H.R. 1317: Improving Care and Access to Nurses Act

This bill, known as the Improving Care and Access to Nurses Act (or I CAN Act), aims to enhance access to healthcare services provided by advanced practice registered nurses (APRNs) under the Medicare and Medicaid programs. Here are the main components of the bill:

Title I – Nurse Practitioners

The bill seeks to remove barriers for nurse practitioners (NPs) in various areas:

• Cardiac and Pulmonary Rehabilitation: NPs will be allowed to provide and prescribe exercise for cardiac and pulmonary rehabilitation programs, expanding access under Medicare.
• Diabetes Shoes Coverage: NPs and physician assistants will be able to document the need for diabetic shoes for Medicare patients.
• Shared Savings Program: Improvements to how beneficiaries are assigned in the Medicare shared savings program will be made.
• Medical Nutrition Therapy: NPs will be included in the provision of medical nutrition therapy services under Medicare.
• Home Infusion Therapy: NPs will be empowered to create and manage home infusion therapy plans without physician supervision.
• Hospice Care: NPs will have a more significant role in providing hospice services, including billing for those services.
• Skilled Nursing Facilities: NPs will be authorized to care for Medicare and Medicaid patients in skilled nursing facilities more effectively.
• Medicaid Access: Increased access to Medicaid clinic services will be facilitated for NPs.

Title II – Certified Registered Nurse Anesthetists (CRNAs)

This section aims to clarify and improve reimbursement for CRNAs:

• Evaluation and Management Services: CRNAs will be reimbursed by Medicare for their evaluation and management services, including pre-anesthesia evaluations.
• Ordering and Referrals: Conditions for payment for services ordered by CRNAs will be revised to clarify their role.
• Teaching Student CRNAs: Special payment rules will be established for teaching student registered nurse anesthetists.
• Supervision Removal: The bill removes the unnecessary supervisory requirements for CRNAs.
• Medicaid Requirements: CRNA services will be recognized as a required benefit under Medicaid.

Title III – Certified Nurse-Midwives (CNMs)

This section enhances the role of CNMs in healthcare:

• Training Access: Improved access to training in maternity care for CNMs will be established.
• Home Health Services: CNMs will be authorized to provide Medicare-certified home health services.
• DMEPOS Access: Access to durable medical equipment and supplies for Medicare beneficiaries will be improved.
• Qualifications and Conditions: Updates will be made regarding the qualifications and conditions for CNMs to practice.

Title IV – Federal Health Programs for All APRNs

This title focuses on improving health programs for all APRNs:

• Local Coverage Determination: The bill revises the local coverage determination process for Medicare, enhancing transparency and accountability.
• Locum Tenens: Specific provisions will allow NPs, CRNAs, and CNMs to have similar locum tenens arrangements as physicians.

Title V – Effective Date

The provisions of this act will take effect 90 days after its enactment, with the Secretary of Health and Human Services being responsible for implementation through interim guidance as necessary.

Relevant Companies

None found