I CAN Act
Sponsored By: Representative Joyce, David P. [R-OH-14]
Introduced
Summary
Expands APRN authority across Medicare and Medicaid. It would let advanced practice registered nurses (NPs, clinical nurse specialists, physician assistants, certified nurse‑midwives, and certified registered nurse anesthetists) order, certify, prescribe, supervise, furnish, and be paid for many more services where State law allows, and it would add new transparency rules and penalties for Medicare local coverage decisions.
Show full summary
- Families and patients would see broader access to care at home and in hospitals because APRNs could provide and supervise home health, hospice, cardiac and pulmonary rehab, diabetes‑related footwear coverage, medical nutrition therapy, durable medical equipment, and inpatient services where State law permits.
- APRNs and other clinicians would gain clearer billing and payment rights, reduced supervision requirements in some facility settings, and expanded locum tenens coverage to support staffing flexibility.
- Medicare administration would face new disclosure and appeal rules for local coverage determinations, including required disclosure of consulted experts and relied‑on communications, complaint rights, and civil penalties up to $10,000 per failure. The bill also sets short implementation deadlines such as 90 days for certain billing updates.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 3 benefits, 0 costs, 2 mixed.
More transparent Medicare coverage rules
If enacted, Medicare contractors would have to list the experts they used and link to the sources behind a local coverage rule. They would have to link any rules, guidelines, or protocols they relied on and could not limit coverage based on a provider’s qualifications. Contractors that do not comply could face up to $10,000 per failure. You would be able to file a complaint once a coverage rule is posted, even before it takes effect.
More primary care counts for Medicare groups
If enacted, starting with the 2026 performance year, more primary care visits by certain clinicians would count when assigning you to a Medicare care group. This could change which group is responsible for your care and quality measures. Networks and care coordination could shift.
Most changes start 90 days after enactment
If enacted, most changes in this bill would apply to items and services furnished 90 days after enactment. Sections 103 and 401 would be excluded. HHS could use interim final rules or guidance to meet these deadlines.
More Medicare and Medicaid care by nurses
If enacted, Medicare and Medicaid would let more advanced nurses and physician assistants handle key tasks. Nurse practitioners, clinical nurse specialists, physician assistants, and nurse‑midwives could certify, prescribe, order, or supervise care, where State law allows. Examples include hospice eligibility, diabetic shoes, home infusion plans, cardiac and pulmonary rehab, home health, and skilled nursing facility care. Payment would follow existing program rules. Most changes would start 90 days after enactment.
Nurse practitioners could bill Medicare hospice
If enacted, HHS would update rules within 90 days so nurse practitioners can bill Medicare for some hospice services like doctors. Those services would be paid at the percent of the physician fee schedule set by law. This could help hospice access where physicians are scarce.
Sponsors & CoSponsors
Sponsor
Joyce, David P. [R-OH-14]
OH • R
Cosponsors
Bonamici
OR • D
Sponsored 2/13/2025
Rep. Kiggans, Jennifer A. [R-VA-2]
VA • R
Sponsored 2/13/2025
Rep. Underwood, Lauren [D-IL-14]
IL • D
Sponsored 2/13/2025
Rep. Rogers, Mike D. [R-AL-3]
AL • R
Sponsored 2/13/2025
Rep. Smith, Adrian [R-NE-3]
NE • R
Sponsored 2/14/2025
Rep. Grothman, Glenn [R-WI-6]
WI • R
Sponsored 2/27/2025
Rep. Finstad, Brad [R-MN-1]
MN • R
Sponsored 3/26/2025
McBride
DE • D
Sponsored 4/1/2025
Rep. Tlaib, Rashida [D-MI-12]
MI • D
Sponsored 4/17/2025
Rep. Pappas, Chris [D-NH-1]
NH • D
Sponsored 4/29/2025
Rep. Tokuda, Jill N. [D-HI-2]
HI • D
Sponsored 4/29/2025
Rep. Hoyle, Val T. [D-OR-4]
OR • D
Sponsored 5/19/2025
Rep. Gottheimer, Josh [D-NJ-5]
NJ • D
Sponsored 5/20/2025
Rep. Clarke, Yvette D. [D-NY-9]
NY • D
Sponsored 6/5/2025
Rep. Hinson, Ashley [R-IA-2]
IA • R
Sponsored 6/6/2025
Stansbury
NM • D
Sponsored 6/26/2025
Rep. Van Orden, Derrick [R-WI-3]
WI • R
Sponsored 7/16/2025
Rep. Vasquez, Gabe [D-NM-2]
NM • D
Sponsored 7/16/2025
Rep. Hayes, Jahana [D-CT-5]
CT • D
Sponsored 7/16/2025
Rep. McClain Delaney, April [D-MD-6]
MD • D
Sponsored 8/8/2025
Rep. Dingell, Debbie [D-MI-6]
MI • D
Sponsored 8/22/2025
Randall
WA • D
Sponsored 8/22/2025
Thompson (MS)
MS • D
Sponsored 8/22/2025
Rep. Vindman, Eugene Simon [D-VA-7]
VA • D
Sponsored 8/29/2025
Rep. Bergman, Jack [R-MI-1]
MI • R
Sponsored 10/10/2025
Pingree
ME • D
Sponsored 11/7/2025
Rep. Courtney, Joe [D-CT-2]
CT • D
Sponsored 11/17/2025
Rep. Foster, Bill [D-IL-11]
IL • D
Sponsored 12/11/2025
Rep. Neguse, Joe [D-CO-2]
CO • D
Sponsored 2/13/2026
Rep. Balint, Becca [D-VT-At Large]
VT • D
Sponsored 2/23/2026
Rep. Thompson, Glenn [R-PA-15]
PA • R
Sponsored 5/7/2026
Roll Call Votes
No roll call votes available for this bill.
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