Medicare quietly expands nurse practitioner authority, reshaping primary care
S. 575 — I CAN Act · Filed by Jeff Merkley (D-OR) · 6 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 administrative restrictions on nurse practitioner coverage and streamlining appeals—a straightforward regulatory reform aimed at broadening access to qualified healthcare providers.
What the text implies
- Expansion of nurse practitioner scope may shift demand away from physician services, affecting physician billing and practice patterns, particularly in primary care and specialty areas where nurses increasingly compete.
- Medicare contractors lose discretion to impose local coverage restrictions based on provider type, centralizing coverage policy and potentially reducing their ability to respond to regional healthcare variation.
The full analysis lists 4 implications of this text.
Who stands to gain
advanced practice registered nurses and nurse-staffed practices; healthcare systems and clinics employing nurses in expanded roles; patients through reduced out-of-pocket costs and improved access