmetic Act have produced similar record-breaking results. These combined efforts coordinated under HEAT have expanded local partnerships and helped educate Medicare beneficiaries about how to protect themselves against fraud.  In FY 2012, the two departments continued their series of regional fraud prevention summits, and the Justice Department hosted a training conference for federal prosecutors, FBI agents, HHS Office of Inspector General agents and others.

The strike force teams use advanced data analysis techniques to identify high-billing levels in health care fraud hot spots so that interagency teams can target emerging or migrating schemes as well as with chronic fraud by criminals masquerading as health care providers or suppliers. In July, Attorney General Holder and Secretary Sebelius announced the launch of a ground-breaking partnership among the federal government, state officials, leading private health insurance organizations and other health care anti-fraud groups to share information and best practices to improve detection of and prevent payments to scams that cut across public and private payers.

In FY 2012, the Justice Department opened 1,131 new criminal health care fraud investigations involving 2,148 potential defendants, and a total of 826 defendants were convicted of health care fraud-related crimes during the year. The department also opened 885 new civil investigations.

The strike force coordinated a takedown in May 2012 that involved the highest number of false Medicare billings in the history of the strike force program. The takedown involved 107 individuals, including doctors and nurses, in seven cities, who were charged for their alleged participation in Medicare fraud schemes, involving about $452 million in false billings. As a part of the May 2012 takedown, HHS also suspended or took other administrative action against 52 providers using authority under the health care law to suspend payments until an investigation is complete.

Strike force operations in the nine cities where teams are based resulted in 117 indictments, informations and complaints involving charges against 278 defendants who allegedly billed Medicare more than $1.5 billion in fraudulent schemes. In FY 2012, 251 guilty pleas and 13 jury trials were litigated, with guilty verdicts against 29 defendants, in strike force cases. The average prison sentence in these cases was more than 48 months.

The new authorities under the Affordable Care Act granted to HHS and the Centers for Medicare & Medicaid Services (CMS) were instrumental in clamping down on fraudulent activity in health care. In FY 2012, CMS began the process of screening all 1.5 million Medicare-enrolled providers through the new Automated Provider Screening system that quickly identifies ineligible and potentially fraudulent providers and suppliers prior to enrollment or revalidation to verify the data. As a result, nearly 150,000 ineligible providers have already been eliminated from Medicare’s billing system.

CMS also established the Command Center to improve health care-related fraud detection and investigation, drive innovation and help reduce fraud and improper payments in Medicare and Medicaid.

From May 2011 through the end of 2012, more than 400,000 providers were subject to the new screening requirements and nearly 150,000 lost the ability to bill the Medicare program due to the Affordable Care Act requirements and other proactive initiatives.

The Department of Justice and HHS also continued their successes in civil health care fraud enforcement during FY 2012.  The Justice Department’s Civil Division Fraud Section, with their colleagues in U.S. Attorneys’ offices throughout the country, obtained settlements and judgments of more than $3 billion in FY 2012 under the False Claims Act (FCA).  These matters included unlawful pricing by pharmaceutical manufacturers, illegal marketing of medical devices and pharmaceutical products for uses not approved by the Food and Drug Administration, Medicare fraud by hospitals and other institutional providers, and violations of laws against self-referrals and kickbacks.  This marked the third year in a row that more than $2 billion has been recovered in FCA health care matters. Additionally, the Civil Division’s Consumer Protection Branch, working with U.S. Attorneys’ offices, obtained nearly $1.5 billion in fines and forfeitures, and obtained 14 convictions in matters pursued under the Federal Food, Drug and Cosmetic Act.  

The HCFAC annual report is available at www.oig.hhs.gov/publications/hcfac.asp.  For more information on the joint DOJ-HHS Strike Force activities, visit: www.StopMedicareFraud.gov/.

For more information on the fraud prevention accomplishments under the Affordable Care Act visit: www.healthcare.gov/news/factsheets/2012/02/medicare-fraud02142012a.html.

The Pennsylvania State Nurses Association (PSNA), the voice for registered nurses in Pennsylvania, recently elected five new members to serve on its board of directors.  At PSNA’s November meeting, PSNA Chief Executive Officer Betsy M. Snook, MEd, BSN, RN welcomed:

Patrick E. Kenny, EdD, RN, ACRN, APRN-PMH, NE-BC, will serve as secretary on the PSNA board of directors. He is assistant professor in the Department of Nursing and Health at DeSales University where he currently teaches courses in the undergraduate nursing curriculum.  From 2007-2011, he served as president of PSNA. In addition, Kenny has held and holds several organizational positions including: director at large, Association of Nurses in AIDs Care; board member, The Eastern Pennsylvania Geriatrics Society; and treasurer, Mu Omicron Chapter, DeSales University, Sigma Theta Tau International.

