ICAN Act Supported by More Than 235 Health Care Organizations

Leading health care organizations voiced support for the ICAN Act in a letter to Congress.

More than 235 health care organizations declared their support for The Improving Care and Access to Nurses Act (ICAN Act, HR 2713) in a letter sent to the U.S. House of Representatives Committee on Ways and Means and the Committee on Energy and Commerce on June 6, 2023.

This bipartisan legislation, which was reintroduced in April 2023 in the House of Representatives, would remove administrative and practice barriers under Medicare and Medicaid for advanced practice registered nurses (APRNs) and PAs (Table).

The purpose of the ICAN Act is to increase access, improve quality of care, and lower costs in the Medicare and Medicaid programs by removing federal barriers to practice for APRNs, consistent with state law.

The act would amend titles XVIII and XIX of the Social Security Act and allow patients managed by nurse practitioners (NPs) and clinical nurse specialists to fully be included in the beneficiary attribution process for the Medicare Shared Savings Program. Over 40% of Medicare beneficiaries receive care from NPs, and NPs are the fastest-growing Medicare provider group, according to the American Association of Nurse Practitioners (AANP).

Table. Proposed Removal of Barriers to APRNs and PAs in the ICAN Act

Bill ProvisionClinician Type
Sec. 101: Expanding access to cardiac rehabilitation programs and pulmonary rehabilitation programs under the Medicare programCNS, NP, and PA
Sec. 102: Permitting nurse practitioners to satisfy documentation requirement for coverage of certain shoes for individuals with diabetesNP and PA
Sec. 103: Improvements to the assignment of beneficiaries under the Medicare Shared Savings Program (MSSP)CNS, NP, and PA
Sec. 104: Expanding the availability of medical nutrition therapy services under the Medicare ProgramCNS, NP, and PA
Sec. 105: Preserving access to home infusion therapyNP and PA
Sec. 106: Increasing access to hospice care servicesNP
Sec. 107: Streamlining care delivery in skilled nursing facilities (SNFs) and nursing facilities and authorizing Medicare and Medicaid Patients to be under the care of a nurse practitioner in a hospitalNP
Sec. 108: Improving access to Medicaid clinic servicesNP
Sec. 201: Amendments to Section 1861 of the Social Security Act Sec. 202: Revision of Conditions of Payment Relating to Services Ordered and Referred by Certified Registered Nurse Anesthetists Sec. 203: Special Payment Rule for Teaching Anesthesiologists Sec. 204: Removing Unnecessary and Costly Physician Supervision Sec. 205: CRNA Services as Medicaid-Required BenefitCRNA
Sec. 301: Improving access to training in maternity care Sec. 302: Improving Medicare patient access to home health services provided by CNMs Sec. 303. Improving access to DMEPOS for Medicare beneficiaries Sec. 304: Technical changes to qualifications and conditions of CNMs’ servicesCNM
CNM, certified nurse-midwives; CNS, clinical nurse specialists; CRNA, certified registered nurse anesthetists; DMEPOS, durable medical equipment, prosthetics, orthotics, and supplies; NP, nurse practitioners

“This critical legislation will remove outdated barriers to practice that delay access to health care for our patients,” said AANP President April Kapu, DNP. “Health care policies should be responsive to patient needs and inclusive of the health care providers delivering care in our communities. The ICAN Act will move health care delivery forward for patients, providers, and our nation.”

This legislation is particularly important for patients in rural and underserved communities who are more likely to receive care from APRNs. In 2018, APRNs and PAs represented approximately 50% of clinicians who billed Medicare in rural areas, to data from MedPac.

“The purpose of the ICAN Act is to increase access, improve quality of care, and lower costs in the Medicare and Medicaid programs by removing federal barriers to practice for APRNs, consistent with state law,” the organizations stated in the letter.

This article originally appeared on Clinical Advisor


More than 235 organizations show their support for the Improving Care and Access to Nurses Act. News release. American Association of Nurse Practitioners; June 6, 2023. Accessed June 9. 2023. https://www.aanp.org/news-feed/more-than-235-organizations-show-their-support-for-the-ican-act