Bill to expand scope of practice for advanced practitioners reintroduced to Congress

A bill that seeks to expand the range of practice for nurse practitioners and physician assistants has been reintroduced to Congress after not passing in the last session in late 2022. The scope of it aims to bring accessible care to communities lacking.

Originally introduced to the House of Representatives in September 2022, the Improving Care and Access to Nurses Act outlines an approach that "allows a nurse practitioner or physician assistant to fulfill documentation requirements for Medicare coverage of special shoes for diabetic individuals; expedites the ability of physician assistants, nurse practitioners, and clinical nurse specialists to supervise Medicare cardiac, intensive cardiac, and pulmonary rehabilitation programs; and allows nurse practitioners to certify the need for inpatient hospital services under Medicare and Medicaid." 

In the last congressional session, the bill attracted support from more than 160 healthcare organizations. Because nurse practitioners and physician assistants tend to work in regions that are rural or underserved more frequently than physicians, advocates say expanding their scope of practice would increase care access opportunities for many in need who face a shortage of providers.

"The ICAN Act removes superfluous regulations that serve as barriers to expanding care in areas where APRNs are often the primary provider," the American Nurses Association noted in an April 20 statement. "APRNs fill an essential, often lifesaving role for people who may have no other access to critically important medical services. But it's not just rural America that stands to benefit. The ICAN Act means that communities nationwide will get improved access to high-quality care from trusted, highly skilled nurses."

However, opponents of the bill say removing physicians from some of these care areas for which they are specially trained is concerning.

"This legislation would allow NPPs to perform tasks and services outside their education and training and could result in increased utilization of services, increased costs and lower quality of care for our patients," a letter in opposition of the legislation that was published by the American Medical Association and nearly 90 physician organizations after the introduction of the ICAN Act reads.

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