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Increased Access to Nurse Services in Medicare and Medicaid Programs

This Act aims to enhance citizens' access to medical services by expanding the authority of nurses, nurse anesthetists, and nurse-midwives within Medicare and Medicaid programs. This will provide patients with easier access to rehabilitation, home care, hospice services, and other benefits, potentially reducing waiting times and improving the quality of care.
Key points
Nurse practitioners and physician assistants can now order cardiac and pulmonary rehabilitation programs and document the need for diabetic shoes under Medicare.
Certified Registered Nurse Anesthetists (CRNAs) are authorized to independently order, certify, and refer services, and are exempt from physician supervision requirements in Medicare and Medicaid.
Certified Nurse-Midwives gain broader authority in home health services and access to medical equipment for Medicare patients, and can supervise intern training.
Administrative processes in skilled nursing facilities are streamlined, allowing nurse practitioners to certify services and oversee care in hospitals and nursing homes.
Changes to the Medicare local coverage determination process increase transparency and prohibit imposing additional practitioner qualifications.
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Additional Information
Print number: 117_S_5212
Sponsor: Sen. Merkley, Jeff [D-OR]
Process start date: 2022-12-08