Nurse Overtime and Patient Safety Act of 2026
Sponsored By: Representative Matsui, Doris O. [D-CA-7]
Introduced
Summary
Limits mandatory nurse overtime at Medicare-participating providers. This bill would bar providers that receive Medicare payments from requiring nurses to work beyond set hour caps and would create enforcement, penalties, and worker protections to back those limits.
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- Nurses: Gives registered nurses, licensed practical nurses, and licensed vocational nurses the right to refuse mandatory overtime without retaliation and a whistleblower complaint path. It sets hour caps like 48 hours per workweek and 12 consecutive hours in 24 hours and covers required meetings and on-call time as hours worked.
- Patients and families: Aims to reduce long nurse shifts to protect patient safety and directs the Agency for Healthcare Research and Quality to study safe maximum nurse hours and report recommendations to Congress within 2 years.
- Providers and federal facilities: Requires Medicare providers to post schedules, keep written overtime policies, and notify staff of rights. The Secretary may levy civil money penalties up to $10,000 for each knowing violation and the Office of Management and Budget must report on federally operated facilities within 6 months.
Effective date is 1 year after enactment and State laws providing greater protections remain valid.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 4 benefits, 0 costs, 1 mixed.
New limits on mandatory nurse overtime
If enacted, the bill would stop Medicare-participating providers from forcing nurses to work past set limits. You could not be required to work more than 48 hours in a workweek or more than 12 hours in a row. You also could not be required to work during the 10 hours after a 12-hour shift or beyond a previously scheduled shift. The bill would count required meetings, training, and on-call or standby time as hours worked, and it ties the workweek definition to current federal rules (29 C.F.R. 778.105).
Protections and penalties for nurses
If enacted, nurses would be protected from firing or other retaliation for refusing mandatory overtime or for reporting violations in good faith. Nurses could file complaints with the HHS Secretary, who would investigate and require providers to fix problems. The Secretary could fine providers up to $10,000 for each knowing violation and publish penalized providers on HHS's website.
Keeps state and contract protections intact
If enacted, the bill would not replace stronger Federal, State, or local laws or collective bargaining rights. Existing union agreements or state laws that give greater protection against mandatory overtime would still apply. The overtime subsection would not reduce rights already available to nurses.
Provider notice and scheduling rules
If enacted, providers would have to make written mandatory-overtime policies and give them to new nursing staff. Providers would also post unit or department nurse schedules and make daily schedules available on request. They would post a Secretary-prescribed notice about nurses' rights and how to file complaints.
Emergency exception for nurse overtime
If enacted, providers could require nurses to work past the overtime limits during declared major disasters or state/tribal emergencies. That would be allowed only if the provider tried reasonable staffing alternatives; the extra hours end when the emergency ends or when the provider's response ends; a vacancy for the next shift becomes known at the end of the current shift; and the patient would face potential harm if the nurse left. The exception does not cover emergencies caused by labor disputes or chronic understaffing.
Sponsors & CoSponsors
Sponsor
Matsui, Doris O. [D-CA-7]
CA • D
Cosponsors
Rep. Kiggans, Jennifer A. [R-VA-2]
VA • R
Sponsored 8/6/2026
Rep. Stansbury, Melanie A. [D-NM-1]
NM • D
Sponsored 8/13/2026
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 8/13/2026
Rep. Davis, Danny K. [D-IL-7]
IL • D
Sponsored 8/20/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov