I CAN Act

This legislation makes it easier for patients to get care by letting more types of nurses provide and get paid for services under Medicare and Medicaid. It moves some tasks that used to require a doctor to qualified nurses, so people can get help sooner and closer to home.

Key changes

• Cardiac and pulmonary rehab: lets nurse practitioners, physician assistants, and clinical nurse specialists take key roles in these programs, rather than limiting them to doctors.
• Diabetes care: allows a nurse practitioner or physician assistant to handle the paperwork Medicare needs for special shoes for people with diabetes.
• Hospital and nursing home care: allows nurse practitioners to sign off on the need for inpatient hospital and skilled nursing facility care under Medicare and Medicaid, when allowed by state law.
• Nutrition and home treatments: expands access to medical nutrition therapy and lets more providers set up home infusion therapy plans, not just physicians.
• Hospice: increases access to hospice and lets nurse practitioners bill for more hospice services.
• Medicaid clinics: makes it clear that Medicaid clinic services can be provided by nurse practitioners.
• Nurse anesthetists: recognizes more services by certified registered nurse anesthetists and makes their services a required Medicaid benefit, with payment rules clarified.
• Nurse-midwives: strengthens roles for certified nurse-midwives, including training, the ability to order home health services, and to order certain medical equipment and supplies.
• Fair coverage rules: makes Medicare coverage decisions more transparent and stops contractors from limiting which qualified clinicians can provide a covered service; penalties apply if they don’t follow these rules.

When

• Most changes start 90 days after the bill becomes law, though a few parts have their own timelines.