The Improving Care and Access to Nurses (ICAN) Act (HR 2713) was reintroduced to Congress on April 19, 2023. The ICAN Act aims to remove administrative and practice barriers under Medicare and Medicaid by authorizing advanced practice registered nurses (APRNs) to order and supervise cardiac and pulmonary rehabilitation; order diabetic shoes; refer patients for medical nutrition therapy; certify and recertify a patient’s terminal illness for hospice eligibility; and perform all mandatory examinations in skilled nursing facilities.

If passed, the act would amend titles XVIII and XIX of the Social Security Act and the Bipartisan Budget Act of 2018 and allow patients managed by APRNs to fully be included in the beneficiary attribution process for the Medicare Shared Savings Program.

April Kapu AANP
Dr April Kapu

“This critical legislation would remove outdated barriers to practice that delay access to health care for our patients,” said American Association of Nurse Practitioners (AANP) President April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN. “Health care policies must be reflective of those who are providing high-quality care in our communities. The ICAN Act will move health care delivery forward for patients, providers, and our nation.”

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Nurse Anesthetist Services to Be Covered by Medicaid Under ICAN Act

The American Association of Nurse Anesthesiology (AANA) also supports this legislation, which will remove physician supervision of certified registered nurse anesthetists (CRNAs) and provide access to CRNA services in Medicaid.

Specifically, this legislation will ensure proper reimbursement for CRNAs to provide anesthesia and pain management for Medicare recipients, allow CRNAs to order and refer medically necessary services, permanently remove unnecessary physician supervision under Medicare, promote payment parity in the teaching rules, and provide access to CRNA services in Medicaid.

“As the only anesthesia providers in most rural hospitals, and the predominant providers in underserved communities, CRNAs play an important role in maintaining critical access in communities across the country,” said AANA President Angela Mund, DNP, CRNA. “However, superfluous regulations serve as barriers to expanding care, especially at a time when those same communities face a shortage of providers. This critical legislation will help ensure that everyone who needs access to the high-quality care provided by advanced practice registered nurses such as CRNAs can have it.”

“For nearly 3 years Medicare has temporarily waived practice barriers to allow CRNAs and others to step up on the front lines of multiple global health challenges,” Dr Mund said. We have seen how much nurses can do when we remove burdensome regulations and allow them to reach the full potential of their education and scope of practice.”

The bill was reintroduced to the US House of Representatives by Dave Joyce (R-OH), Suzanne Bonamici (D-OR), Lauren Underwood (D-IL), Jen Kiggans (R-VA), Adrian Smith (R-NE), Kelly Armstrong (R-ND), Earl Blumenauer (D-OR), Jan Schakowsky (D-IL), Glenn Grothman (R-WI), Chris Pappas (D-NH), and Ann Kuster (D-NH).


AANP supports US house legislation strengthening patient access to health care. News release. American Association of Nurse Practitioners; April 20, 2023. ICAN act increases patient access to high-quality healthcare. News release. American Association of Nurse Anesthesiology; Apr 20, 2023.

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