H.R.1317 - Improving Care and Access to Nurses Act; I CAN Act (119th Congress)
Summary
H.R.1317, the "Improving Care and Access to Nurses Act" or "I CAN Act," aims to amend Titles XVIII and XIX of the Social Security Act to increase access to services provided by advanced practice registered nurses (APRNs) under Medicare and Medicaid. The bill addresses barriers to practice for nurse practitioners, certified registered nurse anesthetists (CRNAs), and certified nurse-midwives. It seeks to expand the scope of services these professionals can provide and be reimbursed for under federal healthcare programs.
The bill includes provisions for expanding access to cardiac and pulmonary rehabilitation programs, allowing nurse practitioners and physician assistants to satisfy Medicare documentation requirements for diabetic shoes, and improving beneficiary assignment under the Medicare shared savings program. It also focuses on streamlining care delivery in skilled nursing facilities and increasing access to hospice care services.
Furthermore, the Act aims to clarify reimbursement for CRNA evaluation and management services, revise conditions of payment for services ordered by CRNAs, and remove unnecessary supervision requirements. It also seeks to improve access to training in maternity care and home health services provided by certified nurse-midwives, along with revising the local coverage determination process under Medicare.
Expected Effects
The likely effect of this bill is an increased role for APRNs in the healthcare system, potentially leading to greater access to care, particularly in underserved areas. This could result in more efficient healthcare delivery and cost savings for Medicare and Medicaid.
However, it may also lead to concerns about the quality of care if APRNs are not adequately supervised or if their scope of practice expands too broadly. The bill could also impact the financial interests of physicians and other healthcare providers.
Ultimately, the bill's success will depend on how effectively it is implemented and whether it achieves its goal of improving access to care without compromising quality or patient safety.
Potential Benefits
- Increased Access to Care: By expanding the scope of practice for APRNs, the bill could improve access to healthcare services, especially in rural and underserved areas where there may be a shortage of physicians.
- Cost Savings: Allowing APRNs to provide certain services could potentially lower healthcare costs, as APRNs may be reimbursed at lower rates than physicians.
- Improved Efficiency: Streamlining care delivery in skilled nursing facilities and other settings could lead to more efficient use of healthcare resources.
- Greater Patient Choice: Patients may have more options for choosing their healthcare providers, as APRNs become more widely recognized and utilized.
- Modernization of Healthcare System: The bill could help to modernize the healthcare system by recognizing the important role that APRNs can play in providing high-quality care.
Potential Disadvantages
- Potential for Reduced Quality of Care: If APRNs are not adequately trained or supervised, there could be a risk of reduced quality of care or patient safety.
- Scope of Practice Concerns: Some physicians may argue that APRNs are not qualified to perform certain procedures or provide certain services, leading to concerns about patient safety and liability.
- Impact on Physician Employment: Expanding the role of APRNs could potentially lead to reduced employment opportunities for physicians, particularly in certain specialties or geographic areas.
- Lack of Standardized Training: The training and education requirements for APRNs may vary across states, which could lead to inconsistencies in the quality of care provided.
- Potential for Increased Costs: While the bill aims to reduce costs, there is a risk that it could actually increase costs if APRNs order unnecessary tests or procedures.
Constitutional Alignment
The bill's alignment with the U.S. Constitution is primarily based on the principle of promoting the general welfare (Preamble). By aiming to improve healthcare access and efficiency, the bill arguably contributes to the well-being of the population.
However, the Constitution does not explicitly address healthcare, leaving such matters largely to the states. Therefore, the federal government's role in regulating healthcare through Medicare and Medicaid, as amended by this bill, is subject to ongoing debate regarding the balance of power between the federal government and the states (Tenth Amendment).
There are no apparent violations of individual rights or liberties as defined by the Bill of Rights. The bill does not infringe upon freedom of speech, religion, or other fundamental rights.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).