NSGC Billing and Reimbursement Education

While genetic counselors are educated in the medical model, the profession has not been fully integrated into the health care system. As a result, consumer access to care and adequate reimbursement for services are severely lacking. The following explains why this is so, how improvements can be achieved, and how NSGC is planning to improve the access to genetic counseling services. This is aimed at educating the membership about NSGC’s plans to improve the outlook. Included is background about state and federal legislation, as well as specific language common to these laws that will be used in our state and federal efforts.

General Background

What does it mean to be fully integrated into the health care system?

As we all know, genetic counselors and their services are typically not directly reimbursed causing very little revenue generation. If we continue to be subsidized by grants or by our institutions, this could result in a reduction of employed genetic counselors and in turn will limit the number of patients who receive quality genetic services. In some instances, genetic counselors have been successful in gaining direct payment from insurance companies; however, not many genetic counselors have been successful in this recognition.

If you look at other health care providers who are considered fully integrated, they have attained state licensure, recognition by the Centers for Medicare and Medicaid Services, and they are reimbursed for their services by health insurance. Many allied health care professionals have been successful in achieving these goals, such as certified nurse midwives, nutritionists, physician assistants, and physical and occupational therapists. This recognition allows patients to easily access their services.

Why are genetic counseling services not fully integrated into the health care system?

The main reason is the lack of regulation and recognition by state and federal laws of both genetic counselors and genetic counseling services. State laws regulate both healthcare practitioners and medical services provided in the state while federal statutes regulate the delivery of services through a provider’s direct participation in federal health programs such as Medicare. The lack of regulation and recognition for genetic counselors leads to poor access and reimbursement for services as payers (commercial health insurance carriers) often won’t allow the direct participation of genetic counselors in their programs. It is because of these factors that the provision of genetic counseling services has not been integrated into the health care system as well as it has for other licensed and federally recognized providers. Many other healthcare professionals have faced or face these same problems. These issues are not unique to genetic counselors.

What progress have genetic counselors made to integrate themselves into the health care system?

On a national level, two steps have already been taken to help address this problem. First, genetic counselors have been granted the ability to obtain a National Provider Identifier (NPI) and the second was the creation of the new CPT code specifically for use by genetic counselors.* At the state level, 5 state licensure laws have been passed allowing genetic counselors in these states to become licensed providers. Perhaps most importantly, these advances illustrate that policymakers are willing to recognize the uniqueness of our profession and services. However, federal legislation as well as state licensure in more states is necessary to broadly take advantage of these accomplishments.

*For more information on these issues, please see Perspectives volume 28, issue 2 (Summer 2006) and the CPT FAQ on the NSGC website.

Who decides what services health care practitioners are legally able to provide?

Under the 10th Amendment of the U.S. Constitution, states have the authority to regulate activities that affect the health, safety and welfare of their citizens. To protect the public from the unprofessional, improper, unlawful, fraudulent and/or incompetent practice of medicine, state laws and regulations provide the outline for the delivery of quality health care.

The federal government also regulates certain providers to deliver care in federal health programs generally through the mechanism of reimbursement for services. The Centers for Medicare and Medicaid Services (CMS) oversee Medicare and Congress passes legislation that dictates the benefits covered and who can provide them to Medicare beneficiaries. Other payers will often follow CMS policies regarding the delivery and payment of services.

It is important to recognize that state and federal regulations are interrelated in terms of helping more people access genetic counseling services.

Why pursue both state and federal legislation?

It will be difficult and time-consuming to pass 50 state licensure bills. Licensure will not always be possible due to a small number of providers residing in some states making it prohibitive from a cost versus the public interest standpoint. Politically it may not be possible as well. Passing one federal bill will allow services to be delivered to Medicare beneficiaries nationally, and since many payers follow the lead of CMS, ultimately this will lead to additional integration into the health care system. The federal bill would allow genetic counselors to directly bill for services and also create a federal scope of practice with a mechanism to protect consumers. In a state that does not have licensure, these federal provisions would provide a delivery of care model that payers may adopt, thus allowing consumers increased access to services.

Why is it important for us to pursue legislation?

State and federal statutes will improve access to genetic counseling services for our consumers and help with reimbursement. In order to accommodate for the influx of genomic information, we need to grow as a profession to serve our clientele. To do this, genetic counselors need to achieve a level of recognition that gains status with insurers, legislators, physicians, and patients. Becoming recognized providers allows us to expand how we practice, thereby increasing access to care and meeting the increasing needs of our consumers.

What issues will be considered by policymakers when enacting these bills?

Whether enacting laws at the state or federal level, there are certain factors that legislators will need to consider including: the economic impact on health care delivery; standards for education, training and examination; practice parameters (scope of practice); and regulatory mechanisms. Patient safety, costs, accountability, and access to care are the most important factors in establishing expectations and limitations associated with these bills.

What needs to be included in both types of bills?

The components of the bills will include provisions that will allow genetic counselors to better integrate into the existing healthcare system. The integration would be similar to other providers, thus allowing the practice of genetic counseling to take place in a variety of settings. Legislation would define “genetic counselor,” including our qualifications and our scope of practice. It would also need to define how we practice to some extent, including issues of supervision. Title protection is also a component that determines who can call themselves a "genetic counselor."

What legislative components are different between the federal bill and state licensure bills?

In the federal bill, it will be important to include information about how consumers access our services and the mechanism of payment. The bill would allow counselors to provide services in all types of work settings (for example, in a teaching hospital versus a community hospital versus a private practice office). Medicare is a payer, therefore, the bill would define under what circumstances and how payments for genetic counseling services are made.

There will also need to be language regarding certified genetic counselors practicing in states without licensure. In these states, the ABGC grievance process would act as the body that protects the public much like a medical board would in states with licensure.

In state licensure laws, billing arrangements are usually not specified although it would be typical for this legislation to define supervisory or collaborative relationships with other healthcare providers which ultimately influences billing practices. Additionally, licensure legislation routinely includes provisions for addressing grievances against individual providers.

Are there any anticipated hurdles to passing legislation?

Yes. There are several issues that could become contentious such as the defined scope of practice and how individuals access healthcare services. Currently, there are practice battles ensuing regarding some non-physician providers that desire direct access to patients. Direct access refers to whether a referral is needed to see the non-physician provider (e.g. self-referrals) and physicians are standing firm on their involvement in the referral process. Although NSGC supports direct access for our services, we are willing to compromise on this issue rather than jeopardizing the enactment of legislation that will only accommodate a small number of our patients who have no access to a physician referral. In these limited cases, it is likely that the counselor can help find such a referral source.

State Licensure

How is state licensure created?

Historically, state legislatures have enacted laws to create state medical and/or specific health practitioner licensing boards. The legislation generally provides authority to the boards to develop rules (“rulemaking authority”) governing the specific activities and roles of the health care professionals in that state, although, in some cases, the legislation may specify certain regulations itself. The board acts as an overseer for the profession in the state.

State governments generally do not actively seek regulation for specific professions without cause or input from constituents/citizens of the state. There are several avenues that can result in state regulation of a health profession. The most common way is for members of a profession to actively pursue regulation themselves usually because of the desire for state recognition and opening the avenue for better consumer access and reimbursement for services. Legislators are only interested in supporting regulation if there is reason to believe that harm will come to citizens if the profession is not regulated; members of the profession usually need to provide evidence of harm in order to gain legislative support for regulation.

What is a state medical or licensing board?

This is the entity that administers the licensing provisions for health professionals in a state. Its primary function is to ensure that services provided by the professionals it licenses are performed safely and competently by developing and enforcing standards of practice. Patient safety is at its essence

Some states have one medical board with allied health care professionals falling under its jurisdiction. Others have created specialized licensing boards specific for each allied health profession.

Do all health care providers have state licensing?

No. Some providers are not recognized in state law, and there are many possible reasons why they are not referenced. One reason is that it is expensive for states to regulate small numbers of providers. Another reason is that legislators may not believe there is significant risk of harm to consumers that would warrant the expense of regulating the occupation. Because licensure is a way for payers to determine whether or not a provider or service is truly qualified to provide services, lack of licensure generally results in payers not recognizing or directly paying these providers.

What does licensure do?

Licensure mandates that all licensed providers follow certain rules when providing services; these rules are intended to protect consumers and the profession.

A state licensing law defines a profession with a unique scope of practice and qualifications that separates it from other providers and the public. It then establishes a license for those individuals who attain the qualification so that the public is able to identify qualified providers. The license can be viewed as a seal of approval from the state. It ensures that only those people who qualify may use the title “genetic counselor,” but it doesn’t prevent other professionals from providing genetic counseling services if it is within their scope of practice. However, others will not be able to use the title “genetic counselor.” State licensure requires a governmental entity (licensure board) to oversee the licensed professional.

State licensure will help enable genetic counselors to be integrated into the health care system. It will make it more likely for third party payers to include genetic counseling services in their plans and directly pay genetic counselors for their services.

