Sponsors (4)
The bill prioritizes nurse and patient safety by limiting excessive hours and strengthening enforcement and transparency, but it raises staffing, administrative, and compliance costs—especially for smaller and rural providers—and leaves some safety gaps during declared emergencies.
Nurses and patients: caps on excessive work hours and limits on mandatory overtime reduce nurse fatigue and are likely to improve patient safety and care quality.
Nurses: reducing extended shifts and mandatory overtime should improve nurses' job satisfaction, workplace safety, and reduce burnout.
Hospitals and taxpayers: fewer clinician errors and better nurse retention could lower costs from adverse events and turnover over time.
Hospitals, providers, and taxpayers: enforcing hour caps and scheduling rules will raise staffing and administrative costs (hiring, scheduling changes, investigations, corrective plans), potentially increasing healthcare prices or straining facility budgets.
Rural and smaller providers: limited access to replacement staff and lack of accompanying funding/workforce expansion could cause operational strain or reduced services in understaffed areas.
Nurses and patients during crises: the emergency exception allowing mandatory overtime means nurses and patients may still face extended fatigue and safety risks in declared emergencies.
Based on analysis of 4 sections of legislative text.
Prohibits most mandatory nurse overtime for Medicare/Medicaid providers, adds protections and penalties, and requires federal studies on nurse work-hour standards.
Official title: Amend title XVIII of the Social Security Act to provide for patient protection by limiting the number of mandatory overtime hours a nurse may be required to work in certain providers of services to which payments are made under the Medicare Program.
Introduced August 6, 2026 by Jeff Merkley · Last progress August 6, 2026
Prohibits most mandatory nurse overtime for health care providers that participate in Medicare/Medicaid, creates complaint and enforcement processes with civil money penalties, and requires protections for nurses who refuse overtime. It also directs two federal studies—one by HHS/AHRQ to recommend maximum nurse work-hour standards and one by OMB to review overtime practices at federally operated medical facilities. The overtime prohibition becomes effective one year after enactment; exemptions allow limited use of overtime during declared emergencies and disasters. The law requires notice, scheduling, posting, whistleblower protections, and allows the Secretary to investigate complaints, require corrective action, and impose penalties for violations.