Committee on Education and the Workforce

Testimony of Jan Towers
Director of Health Policy
before the

House Education and Workforce Committee
Subcommittee on Workforce Protections

May 26, 2005

 My name is Jan Towers. I am here representing the American Academy of Nurse Practitioners, the full service organization representing over 90,000 nurse practitioners of all specialties throughout the United Sates. I am the Director of Health Policy and a family nurse practitioner. I am here to speak to the proposed amendment to the Federal Employees Compensation Act that would allow nurse practitioners and physician assistants to be covered providers under that act.

 Certified registered nurse practitioners are advanced practice nurses who have completed a formal nurse practitioner program culminating in a minimum of a Masterís education beyond their four-year baccalaureate education in professional nursing. They are prepared to be primary care providers in todayís health care arena. As the committee knows, nurse practitioners are highly qualified health care providers who have demonstrated their skills in providing primary care to individuals in both rural and urban settings regardless of age, occupation or income. The quality of their care has been well documented over the years. With their advanced preparation, they are able to manage the medial and health problems seen in the primary care and acute care settings in which they work.

 Nurse practitioners constitute an effective body of health care providers that may be utilized at a cost savings in both fee for service and managed care arenas in this country. Recent managed care data reports an aggregate patient per month cost savings of over 50% among patients seen by nurse practitioners when compared to similar patients being seen by physicians. Other cost savings realized when nurse practitioners are properly utilized include savings due to reductions in emergency room visits and hospitalizations.

 Not recognizing nurse practitioners as attending providers for federal employees in the Federal Employees Compensation Program actually creates a cost for the federal government because the patient is required to see a physician for any work related medical problem. This potentially increases the numbers of medical encounters incurred by patients who will continue to see their regular health care provider for other medical problems while seeing the required physician provider for the problem coming under the aegis of the Federal Employees Compensation Program.

 Nurse practitioners diagnose and treat patients of all ages and walks of life. This includes taking patient histories, conducting physical examinations, ordering and interpreting their diagnostic tests and prescribing medications and other treatments for their medical problems. Nurse practitioners are often the only provider in a particular health care setting. In rural areas this means that patients have to travel distances to see other providers. The inability of nurse practitioners to serve their patients when an occupationally related injury or illness occurs, not only creates additional costs by forcing patients to go elsewhere for the care of theses conditions (often to more expensive emergency rooms), but also creates fragmentation of care that can have implications for other health care outcomes.

 Nurse practitioners are covered medical providers in Medicare, Medicaid, Tri-care and private insurance plans. They serve as medical providers in the Veterans Administration, the Department of Defense and the Indian Health Service. They are capable of performing services for workerís compensation patients in state programs, but are still excluded from doing the same for federal employees who are under their care.

 Nurse practitioners are licensed to practice in all fifty states and the District of Columbia. They are authorized to diagnose, treat and prescribe medications under their own signature. They are Board certified. They carry malpractice insurance. They are capable of making medical judgments related to occupational hazards, diseases and injuries. They have an outstanding record for providing high quality care.

 According to the current statute, federal employees coming under the jurisdiction of the Federal Employees Compensation Act, have the right to choose their own health care provider for the treatment of their condition. Yet, if their health care provider is a nurse practitioner, they are forced to go elsewhere for that part of their medical care, even though the nurse practitioner is perfectly qualified to provide the care they need. It is for this reason that we are asking the Federal Employees Compensation Act be amended to include nurse practitioners as medial providers in the act.

 We thank you for the opportunity to discuss this issue with you. I will be glad to answer questions or provide you with further information that you may need.

Submitted by: Jan Towers, PhD, NP-C, CRNP, FAANP
Director of Health Policy