How is licensure different from certification?

The two are very different. Certification is a professional designation conferred by a credentialing board that identifies a professional as having met certain educational and examination standards. In our profession, this is the American Board of Genetic Counseling (ABGC). Certification is voluntary. Additionally, it does not have any regulatory standing. Conversely, licensure is conferred by a state regulatory board/agency, identifying providers who meet state-required standards for competency and is mandatory for all providers who use the title, and is legally binding (i.e., providers without a license cannot legally provide services or use the title in states that have licensing). Additionally, licensure provides a mechanism to sanction professionals who do not adhere to the tenants of the state law. Many professionals need to demonstrate certification as a prerequisite to licensure but this is not always the case. All of the genetic counseling licensing bills to date have used ABGC certif ication as a prerequisite.

How do licensure laws protect the public?

Licensure laws specifically require that professionals meet certain education and/or certification standards and follow minimum standards for continuing education. The law also specifies the scope of practice a professional is able to provide consumers and mandates recognized standards of professional conduct. Professional accountability occurs by granting the Board authority to develop a process to respond to and investigate complaints involving a professionals practice. This process will evaluate an individual’s compliance with state law, board rules and regulations, and identify patterns of substandard care. Boards generally have full discretion and authority with respect to disciplinary actions when it determines that a violation has occurred. It is this particular activity of licensure that ensures the public’s protection.

How do genetic counselors attain state licensure?

They will need to pass a state licensure bill. California, Utah, Illinois, Oklahoma, and Massachusetts have passed genetic counseling licensure laws, but to date only Utah has implemented their state licensing. NSGC supports state licensure efforts and many states are currently pursuing it. The Licensure Subcommittee is creating documents to help guide states in their efforts. Look for these on the NSGC website in the coming weeks.

How is licensure tied to access to services and payment?

Licensure allows for the recognition of a profession through regulation. Private health insurance plans are more likely to recognize the profession and services they deliver, because there is a mechanism of regulation in place. It is also provides a mechanism by which an insurer can identify qualified providers. The insurer doesn’t have to regulate the provider themselves. This can lead to better access for consumers as the payers are more apt to cover and provide direct reimbursement for services.

Is licensure required for consumers to access our services?

Not always, but it will help. Even without licensure, genetic counselors can participate in private health insurance plans if they can gain recognition from a plan, but payers often require some type of regulatory regime to be in place to guide the profession. Payers have specific requirements that need to be met in order for a professional to participate in a plan and further requirements for them to be reimbursed directly. These decisions are determined on a state or regional level. Because we have a health care system that contains different payers (Medicare, Medicaid, private insurance), recognition of genetic counselors needs to occur at different levels so that consumers and beneficiaries of these plans areas are able to access our services.

Federal Legislation

How are federal regulations created for health care providers?

Laws need to be enacted by the U.S. Congress. Health care providers and their professional organizations have pursued enactment of federal laws for various reasons such as having the ability to participate in federal health care programs. NSGC will do the same and pursue legislation that affects Medicare.

What would federal legislation do?

Federal legislation, drafted by NSGC, would amend the Social Security Act (SSA) to allow Medicare beneficiaries to access genetic counselor services and allow the direct reimbursement for these services to genetic counselors. The SSA is federal legislation that outlines what healthcare services can be provided, how that care is delivered, how the providers are paid, and what level of payment the providers are subject to under Medicare. Schemes such as accessing services and payment are prescribed in the SSA. The SSA is modified by Congress; therefore, genetic counselors need to work with Congress to pass a bill to gain this recognition. NSGC will need to find a congressional champion to introduce legislation and then work to have the bill enacted. A champion is a congressperson who introduces the legislation and will stand up for our cause.

Can genetic counselors participate in Medicare now?

Yes, but on a limited basis. In order to be a provider of record under Medicare using your individual NPI, the provider needs to be recognized under the Social Security Act. Genetic counselors are not listed in the SSA because the field is relatively young and Congress has not passed legislation that includes us. Genetic counselors, therefore, cannot be directly reimbursed when they see Medicare patients and can only participate by providing services "incident to" a physician.

Why is it important for genetic counselors to practice under Medicare?

Medicare has roughly 40 million beneficiaries making it the largest insurer in the country. Their coverage and reimbursement policies have a lot of influence even though it only covers people 65 and older and individuals with disabilities. Although many consumers of genetic counseling services are not Medicare beneficiaries, recognition under Medicare is critical as private health insurers often adopt CMS policies in terms of these coverage and payment decisions.

