I CAN Act

Key Points

• The bill expands the authority of nurse practitioners, physician assistants, and clinical nurse specialists to prescribe and supervise cardiac and pulmonary rehabilitation programs, medical nutrition therapy, home infusion therapy, and hospice care under Medicare, tasks that currently require a physician.
• It removes the federal requirement that certified registered nurse anesthetists (CRNAs) must be supervised by a physician in order to provide anesthesia services under Medicare, and it makes CRNA services a required benefit under Medicaid with a payment floor tied to Medicare rates.
• Certified nurse-midwives gain expanded authority to supervise medical interns and residents, order home health services and durable medical equipment for Medicare patients, and establish care plans, bringing their role closer to that of physicians.
• The bill prevents local Medicare insurance contractors from imposing their own restrictions on which qualified providers can deliver covered services, and creates a civil penalty of up to $10,000 per violation for contractors that fail to comply or disclose required information.
• Most provisions take effect 90 days after the bill is signed into law. The HHS Secretary can use interim final rules or subregulatory guidance to implement the changes quickly if needed.