The bill proposes significant amendments to titles XVIII and XIX of the Social Security Act, which govern Medicare and Medicaid, respectively. Notably, it seeks to eliminate restrictive supervision requirements for certified registered nurse anesthetists (CRNAs), thereby streamlining patient access to anesthesia services. Furthermore, the act will empower nurse practitioners to perform certain medical evaluations and treatments, enhancing patient access to care in underserved areas, especially in rural settings. If enacted, these changes could lead to improved health outcomes for patients by allowing APRNs to practice to the full extent of their training and education.
Summary
Senate Bill 2418, known as the Improving Care and Access to Nurses Act or the I CAN Act, aims to enhance the roles of advanced practice registered nurses (APRNs) under Medicare and Medicaid by reducing barriers to practice. The key provisions include allowing nurse practitioners (NPs) and certified nurse-midwives (CNMs) to have a broader scope of practice, which includes expanding access to various medical services. The bill addresses the need for better integration of APRNs in delivering healthcare, especially in primary and specialized care settings, enabling them to provide comprehensive care to patients without unnecessary hindrances.
Contention
While the intent of SB 2418 is largely positive, discussions around the bill highlight concerns regarding regulatory changes. Some critics argue that reducing physician supervision requirements could lead to varying standards of care and result in ineffective oversight in certain instances. Additionally, stakeholders express concerns over the rapid integration of APRNs into roles traditionally held by physicians, fearing potential challenges in maintaining quality care during the transition period. The balance between increased access to care and ensuring rigorous safety standards is likely to be a point of contention as the bill progresses through the legislative process.
Advanced Safe Testing at Residence Telehealth Act of 2023 This bill temporarily establishes several programs to provide telehealth services for at-home testing, evaluations, and other health care. Specifically, the bill establishes a demonstration program to provide assistive telehealth consultations and home- and community-based care for certain Medicare beneficiaries through Medicare Advantage (MA) plans. Covered services include certain at-home diagnostic tests, telehealth consultations, transportation services, and meal benefits. Beneficiaries must be (1) age 65 or older and eligible to enroll in a qualifying MA plan and to receive certain low-income subsidies under the Medicare prescription drug benefit, or (2) dually eligible for Medicare and Medicaid benefits. The bill also establishes a grant program for state Medicaid programs to cover similar at-home tests and related telehealth consultations. Additionally, the Department of Veterans Affairs must establish a pilot program to provide tests and related telehealth consultations free of charge to veterans.