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From "Welcome to A.S.P.E.N.'s Advocacy and Public Policy Highlights."

 

This is an exciting time in healthcare and public policy, as healthcare reform legislation is almost ready with both the House and Senate developing bills to cover the uninsured. It will be important to our patients that nutrition therapy coverage and quality enteral and parenteral services be included in the final legislation. We are working on nutrition and public policy and welcome your feedback and contributions to our efforts.
 
Peggi Guenter, PhD, RN, CNSN
Director, Clinical Practice, Advocacy, and Research
peggig@aspen.nutr.org

A.S.P.E.N. Follows Healthcare Reform

A.S.P.E.N. is closely following legislation on healthcare reform, with the Public Policy Committee ready to review and respond on nutrition support issues. It is anticipated that Medicare may be cut back and that could affect Part B which covers home nutrition support therapy. We are developing an action alert letter so that members can support our call for legislative action. More details will be provided as the legislation moves forward.

The Lyn Howard Nutrition Support Consumer Advocacy Award - Nominations Due Nov. 15th

American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) members work directly with patients, families, and/or caregivers who perform admirable activities and heroically advocate for others like themselves and their families. To recognize those individuals, an award of appreciation to one patient/family member/caregiver is given annually. The A.S.P.E.N. Patient,  Family, Caregiver Advocacy Award has been named in honor of an A.S.P.E.N. member and Oley Foundation co-founder,  Lyn Howard, MB, FRCP. Nominations for the award are being accepted through November 15, 2009. A.S.P.E.N. annually presents this award to a nutrition support patient or caregiver who has demonstrated admirable activities which advocate for themselves or others receiving EN or PN. 

More Information..

NutritionDay U.S.

A.S.P.E.N. is supporting a new annual event, NutritionDay U.S., November 5, 2009. This event focuses on gathering nutrition intake and patient outcome data in the United States. It is an opportunity to increase awareness of the prevalence of disease-related malnutrition in the U.S. through patient monitoring and benchmarking. Led by our colleagues in the European Society for Clinical Nutrition and Metabolism (ESPEN), NutritionDay is a global initiative that has already been successful in more than 25 countries. The NutritionDay team is seeking participation from U.S. hospitals and charter sponsors. Organizations that are already endorsing and partnering in the project include:

  • A.S.P.E.N.
  • ESPEN (European Society for Clinical Nutrition and Metabolism)
  • SCCM (Society for Critical Care Medicine)
  • RD411, organization of Registered Dietitians

Hospitals can register for the program by contacting Gail Gewirtz at nutritiondayus@ymail.com. The name of each facility or unit as well as related details will be encoded to ensure anonymity. There's no special knowledge needed to conduct the audit. Single-sheet questionnaires make data collection quick and easy, while providing actionable information. All documents are provided by the coordinating center and are available on the global web site, www.nutritionday.org. Thirty days after NutritionDay, each patient's situation will be re-assessed, providing progressive outcome information for review and analysis. Each facility or ward will receive a comparison of its own results and the collective data from all units of the same specialty type. Examples of these reports from NutritionDay in Europe can be viewed on the global site, www.nutritionday.org. 

 

Medicare Proposed Ruling on Physician Payment

The A.S.P.E.N. Public Policy Committee sent comments to the Centers for Medicare & Medicaid Services (CMS) for the Proposed Rule published July 13, 2009: Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2010. This notice outlined proposed payment changes and new programs mandated by Congress under the Medicare Improvement for Patient and Providers Act (MIPPA) of 2008. Several new programs created under MIPPA provide opportunities for nutrition care for patients in physician offices and hospital outpatient settings. These programs include a new intensive cardiac rehabilitation (ICR) program and one for general cardiac rehabilitation (CR) as well as one for pulmonary rehabilitation (PR) and kidney disease education (KED).


A.S.P.E.N. commented that Registered Dietitians (RD) are the best qualified Medicare providers to deliver nutrition education and nutrition counseling services in Medicare covered benefits.  As such, A.S.P.E.N. recommends CMS recognize RDs in the regulations for these programs as qualified providers who can either individually or as part of the multidisciplinary team provide program topics on nutrition education and counseling. For those program(s) when an RD may not be available, we recommend a Nutrition Support Clinician (nutrition support physician, nurse, or pharmacist) provide nutrition education and counseling.

 

Practice Management Survey: Nutrition Support Teams & Reimbursement

A.S.P.E.N.'s Practice Management Task Force has completed the report on the current state of nutrition support teams; the content is based on survey data collected last summer. This exciting report will be published in Nutrition in Clinical Practice in early 2010.  Interviews of clinicians and data on reimbursement are also being analyzed and developed into a separate report.

 

Enteral Connectors Redesign

Recently in London, UK, a meeting was convened by the International Organization for Standardization in cooperation with the Association for the Advancement of Medical Instrumentation (AAMI) to discuss redesign of enteral connectors in order to prevent misconnections. An Enteral Connectors Working Group made up of representatives from industry, regulatory agencies, and safety organizations met, including an A.S.P.E.N. representative. The goal is to design standards for an enteral connector so that it is not compatible with connectors from other medical devices such as IVs, neuroaxial devices, breathing systems, medical gases, urinary systems or blood pressure cuffs. Standards redesign takes years to develop and implement but the concern is great about medical misconnections and the change process has begun. This group is working on an educational webinar on the issue and will be sponsored by AAMI, to be released in Spring 2010. A.S.P.E.N. initiatives and recommendations will be included.