How would the federal bill help with payment for our services?

If the federal bill was enacted into law, genetic counselors would be paid directly for services provided to Medicare beneficiaries. Certified genetic counselors might be reimbursed by Medicare using CPT code 96040. It is also possible that federal recognition would allow us to use other CPT codes, such as the evaluation and management (E&M) codes used by other health care professionals.

Would we receive the same payment as physicians?

It is customary for allied health professionals to be paid at 50%-85% of a physician’s payment. The federal bill most likely will create the payment at 85% of the physician’s payment but it may depend on the exact mechanism used. The current genetic counselor CPT code, 96040 is a non-physician code therefore payment should be 100% of the value. The committee who assigns the cost or value to a code placed the payment at approximately $70/hour. CMS, the payer of Medicare, may not accept this value but it can be used as a guide. If the legislation allows physician E&M codes to be used, the bill would set payment at 85% of the physician’s payment.

Are the terms of the federal bill set in stone?

The federal bill is presently in the drafting stage and details won’t be known until the bill is introduced. We need to test the waters and see if the champion or cosponsors of the bill have any suggestions, which could alter its language. The bill could also be amended by Congress through the legislative process. After enactment, we can attempt to amend the bill as needed to respond to changes occurring in how healthcare is delivered.

American Board of Genetic Counseling’s Relationship to Legislation

How will we define a genetic counselor? The following are the definitions to be used in both the Federal and State legislations.

• "Certified Genetic Counselor" means an individual who has obtained certification from the American Board of Genetic Counseling (ABGC) or the American Board of Medical Genetics (ABMG) and who is eligible to be covered by these bills.
• "Licensed Genetic Counselor" means an individual who is licensed as a genetic counselor by the State in which the individual furnishes to engage in the competent practice of genetic counseling.

Why should ABGC certification status be used to determine who will qualify for a state license or recognition under Medicare?

Most states require some type of an examination (certification) to verify proficiency in the field. Certification reflects achievement of a certain level of training and expertise that helps ensure public safety. It is the credential that separates certified genetic counselors (CGCs) from other providers and the public. ABGC certification demonstrates competency has been successfully completed by passing an examination. Utilizing the ABGC certifying examination limits the need for an additional state-specific licensing examination.

Will I be recognized by the enactment of legislation if I didn’t go to an ABGC/ABMG accredited training program?

In order to not exclude those counselors who entered the field before ABGC began to accredit training programs, the federal bill and newer state licensures bills will not require graduation from an ABGC accredited program. The requirement for obtaining a license or to be covered by the federal bill is having certification by either ABGC or ABMG regardless of your training program.

Why is NSGC adopting ABGC policies when pursuing regulation?

Utilizing ABGC certification is important for these efforts as it demonstrates competency in the field. Certification is the basis for licensing on the state level. In addition, for the state effort the ABGC certifying exam can act as the licensure examination reducing costs to the state.

For the federal effort, certification illustrates a level of competency and since there isn’t a medical board in place that oversees professional actions as there is with state medical boards, it will be favorable for federal legislators to know that there is a well-recognized credentialing body for genetic counselors that provides oversight of our professional standards. ABGC has a grievance process that protects the public from genetic counselors that are not in compliance with competency and ethical standards. ABGC policies can be found at www.abgc.net.

Scope of Practice Issues

What is a "Scope of Practice" (SOP)?

Scope of Practice is terminology used by licensing boards created in state and federal legislation for various medical related fields that define the procedures, actions, and processes that are permitted for a health care professional to perform in a clinical setting. The scope of practice is limited to those areas of practice where the individual has received education and clinical experience, and for which he/she has demonstrated competency.

A state license allows providers to deliver care in line with their scope of practice. State laws and the medical or licensing board ultimately define the scope of practice the provider is able to perform legally. The scopes of practice may differ from state to state within the definition of the same provider type, as these laws and regulations are unique to individual states. Each state has specific regulations based on entry education and additional training and practice.

Why is a scope of practice important?

Scopes of practice are among the most highly charged health care policy issues facing state legislators and health care regulators today. Debates on scope of practice can be contentious and are influenced by a variety of factors, including: fluctuations in the health care workforce and specific health care specialties; geographic and economic disparities in accessing health care services; economic incentives for physicians and other health care practitioners; and consumer demand. At the state level, requests to create, change, or expand a scope of practice needs the approval of the licensing board and sometimes legislatures. Patient safety and public protection must always be the primary objectives.

