The mission of the GAPNA Health Affairs Committee is to track and promote legislation and policies that enhance APN practice and quality care for older adults.
GAPNA is a member of the Nursing Community Coalition which is comprised of national professional nursing associations dedicated to building consensus and advocating on a wide spectrum of healthcare issues, including practice, education, research, and regulation.
The Nursing Community Coalition is committed to improving the health and health care of our nation by collaborating to support the education and practice of registered nurses (RNs) and advanced practice registered nurses (APRNs).
Below find letters in support or opposition of current/pending legislation.
March 6, 2023 - U.S. Citizenship and Immigration Services Fee Schedule and Changes to Certain Other Immigration Benefit Request Requirements (RIN: 1615-AC68)
March 3, 2023 - Sign On Letter CMS-2023-0010, 2024 Medicare Advantage and Part D Advance Notice
March 1, 2023 - CMS-2023-0010, 2024 Medicare Advantage and Part D Advance Notice
January 26, 2023 - Sign On to Letter to CMS on Extending Telehealth Codes through CY 2024
December 12 2022 - President Biden Sign-On Letter On CMS Amyloid PET CED
October 11, 2022 - Transparency Section 6101 Sign-on Letter
September 26, 2022 - NCC Fall Priority Letter
September 15, 2022 NCC FY 2023 Title VIII and NINR Updated Request
August 12, 2022 CMS-4203-NC; Medicare Program - Request for Information on Medicare Advantage
July 8, 2022 - Public Statement on Medicare Coverage of Medically Necessary Oral and Dental Health Therapies
June 18, 2022 - NCC Nurses Week Resolution Thank You
June 9, 2022 - NCC Letter Supporting S.4182 Workplace Violence Prevention Act
June 7, 2022 - NCC SC Letter Supporting H.R. 6087
May 11, 2022 - NCC Senate FY2023
May 11, 2022 - NCC House FY2023 Testimony
May 6, 2022 - NCC Nursing Priorities Letter
April 25, 2022 - NCC Waiver Request Letter Final
April 11, 2022 - NCC FY 2023 Title VIII and NINR Request Senate
April 11, 2022 - NCC FY 2023 Title VIII and NINR Request House
March 18, 2022 - 4 NCC Welcome Letter to AHRQ Director Dr. Otto Valdez
February 24, 2022 - APRN Workgroup Letter to the Departments To January 19 Listening Sessions
February 14, 2022 - NCC U.S. Cadet Nurse Corps Support Letter to HVAC
January 19, 2022 - NCC FY 2022 Title VIII and NINR Requests
January 19, 2022 - NCC BBB Act Requests January 19, 2022
July 14, 2021 Congressional Task Force on Alzheimer's Disease and Congressional Neuroscience Caucus
December 17, 2020 - AELTCC Letter PFS Cuts in 2021
September 30, 2020 - NCC Letter to Support FAAN Act
September 11, 2020 - NCC Letter on United States Cadet Nurse Corps Service Recognition Act of 2019
September 18, 2020 - Stakeholder Letter of Support IAH Extension
June 18, 2020 - Post COVID Telehealth Priorities
May 21, 2020 - LEAD Coalition Letter- Leaders Engaged on Alzheimer's Disease
May 21, 2020 - Community Statement on the Integral Role of Oral and Dental Health Care in Protecting Americans from Viral Pandemics
May 19, 2020 - Reasonable Liability Protections
May 15, 2020 - COVID-19 Nursing Mental Health Letter
April 14, 2020 - Development of Medicare Quality Innovation Network - Quality Improvement Organization (QIN-QIO)
April 16, 2020 - APRN Practice Expansion
April 13, 2020 - Red Hand Alert Letter
March 23, 2020 - Statement Regarding Nurse Practitioner Students and Direct Care Clinical Hours
January 17, 2020 - Centers for Medicare and Medicaid Services (CMS) feedback on Scope of Practice Letter
December 20, 2019 - Support Letter of President’s Executive Order entitled Protecting and Improving Medicare for our Nation’s Seniors (EO)
December 13, 2019 - Repeal Letter of the Health Insurance Tax (HIT) for Medicare Advantage and Part D Beneficiaries
August 8, 2019 - NP Roundtable Positionon Post-Licensure Clinical Training
March 21, 2019 - National Nurse Acton 2019
February 21, 2019 - Nurse Practitioner Perspective on Education Post Graduate Training
November 26, 2018 - Regulatory Provisions on Burden Reduction Comment
GAPNA, in support of the Home Health Group, appreciates the opportunity to provide comment in response to the proposed rule to promote program efficiency, transparency and burden reduction in the Medicare and Medicaid programs (83 FR 47686). Supporting organizations are writing in support of reducing burden on nurse practitioners, certified nurse-midwives, clinical nurse specialists(collectively referred to as advanced practice registered nurses-APRNs), and physician assistants (PAs) within the Medicare and Medicaid Home Health Care Programs.
