I CAN Act
Sponsored By: Senator Jeff Merkley
Introduced
Summary
This bill would expand the role of nurse practitioners and other non-physician clinicians in Medicare and Medicaid. It would let advanced practice clinicians do more of the ordering, certifying, documenting, and billing work now often limited to physicians, and boost transparency for coverage rules.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 3 benefits, 0 costs, 1 mixed.
More ACO assignments for nurse care
If enacted, this bill would add certain non‑physician primary care services to how Medicare assigns patients to Accountable Care Organizations (ACOs). The change would apply for performance years beginning on or after January 1, 2026. This could change which ACO is responsible for your Medicare care.
More Medicare and Medicaid care from nurses
If enacted, this bill would let nurse practitioners, physician assistants, clinical nurse specialists, certified nurse‑midwives, and certified registered nurse anesthetists provide, document, order, certify, and bill for more Medicare and Medicaid services. It would add these clinicians to cardiac and pulmonary rehab, medical nutrition therapy, therapeutic footwear documentation, home infusion, hospice billing parity, and certain hospital and nursing facility certifications. Most changes would apply to items and services furnished 90 days after enactment. Some authorities would still depend on your State law.
More transparency for Medicare coverage rules
If enacted, Medicare contractors would have to list the medical or scientific experts who advised local coverage decisions and link the written materials they relied on. You could file a formal complaint as soon as a decision is posted online. Contractors that fail to disclose or that limit coverage based only on physician qualifications could face civil fines up to $10,000 per failure.
HHS may speed program start
This bill would make most provisions take effect 90 days after enactment. It would allow the HHS Secretary to use interim final rules or guidance to meet that deadline. Sections 103 and 401 would not be covered by the 90‑day rule.
Sponsors & CoSponsors
Sponsor
Jeff Merkley
OR • D
Cosponsors
Cynthia Lummis
WY • R
Sponsored 2/13/2025
Christopher Coons
DE • D
Sponsored 3/5/2025
Peter Welch
VT • D
Sponsored 3/31/2025
John Fetterman
PA • D
Sponsored 7/30/2025
Roll Call Votes
No roll call votes available for this bill.
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