Improving Care and Access to Nurses Act

Group ICAN SignOn Letter Reintroduction Senate Finance 119th Final

Group ICAN SignOn Letter Reintroduction House 119th Final

Dear Chairman Crapo and Ranking Member Wyden,On behalf of the undersigned organizations, we write to express our support for The Improving Care and Access to Nurses (ICAN) Act (S. 575/H.R. 1317). This bill would increase patient access to care by removing outdated and unnecessary federal barriers on services provided by advanced practice registered nurses (APRNs) under the Medicare and Medicaid programs.

APRNs include nurse practitioners, certified registered nurse anesthetists, certified nurse-midwives, and clinical nurse specialists. They provide high-quality health care throughout our nation and to a continuously growing number of Medicare and Medicaid beneficiaries. According to data released by the Centers for Medicare and Medicaid Services (CMS), as of 2021, over 235,000 APRNs treated Medicare patients and over 40% of Medicare beneficiaries received care from an APRN. While APRNs provide health care to patients in all settings and geographic areas, patients in rural and underserved communities are more likely to rely on APRNs for their health care. According to MedPAC, in 2018, APRNs and PAs accounted for up to 50% of all primary care clinicians treating Medicare beneficiaries in rural areas.

Recognizing the importance of APRNs to our health care workforce, and for patient access to care, the Institute of Medicine (IOM) issued The Future of Nursing: Leading Change, Advancing Health report in 2010, which called for the removal of laws, regulations, and policies that prevent APRNs from providing the full scope of health care services they are educated and trained to provide. In 2021, this position was reaffirmed by the National Academy of Medicine (previously named the IOM) in their 2021 The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity.

Unfortunately, there are still Medicare and Medicaid policies that have not been modernized to reflect the growing and essential role of APRNs. Various federal statutes and regulations remain which prevent APRNs from practicing to the full extent of their education and clinical training. These policies reduce access to care, disrupt continuity of care, increase health care costs, and undermine quality improvement efforts.

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. We urge Congress to pass this important legislation, which will move our health care system forward in an effective and efficient manner for the benefit of patients and providers. If you have further questions please contact MaryAnne Sapio, Vice President of Federal Government Affairs, American Association of Nurse Practitioners, Sam Hewitt, Director, Congressional and Political Affairs, American Nurses Association, Matt Thackston, Director, American Association of Nurse Anesthesiology, or Amy Kohl, Director of Advocacy and Government Affairs, American College of Nurse-Midwives.