November 16, 2018 - Letter in Support of Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction; Proposed Rule (83 Fed. Reg. 47686 September 20, 2018)
July 20, 2018 - Credit for Caring Act
Proposed legislation, called the Credit for Caring Act, would create a federal, nonrefundable tax credit of up to $3,000 for family caregivers who work while also financially helping their parents, spouses, children and adults with disabilities or other loved ones. The bill (S. 1151/H.R. 2505) was introduced by Sens. Joni Ernst (R-Iowa), Michael Bennet (D-Colo.), Shelley Moore Capito (R-W.V.) and Elizabeth Warren (D-Mass.), and Reps. Tom Reed (R-N.Y.) and Linda Sánchez (D-Calif.). AARP has endorsed the Credit for Caring Act, as have other national organizations. AARP is urging the inclusion of this family caregiver tax credit in the final tax reform package. Read the article.
June 22, 2018 - Diabetic Shoe Bill Introduced in the Senate
Last week, Senators Brown (D-OH) and Collins (R-ME) introduced S. 3067, the Promoting Access to Diabetic Shoes Act, a companion bill to H.R. 1617. This bipartisan bill would authorize nurse practitioners and physician assistants to certify a Medicare beneficiary’s need for therapeutic shoes, thus improving the timeliness and access to care while reducing costs.
Please use the AANP Advocacy Center and ask your Senators to cosponsor S. 3067, the Promoting Access to Diabetic Shoes Act.
June 22, 2018 - GAPNA Partnering with AANP and Requests Your Action Now!
This week, the House will continue to vote on bills directed at combating the opioid crisis. We ask that you please reach out to your Representatives and urge them to support H.R. 6, the SUPPORT for Patients and Communities Act – particularly, Section 303. This section will make permanent the authorization, originally granted in CARA, for nurse practitioners and physician assistants to prescribe medication assisted treatments (MATs) and will authorize certified nurse-midwives, clinical nurse specialists and nurse anesthetists to prescribe MATs for a five-year period.
Use the AANP Advocacy Center to continue to send letters to your Members of Congress, urging them to support H.R. 6, the SUPPORT for Patients and Communities Act – particularly, Section 303.
June 19, 2018 - Thank you letter to the Chairmen Walden and Brady as well as Ranking Members Pallone and Neal
June 19, 2018 - Letter to the Honorable Kirstjen M. Nielsen
06-07-2018 - Expand Access to Opioid Addiction Treatment
Lawmakers in both chambers of Congress continue to advance legislation combating the opioid epidemic. As nurse leaders, you know firsthand the devastation and human suffering caused by the opioid epidemic. Our country needs common sense solutions to reduce barriers to care.
The Addiction Treatment Access Improvement Act, H.R. 3692/S. 2317, introduced in both chambers would amend the Controlled Substances Act to permanently authorize advanced practice registered nurses-nurse practitioners, certified nurse-midwives, clinical nurse specialists, and certified registered nurse anesthetists-to prescribe medicated-assisted treatment, specifically buprenorphine, to patients struggling with opioid misuse and addiction.
Urge your legislators to co-sponsor the Addiction Treatment Access Improvement Act and to support its consideration when the full House and Senate take up their respective opioid bills/packages.
03-23-2018 - Congratulations Letter to Secretary Azar Health and Human Svcs
03-22-2018 - Appropriations and Gun Violence Research Act
Below find letters in support or opposition of current/pending legislation. Also included are short articles in the "Legislative Corner," regarding recent legislative information, which are marked with (*LC) after the date. Items are listed by the date they were added to the site.
12-20-17 - ARPN Letter CMS on Carrier Advisory Committee
11-21-17 - Health Insurance Tax letter
10-31-2017 - APRN Letter on VA Telehealth Proposed Rule
10-18-2017 - NCC Letter to new Acting HHS Secretary
10-11-2017 - APRN comment letter on CMS Physician Fee Schedule Proposed Rule Date: Sept 11, 2017
06-01-2017 - 2017 Statement Commitment to America's Health
03.10.2017 - IAH Act Support Letter 2017
03-02-2017 - NP Roundtable Letter to Senate Finance Committee
03-02-2017 - NP Roundtable Letter to Senate HELP Committee
03-02-2017 - NP Roundtable Letter to Ways and Means Committee
02-02-2017 - NP Roundtable Letter to Energy and Commerce Committee
01-01-2017 - NC VHA Comments CRNA 2017
12.16.2016 - Nursing Community Transition Letter to the Honorable Mike Pence, Vice-President-Elect, Chair of the Presidential Transition Team
On December 12, 2016, the Nursing Community sent a letter of transition to the Honorable Mike Pence, Vice-President-Elect, Chair of the Presidential Transition Team.