Carol Ann Coles, RN, MSN, has worked as a professor of nursing at Westmoreland County Community College for more than 16 years. A member of PSNA for more than 20 years, Carol has served as PSNA vice president, former PSNA board member, PSNA-PAC chair and PSNA Awards chair.

Latasha Kast, BSN, RN, is a staff nurse at UPMC and serves as her unit’s Magnet Champion. Latasha served as president of the Student Nurses’ Association of Pennsylvania and is the co-chair of PSNA’s New-to-Practice Committee.

Donna Ayers Snelson, RN, MSN, DEd, is an associate professor and director of the Center for Nursing History at Misericordia University. As a nurse educator for more than 36 years, she has served in a number of leadership roles including: founder and director, Center for Nursing History in Northeastern Pennsylvania; vice president, PSNA District 3; member, PSNA Continuing Education Committee; and chair, Department of Nursing, Misericordia University.

Zane Robinson Wolf, PhD, RN, FAAN, is dean emerita and professor at La Salle University.  She has served as editor-in-chief of Pennsylvania Nurse, editor of the International Journal for Human Caring, former president of the Pennsylvania League for Nursing and member of the Institute for Safe Medication Practices board of trustees.

The Centers for Disease Control and Prevention will be free to do research on the impact of guns on health, President Barack Obama said on Wednesday when he announced a comprehensive set of recommendations for stemming shooting-related deaths and injuries.

CDC researchers have collected statistics on firearm-related deaths but have been barred from conducting in-depth studies since 1996, when then-Rep. Jay Dickey, R-Ark., led the drive to strip the agency’s budget of $2.6 million, the amount spent that year on research into guns. Dickey also successfully inserted report language into the Labor-HHS-Education appropriations bill that said: “None of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” Since then, that prohibition has been renewed annually in spending bills.

Federal officials, concerned about the political ramifications, interpreted the language as a signal to steer away from doing the kind of research that the CDC used to provide. One of the articles that drew protests from the National Rifle Association was a New England Journal of Medicine study that found that people who lived in homes with a gun were nearly three times as likely to die of a homicide and nearly five times as likely to die of suicide than people without guns.

Obama said Wednesday that his lawyers have assured him that such research does not amount to advocacy or promotion, and he signed a presidential memo directing the CDC, the National Institutes of Health and other agencies to conduct it. A senior administration official said that the CDC will begin work immediately on research exploring the causes and prevention of gun violence, and that the White House will propose in its fiscal 2014 budget request that Congress provide $10 million for the CDC to support that research, including investigating whether there is a link between shootings and violent video games or other media.

The administration also will seek an additional $20 million to expand the CDC’s National Violent Death Reporting System, which was created in 2002 to collect de-identified data from 18 states on gun-related deaths, including the type of gun used and how it was stored. The information is gleaned from death certificates, police reports and coroner or medical examiner reports.

Dickey has since repudiated the idea that federally funded researchers should not investigate gun-related deaths. In an opinion piece in The Washington Post last year, Dickey and former director of the CDC National Center for Injury Prevention and Control Mark Rosenberg wrote: “It’s vital to understand why we know more and spend so much more on preventing traffic fatalities than on preventing gun violence, even though firearm deaths (31,347 in 2009, the most recent year for which statistics are available) approximate the number of motor vehicle deaths (32,885 in 2010).”

In an interview Wednesday, Rosenberg said he expected researchers to begin working with data from such departments as Justice and Education. They will try to answer questions about what raises the risks of dying from gun violence. He called Obama’s proposal “a very important start,” likening it to the planting of a tree that requires many years to grow. “The best time to begin was 20 years ago, but the second best time is now,” he said.

“When the NRA threatened the science, they scared researchers away from this field, so today we don’t know what works,” Rosenberg added.

Also on Wednesday. Democratic Reps. Edward J. Markey of Massachusetts and Carolyn B. Maloney of New York said that they and 31 cosponsors would introduce legislation to codify the president’s executive order and end what Markey called “an irrational and counterproductive ban.”

The push by the White House to pursue gun-related research is part of a detailed, four-part plan that includes proposals to reduce problems tied to mental illness. (See related story, CQ News, Jan. 16, 2013).

The proposal also clarified that no federal law in any way prohibits doctors or other health care providers from reporting their patients’ threats of violence to the authorities, or talking to patients about gun safety.

CDC National Violent Death Reporting System

By Rebecca Adams, CQ HealthBeat Associate Editor, Rebecca Adams can be reached at radams@cq.com.