Will the scope of practice be defined in legislation?

In state legislation, it is advised that the bill be written to provide the Licensing Board with the power to define the scope of practice if the majority of Board members will be genetic counselors and there is confidence they will control the rulemaking process. However, it should be defined specifically in legislative language if licenses will be administered by a medical board or another regulatory agency as input from genetic counselors would be limited.

Will the federal bill contain a defined scope of practice?

If you practice in a state with licensure, you will be bound by your state’s scope of practice. However, for those counselors in states without licensure, the federal bill will define the scope of practice when providing care to a Medicare beneficiary. Third party payers may adopt the federal scope in states without licensure as well.

How will genetic counselor legislation affect other licensed healthcare providers with overlapping Scopes of Practice?

We recognize that several other healthcare professionals (e.g. physicians and nurses) can provide genetic counseling services. As such, they will still be able to provide their services although they won't be able to call themselves "genetic counselors" since title protection will be written into the law. This does not restrict who can provide the services as long as it is within their own scope of practice.

Since regulations may dictate a scope of practice, will genetic counselors exposure to liability be increased?

It may. This is part of the protective nature of regulation although genetic counselors currently face liability even when regulation is lacking. Specific regulations that providers must adhere to may open the door to the possibility of professional sanctions if warranted. When a profession’s scope of practice allows for greater independence and responsibility the amount of liability may increase as well. Although liability insurance coverage (malpractice coverage) should be based on economic and risk factors, liability may increase as a health professional’s practice becomes more independent.

Issues Related to Practice

Will regulation affect the way we practice?

Genetic counselors function in a variety of roles and settings. It is important that legislation create regulations around supervision and collaborative relationships that appropriately allow genetic counselors to integrate into the health care system in way that reflects our training and expertise while serving the interests of the public.

What are the theories behind supervision?

Access and reimbursement for services provided by non-physicians are often dictated by the manner in how a patient saw a provider and the level of supervision involved. Relationships between genetic counselors and other providers in medical practice vary considerably. In legislation, the word supervision may have a meaning different from "practicing only with a physician" or "genetic counselor oversight." The following are various ways supervision may be defined.

• "General Supervision" means a supervisor has the overall responsibility to assess the work of the supervisee; this may include regular meetings and chart review. The supervisor’s presence is not required during the provision of the service. An annual supervision contract signed by the supervisor and supervisee must be on file with both parties.
• "Direct supervision" or "Incident to" includes all aspects of general supervision but requires that the supervisor is physically present in the office suite and immediately available to furnish assistance and direction to the supervisee throughout the performance of their work.

Who decides the level of supervision?

Legislation at the state and federal level generally will dictate the fashion in which patients are seen by certain providers.

NSGC will provide guidance to ensure legislative provisions promote the current or future practice of genetic counseling and attain recognition of the profession as valued members of the health care team.

Does NSGC have a position on what is appropriate supervision?

Yes. This should reflect the varied relationships between genetic counselors and other providers in a medical practice. In state licensure bills as well as the federal legislation, there are various ways supervision can be defined. Legislation should never require a licensed genetic counselor to practice under direct supervision. In some states, licensed genetic counselors may practice under general supervision and in others they may operate with complete independence. As previously stated, these issues are highly charged issues with other providers. If a state’s political climate requires a level of supervision that would impede patients’ access to genetic counselors, then it will be best to avoid licensure in that state.

Are there different levels of supervision for genetic counseling graduate students or for individuals who hold ABGC active candidate status in a state that licenses our profession?

Yes. Students should have direct supervision by a licensed genetic counselor or a physician. Individuals who have active candidate status should practice under general supervision by either a licensed genetic counselor or physician (ideally a board certified geneticist) until a full license is obtained. Some states have written in a time-limited temporary license to cover these individuals until they become certified.

Does legislation specify how patients access genetic counselor services?

Sometimes. Often it is spelled out in the legislation but may be left to the medical or licensing board to define. Again, this should be defined in legislation if genetic counselors will not have meaningful input in the rulemaking process.

"Collaboration/gatekeeper" refers to language specifying a requirement for some level of collaboration such as a plan of care or written referral by a physician or other healthcare provider while being able to provide independent genetic counseling services.

What will determine the level of supervision or whether there is a gatekeeper involved?

This is a very complex issue. Unfortunately, medicine is delivered differently regionally and there isn’t any one customary practice universally applied throughout the country. NSGC’s Scope of Practice purposely doesn’t define a specific level of collaboration or supervision. For state licensure, this will be left to negotiation by local genetic counselors, members of the medical community, and legislators as legislation is drafted. The goal is to make sure patients can access services while not being under the direct control of other providers who have less experience in genetics.