GAPNA was among 60 national nursing organizations within the coalition to sign this letter.
06.01.2016, 06.13.2016 Updated (*LC) -- The Sign on Letter -- Regarding Veterans Administration Proposal to Expand Veterans Access to Quality Healthcare, Help Reduce Wait Times
Please take a few minutes to review and respond to a proposal published in the Federal Register by the Veterans Health Administration. The VA has proposed a policy that would allow all of their APRNs to practice to the full extent of their training and education. This is significant and will do much to advance scope of practice opportunities in those states with reduced or restricted practice authority. GAPNA is joining other APRN organizations and encouraging all members to comment on the proposal. In an effort to support you the Health Affairs Committee has developed a template to use for your response.
GAPNA and the Health Affairs Committee thanks you for your support!
5.25.2016 (*LC) Veterans Administration Proposal to Expand Veterans Access to Quality Healthcare, Help Reduce Wait Times
The VHA proposal extends the definition of Full Practice Authority to Advanced Practice Registered Nurses (APRNs) serving in the Veterans Health Administration (VHA). The rule was published in the Federal Register on May 25 triggering a 60-day public comment period ending on July 25, 2016.
The rule protects Veteran patient safety, defines Full Practice Authority within the VHA system and its facilities, and defines an APRN as a person who has successfully completed an accredited graduate-level educational program in one of the four distinct APRN roles (Certified Nurse Practitioner, Certified Registered Nurse Anesthetist, Clinical Nurse Specialist, and Certified Nurse-Midwife), has passed a national certification exam, and possesses licensure in a state.
The Health Affairs Committee encourages all members to review the proposal and submit a public comment.
04-28-16 Final APRN letter to HE&C-H
05.21.2015 APRN letter on the NIH National Pain Strategy
05.05.2015 Letter to VA Secretary McDonald in support of full practice authority for APRNs in the VHAXX
03.24.2015 3.24.2015 APRN Groups Call for Swift Passage of HR 2, “Medicare Access and CHIP Reauthorization Act"
03.03.2015 HR 1247 Improving Veterans Access to Quality Care Act of 2015
02.11.15 - APRN Groups Express Support and Recommendations for the 21st Century Discussion Document
02.03.2015 - NC congratulatory letter to Margaret C. Wilmoth, PhD, MSS, RN, FAAN Major General U.S. Army Reserves on her U.S. Senate confirmation
02.03.2015 - NC letter to the newly elected representatives of the new 114th Congress
02.03.2015 - NC letter to the newly elected senators of the new 114th Congress
02.03.2015 - APRN comment letter on ACO proposed rule
11.05.2014 - NC Testimony for Senate Hearing on Ebola
10.27.2014 - The Nursing Community Stands United for Swift and Coordinated Action to Protect the Public and Health Providers against the Ebola Virus Disease
10.01.2014 - Support for the AHRQ Senior Advisor for Nursing Position
08.20.2014 - THEY’RE COMING HOME: Go Meet Them! - A Note from Health Affairs Chair Evelyn Duffy
08.18.2014 - Congratulations to Senator Merkley
07.28.2014 - Congratulations to Honorable Sylvia Mathews Burwell
06.11.2014 - Draft_NC Letter of Support Dr. Schwartz Congratulations to Honorable Sylvia Mathews Burwell
06.10.14 - Letter of support for President Obama’s nomination Secretary of HHS
06.10.14 - Letter of support for the VA modernize the VHA's Nursing Handbook
05.28.2014 - Nursing Community FY 2015 Senate LHHS Testimony
05.28.2014 - Sen Merkley DCL - Thank you from NC
05.28.2014 - Rep Hanna DCL - Thank you from NC
05.28.2014 - Rep Capps DCL - Thank you from NC
05.28.2014 - NC Thank You Letter to Secretary Sebelius
Read the letter | Status: Draft
05.20.2014 - 2014 Nurse Practitioner State Practice Environment
Nurse practice laws and regulations are specific to each state. View AANP’s quick reference guide for licensure and regulatory requirements, as well as practice environment details, for all 50 states and the U.S. Territories.
