Sen. Jeff Merkley (D-OR) and Congresswoman Lucille Elsa Royball Allard (D. Calif.) today announced the HR 8812 Improving Care and Access to Nurses (I CAN) Act had been filed in the 117^th United States Congress.  This landmark piece of legislation has been the result of coordinated efforts by legislative leaders and a coalition of national professional nursing organizations, including the American Association of Nurse Anesthesiology, the American Association of Nurse Practitioners, the American Nurses Association and the American College of Nurse-Midwives.  The Improving Care and Access to Nurses (I CAN) Act, if passed, would remove barriers to care and increase access to services provided by advanced practice registered nurses (APRNs) under the Medicare and Medicaid programs.

This proposed legislation hopes to modify reimbursement structures for APRNs, improve the ability of APRNs to act as primary care providers, remove unnecessary requirements that APRNs be supervised by a physician, reduce healthcare costs within the Medicare and Medicaid systems, and expand healthcare delivery by removing barriers to APRN care.

It is important to recognize that this legislation would be limited to federal health programs (including Medicare and Medicaid) and would not impact state licensing provisions restricting APRN practice.  However, leaders from nursing organizations have voiced their belief that this legislation could act as a model for legislative action removing costly APRN restrictions within state legislatures.

Key provisions included in the bill are;

• authorization for NPs and PAs to order and supervise cardiac and pulmonary rehabilitation services,
• authorization for NPs and PAs to certify the need for therapeutic shoes for patients with diabetes,
• the elimination of requirements for patients receiving care within accountable care organizations (ACOs) to have an initial evaluation by a physician,
• mandates that require insurers to recognize APRNs and Physicians Assistants as primary care providers within ACOs

The I Care Act also includes additional key provisions that would allow APRNs to refer patients to nutritional professionals, allow APRNs to establish and manage home infusion plans, authorize hospice care services, and remove physician supervisory requirements to bill Medicare and Medicaid.

The legislation also includes substantial language that would restructure billing and reimbursement structures for services provided by Advanced Practice Registered Nurses.

Passage of the legislation is by no means guaranteed.  Multiple influential organizations, including the American Medical Association, are likely to oppose all provisions within the bill strongly.   It is recognized that passage of this legislation will require significant support from all Nurses, stakeholders and concerned community stakeholders.    In the coming days, the sponsoring organizations will initiate key strategies to engage the nursing profession and the public to advance this landmark piece of legislation.

For more comprehensive information regarding the I CARE Act please refer to the attached documents.[pdf-embedder url=”https://aprnadvocacy.com/wp-content/uploads/2022/09/APRN-Omnibus-Final-1.pdf” title=”APRN Omnibus Final”][pdf-embedder url=”https://aprnadvocacy.com/wp-content/uploads/2022/09/APRN-Omnibus-Section-by-Section-Final-2022.08.23.pdf” title=”APRN Omnibus Section by Section Final 2022.08.23″]