Removes a number of federal limits that have prevented advanced practice nurses from providing, certifying, or billing for many Medicare and Medicaid services. It expands the ability of nurse practitioners, certified registered nurse anesthetists, and certified nurse‑midwives to practice and be paid in hospitals, skilled nursing facilities, hospice, home infusion, rehab programs, Medicaid clinics and other settings, directs HHS to update rules quickly, increases Medicaid payment parity for CRNA services, and requires greater transparency and limits on Medicare local coverage determinations (LCDs). Most changes apply to items and services furnished on or after 90 days after enactment, and HHS may use interim rules or guidance to meet that effective date.