05.19.2014 - Nurse Practitioner Perspective on Education and Post Graduate Training
Read the letter | "NP Roundtable Releases Statement: Nurse Practitioner Perspective on Education and Post-Graduate Training."
03.13.2014 - Congress & Senate Ltrs to Approp - Nursing Workforce Dev Prog Support
03.04.2014 - NC - Ltr to HR McDermott re Eliminate Provision in DME Ruling
02.20.2014 - NC - Ltr Congrats RADM STrent-Adams on CNO Appt
02.20.2014 - NC - TY Ltr to KPNesseler for Service as CNO
02.12.2014 - (*LC) APRN Compact Comments from Lisa Byrd, GAPNA President
The Gerontological Advanced Practice Nurses Association (GAPNA) appreciates the opportunity to comment on the Advanced Practice Registered Nurse Compact proposed by the National Council of State Boards of Nursing (NCSBN). The document seeks to establish guidelines for a uniform licensure requirement (ULR) to encourage portability of licensure for APRNs, which is a laudable goal. However, we believe the document as presented raises serious issues of concern for practicing nurse practitioners nationwide, and particularly for many Gerontological Nurse Practitioners (GNPs).
The concerns are with Rule IV-the Grandfathering of APRNs. The proposed document currently states that if an APRN applies for endorsement in another state, the applicant would be forced to demonstrate that he/she meets the requirements as stated in the Consensus Model to be eligible for licensure within that state, specifically that their APRN educational program contain separate courses in Advanced Physiology/Pathophysiology, Advanced Physical Assessment, and Advanced Pharmacology.
The problem arises in that many of the older educational programs for Gerontological Nurse Practitioners did not offer these courses separately and may have combined the content from two or the three required courses into one course. Thus if the certified APRN who attended one of these programs attempted to establish licensure in another state, he/she would be subject to the ULR and face potential denial of a license to practice. While the APRN could retain their licensure in the state(s) where they currently practice, the APRN may no longer be eligible to obtain licensure elsewhere and face limited employment opportunities.
At a time when the demand for advanced practice nurses, particularly those with gerontologic expertise is expected to rise across the nation, it seems particularly imprudent to restrict mobility with a regulation designed specifically to enhance portability. This will limit the ability of NP’s to practice to the full scope of their education and licensure as well as hinder patient access to care.
GAPNA strongly recommends Rule IV be amended to allow Grandfathering of APRNs who hold a current license, have previously met the requirements for APRN licensure and have no encumbrances on their license to be exempted from the requirement of demonstrating separate courses in Advanced Physiology/Pathophysiology, Advanced Physical Assessment, an Advanced Pharmacology. Such a measure will greatly enhance portability and avoid barriers to practice and therefore improve access to care.
Lisa Byrd, PhD, FNP-BC, GNP-BC, Gerontologist
02.05.2014 - NC - Ltr to S - Support Dr Murthy Nomin as Surgeon General
02.05.2014 - NC - Ltr to HR - Proposed Changes to VHA Nursing Handbook
02.04.2014 - (*LC) Senate Passed Nursing Workforce Development Budget, Now on to White House
The Senate and House approved the final spending package and it will now head to the White House for the President to sign. The final bill includes:
- $156.8 billion for the Labor, Health and Human Services, Education, and Related Agencies (LHHS-ED) programs
- $223.841 million for the Nursing Workforce Development programs ($6.3 million more than the final FY 2013 post-sequestration funding level)
- $29.9 billion for the National Institutes of Health ($1 billion more than FY 2013 post-sequestration level)
- $140.517 million for the National Institute of Nursing Research ($4.1 million above the FY 2013 post-sequestration funding level)
The approval of the above bills affects you and your practice. They allow continued funding for the importance of nurse practitioner's as providers.
The 2013 Year in Review
12.11.2013 - APRN Ltr supporting draft legislation repealing SGR cuts to Medicare Part B and reforms Medicare paymentord 1 title
Recently the Committee has approved adding GAPNA’s name to a letter extending our support for legislation awaiting action in the Senate Finance and House Ways & Means Committees that permanently repeals the devastating cycle of "sustainable growth rate" (SGR) cuts to Medicare Part B and reforms Medicare payment.
11.20.2013 - NC Ltr to S/HR Supporting Nursing Education & Research
Read the letter | Status: draft
11.15.2013 - NC - Ltr to S-HR re FY2014 Educ & Research Prog
Read the letter | Status: draft