Promoting high standards of health care throughout Delaware

DCNP Members Testify on Delaware Primary Care Legislation

Posted over 1 year ago by Susan Conaty-Buck

This announcement has 2 attachments:
SB227 (29 KB)

Dear DCNP Members and Followers:

Delaware primary care practices are closing or decreasing services due to inadequate reimburesement rates so patients are have trouble find practitoners for primary care or not getting the services they need from existing PCPs.  Our new NP students who want to work in primary care can't find jobs. The DCNP was invited to participate in stateholder meetings with Senator Townsend and Representative Bentz about this problem and these legislators proposed legislation requiring commercial insurers (i.e. Highmark, Aetna...) to increase primary care payments to a rate not less than the Medicare rate.  

If this sounds low, you may be interested to know Delaware primary care practitioners receive less reimbursement than providers in other states.  Around the country, commercial insurers pay primary care 20 to 30 percent above Medicare rates. In Delaware, commercial insurers pay independent primary care practitioners 15 to 35 percent below Medicare rates, and even less than Medicaid rates.

After consideration and discussion with your DCNP Board of Directors, we agree to support SB227 which has as its goal to require commercial payers to increase rate of payment to primary care practices.   Members of our board attending meetings and testified on behalf of DCNP for this bill during the Senate committee meeting and again yesterday during the House committee meeting.  A copy of this statement is attached. The bill passed unanimously in the Senate and passed in the House Committee yesterday with an amendment to delay the start of the payment until January per request of Highmark.  A copy of this bill without the new start date is attached.

It is important Nurse Practitioners understand this bill but especially the part that requires payers to pay a minimum the Medicare rate for primary care.  For Nurse Practitoners this language is concerning because the CMS rate structure for NPS is 15% below the physicians rate.  Agreeing to accept the Medicare rate could be seen by the commerical insurance vendors as NPs agreeing to this 15% reduction for any patient not covered by Medicare.  There were attempts to write into the legislation this was not acceptable. After several tries, we settled on bill lanuage stating nothing in the legislation is meant to imply it is calling for insurance vendors to follow the  Medicare payment structure (15% less for NPs). 

So what does this mean to you?

1) We need you to contact your House of Representative's member asking them to support SB 227.  Use the language in our statement and let your legislator know what this means to your patients, the need for practices to stay open, and jobs for our newly graduated NP who want to work in Primary Care.  Not sure who to write to?  Please click on this link  FindMyLegislator . 

2) If you work in primary care please talk to your practice adminstrator.  Rates should be going up in January if this legislation passes.  If yours does not go up or your find the rate of physicians is going up but yours is flat or going down, please contact the DCNP board immediately so we can investigate this and report it to the  DE Insurance Commission.

Thanks for your attention to this matter.  Each of us must advocate for our patients and our practice.  We have been given the opporunity to be at the table for this issue and your board is working to make sure we continue to be seen as fully recognized healthcare providers in Delaware.   As the saying goes for those seated at the table: we can choose to eat or be eaten. Please show your support for the work of our organization through your advocacy, membership and participation.  

Best wishes for a safe and healthy summer.

Susan Conaty-Buck, DNP, APRN, FNP-C

President, DCNP