I CAN Act

Key Points

• The bill expands the types of services nurse practitioners, clinical nurse specialists, and physician assistants can provide under Medicare and Medicaid. This includes prescribing cardiac and pulmonary rehabilitation, ordering diabetic shoes, establishing home infusion therapy plans, and certifying hospice care, all without needing a physician's sign-off.
• Nurse practitioners gain authority to admit and manage patients in skilled nursing facilities, nursing homes, and hospitals under both Medicare and Medicaid if allowed by state law. This reduces delays caused by requiring a physician to handle admissions and care plans.
• The bill removes the federal requirement that certified registered nurse anesthetists (CRNAs) must be supervised by a physician to receive Medicare payment, and makes CRNA services a required benefit under every state's Medicaid program.
• Certified nurse-midwives gain the ability to order home health services and durable medical equipment for Medicare patients, and can supervise interns and residents in maternity care training, expanding both patient access and workforce development.
• Most provisions take effect just 90 days after the bill becomes law, and the Secretary of Health and Human Services can use interim final rules or informal guidance to speed up implementation.