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New Medicare Rules Help Nurses Fight the Flu

Influenza and pneumonia season is here again, and that means an estimated 18,000 to 36,000 Americans age 65 and older are at especially high risk of dying from these illnesses this winter. Even though preventive vaccines are a covered benefit of the Medicare program, the Centers for Medicare & Medicaid Services (CMS) reports that in 2001 only 66.6% of white Americans in this age group received flu shots. The figures for Hispanics and for African Americans are even worse--only 55.7% and 48%, respectively.

To help save more senior citizens’ lives and close this minority immunization gap, CMS--the federal agency responsible for the Medicare and Medicaid programs--has issued new regulations that will make it easier for hospitals, nursing homes and home health agencies to administer flu and pneumonia vaccines to elderly patients covered by these plans. Because the changes remove regulatory barriers that had limited the ability of non-physician medical staff to vaccinate Medicare/Medicaid patients in a timely manner, nurses are now better positioned than ever before to play a leading role in protecting elderly minority patients from preventable flu/pneumonia complications and deaths.

Where allowed by state law, the new rules now enable nurses and other appropriate non-physician medical staff in elder care settings to provide flu and pneumococcal vaccines without an individualized physician order when a standing order system is in place. According to Peter Houck, MD, chief medical officer of the CMS Seattle regional office, “A standing order program relieves the burden from the physicians so that they do not have to sign for each individual patient, making it a more effective and efficient system.”

CMS expects these improvements to help boost immunization rates for approximately 12.7 million Medicare/Medicaid hospital patients, 1.5 million residents of long-term care facilities and more than 4 million seniors in home health care programs. For more information about the new regulations, see the CMS Web site at www.cms.gov/providerupdate/regsum.asp#3160FC.