Congress expands nurse practitioner power in Medicare, removing physician-only barriers
H.R. 1317 — I CAN Act · Filed by David Joyce (R-OH) · 36 cosponsors · Introduced Feb 13, 2025 · Referred to committee
Your members of Congress
Enter a ZIP to see where your representative and both senators stood on this bill.
Looked up on this device — your ZIP is never stored on our servers.
What it does
This bill expands Medicare and Medicaid coverage for services provided by advanced practice registered nurses—including nurse practitioners, clinical nurse specialists, certified nurse anesthetists, and certified nurse midwives—by prohibiting Medicare contractors from imposing coverage restrictions based on provider qualifications and allowing faster appeals of coverage denials. It also permits these nurses to work as locum tenens (temporary substitutes) under the same rules as physicians.
Why we flagged it
The bill's core mechanism is removing regulatory barriers to nurse practitioner and advanced practice nurse coverage under Medicare/Medicaid, expanding the scope of care these providers can deliver. This is a straightforward access-and-scope-of-practice measure, not a subsidy or carve-out.
What the text implies
- Expansion of nurse practitioner autonomy may shift some routine care away from physicians to lower-cost providers, potentially reducing physician referral volume and revenue in primary care and certain specialties.
- The prohibition on coverage limitations based on provider qualifications could create pressure on Medicare contractors to accept nurse-provided services without clinical outcome data, raising quality-assurance questions.
The full analysis lists 4 implications of this text.
Who stands to gain
Advanced practice registered nurses (professional group); Healthcare systems and clinics employing nurse practitioners; Patients with reduced out-of-pocket costs for nurse-provided services