Existing federal regulations and institutional rules continue to limit the full scope of Advanced Practice Registered Nurses (APRN) practice, which can result in reduced access to care, increased costs, and disruptions in continuity of care, particularly in underserved areas. Given the shortage of primary care physicians, affecting 1 in 5 Americans, it is crucial that APRNs are enabled to practice to the full extent of their education and training.[1] With over 80 million Americans residing in a Health Professional Shortage Area (HPSA), APRNs are well-positioned to address the need for increased access to care.[2]

The proposed legislation seeks to address these issues by removing certain federal barriers to APRN practice, in line with recommendations from the National Academy of Medicine.[3] The bill aims to improve access to care, enhance the quality of health care services, and reduce costs within Medicare and Medicaid programs.

Specifically, this bill:

• Allows Nurse Practitioners to order and supervise cardiac and pulmonary rehabilitation and home infusion under Medicare;
• Allows Nurse Practitioners and Physician Assistants to fulfill documentation requirements for Medicare coverage of therapeutic shoes for individuals with diabetes;
• Allows Nurse Practitioners to (re)certify eligibility for hospice care programs under Medicare and have Medicare and Medicaid patients admitted to a hospital under their care;
• Authorizes Nurse Anesthetists (CRNAs) to practice without physician supervision under Medicare;
• Allows Nurse Anesthetists to order, certify and refer medically necessary Medicare services when legally authorized;
• Allows Certified Nurse Midwives to certify Medicare beneficiaries for home health services;
• Authorizes Certified Nurse Midwives to issue a prescription for durable medical equipment, prosthetics, orthotics and supplies to Medicare beneficiaries; and
• Ensures that patients of Nurse Practitioners fully benefit from the Medicare Shared Savings Program, and more.