Enacting Legislation

Do we need to work with other health care professionals on these issues?

Absolutely! While other providers may not be critical components to the delivery of our services, some are important stakeholders and they have to be comfortable with our legislative efforts. Enacting legislation is not easy as there are competing interests and priorities. Everyone believes their priority is of the utmost importance. NSGC and our members need to make legislators realize why this issue requires action. We must have support from other medical professionals as they can have significant influence simply because of their greater numbers. If there are differences in the health care community regarding genetic counselor state licensure or practicing under Medicare, legislators may not act upon these measures because they’ll stick to issues where there is agreement.

Why are legislators involved?

Legislators will introduce and enact both state licensure bills and the federal bill. They are held accountable by their constituents and these constituents sometimes have competing interests. Therefore, genetic counselors need to make their voices heard on these issues.

It is also important to understand that certain groups within the medical community are engaged in scope of practice disagreements and are asserting themselves through legislation or other initiatives. NSGC is working with other providers to ensure these legislative efforts are ultimately in the best interests of our patients and all consumers of our services.

Do politics enter into these issues?

Yes, any time legislators and legislation are involved, politics come into play. NSGC will work hard with all the interests to ensure these issues remain nonpartisan and the best interests of consumers are not compromised.

Why do legislators care about this issue?

Keep in mind that your representatives are elected by you, they work for you, and you need to hold them accountable. You need to make sure that your representatives hear from you and consumers regarding the importance of these issues. Without proper reimbursement of our services, we remain largely dependent on support from others, such as grants or sponsoring institutions, which can be unstable sources of funding. Ultimately this can jeopardize access to quality genetic counseling services that will directly impact consumers in the legislators’ constituency. Members of NSGC must make consumers and legislators aware of these issues, educate them, and request they take action.

Is it important that the legislator truly care about our issue?

The most important thing is to find a champion legislator for your cause. It may take some effort to find someone who is truly committed and who will spend political capital on the issue. This means that they may be willing to compromise their position on a different issue in order to help push through our bill. It is worth doing substantial due diligence to ensure your champion will truly represent and carry forward the policy that you require. Again, these legislators work for and are accountable to you as constituents. It is also advantageous to find someone who may be in a position to expedite the process. Find a health policy leader, committee chair, or a member of the leadership.

How long will these efforts take?

For state licensing, it will take some time to achieve licensure in all 50 states. Politics will come into play which is why finding a champion is so important. It also will depend on how long a legislature is in session and how often they meet. It could take as little as a year and it wouldn’t be out of the norm for it to take 5 years or more. Sometimes it just might not be possible if you have a small number of counselors in a state. Budget issues will come into play as many states won’t create an infrastructure for so few providers.

The federal effort will also take some time as NSGC has done limited advocacy in our nation’s capitol in the past. That is why the NSGC membership will be important as effective advocacy relies on the ability to convey local, personal stories to your representatives. We will need to really educate members of Congress about the profession and our field.

If our members truly mobilize themselves, our consumers, family, and friends, we should enjoy success over time. This is what is called a grassroots effort.

How will NSGC help pass these bills?

NSGC has a lobbyist who is able to provide guidance and counsel for the state efforts and who will direct the effort to pass the federal bill. NSGC has developed policy papers that can be customized to your state, to help aid the state licensure effort. We have a checklist of guiding principles and model legislative language that can be used for these efforts. We will also be creating a grassroots network to make it easier for the membership to contact their legislators. Please check out the NSGC website advocacy corner for more information

What can I do to help?

Look for notices to join the grassroots campaign later this spring.

What will the grassroots campaign do?

It will enable you to easily and quickly contact your legislators through email and personal visits. It is also important that the contacts be followed up on throughout the year to ensure the legislator ultimately supports the efforts. Communicating these contacts to the folks leading the effort in your state, or our lobbyist in Washington DC for the federal effort, will ensure these contacts are tracked and follow-up on.

Will NSGC help me meet with my legislators?

Yes. We will have background information and summary papers on both the state and federal effort. For the state efforts, organization is taking shape amongst the members within each state and NSGC is able to provide guidance. For the federal effort, NSGC will help you set up meetings with your Representative and Senators. If you find yourself in Washington, DC, we’ll arrange an in-person meeting with your legislator or their staff. If you’d like to meet with them close to home, we can also help arrange this as well