Joyce, Colleagues Reintroduce Bipartisan, Bicameral Bill to Increase Access to Nurses
WASHINGTON, DC – This week, Representatives Dave Joyce (OH-14), Suzanne Bonamici (OR-01), Jen Kiggans (VA-02), and Lauren Underwood (IL-14) and Senators Jeff Merkley (D-OR) and Cynthia Lummis (R-WY) reintroduced the Improving Care and Access to Nurses (I CAN) Act. This bipartisan legislation would increase healthcare access, improve quality of care, and lower costs by removing the remaining barriers imposed by the federal government in the Medicare and Medicaid programs that prevent Advanced Practice Registered Nurses (APRNs) from practicing the full scope of their education and clinical training to the level that is approved in the state where they practice.
“As our nation faces a nursing shortage, it is only further hurting America’s healthcare system by prohibiting APRNs from providing patient care to the fullest extent of their education,” said Congressman Joyce, Co-Chair of the Congressional Nursing Caucus. “The I CAN Act would eliminate unnecessary federal barriers to increase access to care and strengthen patient choice. In doing so, my colleagues and I will expand access to care, especially in rural communities, while lowering patient costs.”
“As the husband of a nurse, I know just how critical the care provided by nurses is and the valuable impact nurses have on their patients,” said Senator Merkley, Co-Chair of the Senate Nursing Caucus. “Our bipartisan bill will remove barriers for advanced practice registered nurses and will increase staffing of highly-trained nurses, reduce costs, and improve patient care. I’ll keep fighting to ensure nurses in Oregon and nationwide have the support they need to deliver the very best care.”
“Our healthcare system benefits from a wide range of services and care provided to patients by nurse practitioners and other advanced practice registered nurses (ARPNs). Unfortunately, outdated restrictions limit the care APRNs can provide for Medicare and Medicaid patients—depriving millions of Americans from timely access to healthcare. I’m pleased to introduce the bipartisan Improving Care and Access to Nursing Act (ICAN Act) with my Nursing Caucus colleagues Reps. Joyce, Underwood, and Kiggans, to update federal guidelines and allow ARPNs to fully serve their Medicare and Medicaid patients,” said Congresswoman Bonamici, Co-Chair of the Congressional Nursing Caucus.
“As a geriatric nurse practitioner, I know how critical it is to support our healthcare workforce and ensure all patients receive reliable, quality care,” said Congresswoman Kiggans, Vice Chair of the Congressional Nursing Caucus. “Unfortunately, barriers in Medicare and Medicaid currently limit the care Advanced Practice Registered Nurses (APRNs) can provide, preventing them from practicing to the full extent of their abilities and training. Given the growing nursing shortage across our country, it’s more important now than ever to lift up our nurses – not hinder them. I am proud to introduce the ICAN Act with my colleagues on both sides of the aisle to remove these federal barriers and allow APRNs to provide the high-quality care their patients deserve.”
“As a registered nurse and Vice Chair of the Congressional Nursing Caucus, I’m focused on ensuring Advanced Practice Registered Nurses (APRNs) can practice to the full extent of their education and training,” said Congresswoman Underwood, Vice Chair of the Congressional Nursing Caucus. “The evidence is clear: lifting practice barriers for APRNs is safe and makes financial sense. I’m pleased to join my colleagues in introducing the I CAN Act to remove outdated barriers to practice for APRNs and expand access to high-quality health care.”
“The federal government should never stand between Wyoming residents and high-quality health care. Allowing advanced practice registered nurses to treat more patients will increase access to health care and lower medical costs for Wyoming’s rural communities. I am proud to co-lead this critical piece of legislation,” said Senator Lummis.
“The reintroduction of this bill is a critical step toward expanding health care access across the country. By removing outdated barriers, it empowers APRNs to provide the care they are trained for—especially in rural and underserved communities where they are often the primary providers. Time and again, we’ve seen that when restrictions are lifted, APRNs deliver essential, high-quality care. The ICAN Act builds on that progress, making these changes permanent so every patient can get the care they need from the provider they trust” said ANA President Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN.
“The delivery of health care has changed significantly since the creation of Medicare and Medicaid, and the ICAN Act modernizes these programs to reflect our current health care workforce. Despite the fact that nurse practitioners (NPs) are the chosen clinicians for millions of Medicare and Medicaid patients, NPs and their patients still face barriers which impede the course of care. The ICAN Act would retire these outdated barriers to care, improve patient access, increase efficiency and empower Medicare and Medicaid patients. The American Association of Nurse Practitioners (AANP) thanks Senators Merkley and Lummis, and Representatives Joyce, Bonamici, Kiggans and Underwood for their bipartisan leadership on this essential legislation,” said AANP President Stephen A. Ferrara, DNP.
“The ICAN Act is critical legislation that will help ensure that everyone who needs access to the high-quality care provided by advanced practice registered nurses, such as Certified Registered Nurse Anesthetists (CRNAs), can receive that care where and when they need it most. In the midst of shortages in anesthesia providers and healthcare workers broadly, patients can no longer afford these outdated barriers to care,” said AANA President Janet Setnor, MSN, CRNA, Col. (Ret), USAFR, NC. “On behalf of CRNAs, I want to thank Representatives David Joyce (OH-14), Suzanne Bonamici (OR-01), Jen Kiggans (VA-02), and Lauren Underwood (IL-14) and Senators Jeff Merkley (OR) and Cynthia Lummis (WY) for truly understanding the role of APRNs across the country and championing this legislation in the 119th Congress.”
“Ensuring evidence-based midwifery and APRN care is accessible to everyone in all care settings is essential to improving health care in the United States,” stated American College of Nurse-Midwives (ACNM) President Jessica Brumley, PhD, APRN, CNM. “ACNM applauds Representatives Joyce, Bonamici, Kiggans, and Underwood, and Senators Merkley and Lummis for introducing the Improving Care and Access to Nurses Act, as it recognizes the vital role that certified nurse-midwives play as clinical and didactic educators to our nation’s obstetrics and gynecology residents and ensures that midwives and other APRNs are able to provide high-quality care that falls within their respective professional scope of practice.”
BACKGROUND:
APRNs are nurses prepared at the master or doctoral level to provide primary, acute, chronic and specialty care to patients of all ages and backgrounds, and in all settings. Their qualifications enable them to treat and diagnose illnesses, advise the public on health issues, manage chronic disease, order and interpret diagnostic tests, prescribe medication, and direct non-pharmacologic treatments for their patients. Over 40 years of vigorous, peer reviewed research has verified the safety, quality, satisfaction and cost-effectiveness of APRN care. This has led the National Academy of Sciences to call for the removal of laws, regulations, and policies that prevent APRNs from providing the full scope of health care services they are educated and trained to provide.
Currently, several federal statutes and regulations, as well as certain state practice acts and institutional rules, require physician oversight and limit APRN practice. These barriers reduce access to care, create disruptions in care, increase the cost of care, and undermine efforts to improve the quality of care. Specifically, the I CAN Act would remove remaining barriers in the Medicare and Medicaid programs that prevent APRNs from practicing to the full extent of their education and clinical training. Importantly, this bill does not expand scope of practice or impede upon state law. Rather, the bill simply ensures that the federal government honors state law, ensuring that Medicare and Medicaid patients living in states where nurses have already been granted full practice authority are permitted to choose to seek care from a nurse practitioner.
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