I 
118TH CONGRESS 
1ST SESSION H. R. 2713 
To amend titles XVIII and XIX of the Social Security Act to increase 
access to services provided by advanced practice registered nurses under 
the Medicare and Medicaid programs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 19, 2023 
Mr. JOYCE of Ohio (for himself, Ms. BONAMICI, Ms. UNDERWOOD, Mrs. 
KIGGANS of Virginia, Ms. SCHAKOWSKY, Mr. ARMSTRONG, Mr. BLU-
MENAUER, Mr. SMITH of Nebraska, Mr. GROTHMAN, Mr. PAPPAS, and 
Ms. KUSTER) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee 
on Ways and Means, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To amend titles XVIII and XIX of the Social Security Act 
to increase access to services provided by advanced prac-
tice registered nurses under the Medicare and Medicaid 
programs, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Improving Care and 
Access to Nurses Act’’ or the ‘‘I CAN Act’’. 
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TITLE 
I—REMOVAL 
OF 
BAR-
RIERS 
TO 
PRACTICE 
ON 
NURSE PRACTITIONERS 
SEC. 101. EXPANDING ACCESS TO CARDIAC REHABILITA-
TION PROGRAMS AND PULMONARY REHA-
BILITATION PROGRAMS UNDER MEDICARE 
PROGRAM. 
(a) CARDIAC REHABILITATION PROGRAMS.—Section 
1861(eee) of the Social Security Act (42 U.S.C. 
1395x(eee)) is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (A)(i), by striking ‘‘a 
physician’s office’’ and inserting ‘‘the office of 
a physician (as defined in subsection (r)(1)) or 
the office of a nurse practitioner, clinical nurse 
specialist, or physician assistant (as those terms 
are defined in subsection (aa)(5))’’; and 
(B) in subparagraph (C), by inserting ‘‘(as 
defined in subsection (r)(1)), nurse practitioner, 
clinical nurse specialist, or physician assistant 
(as those terms are defined in subsection 
(aa)(5))’’ after ‘‘physician’’; 
(2) in paragraph (3)(A), by striking ‘‘physician- 
prescribed exercise’’ and inserting ‘‘exercise pre-
scribed by a physician (as defined in subsection 
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(r)(1)), nurse practitioner, clinical nurse specialist, 
or physician assistant (as those terms are defined in 
subsection (aa)(5))’’; and 
(3) in paragraph (5), by inserting ‘‘(as defined 
in subsection (r)(1)), nurse practitioner, clinical 
nurse specialist, or physician assistant (as those 
terms are defined in subsection (aa)(5)),’’ after 
‘‘physician’’. 
(b) PULMONARY REHABILITATION PROGRAMS.—Sec-
tion 1861(fff) of the Social Security Act (42 U.S.C. 
1395x(fff)) is amended— 
(1) in paragraph (2)(A), by striking ‘‘physician- 
prescribed exercise’’ and inserting ‘‘exercise pre-
scribed by a physician (as defined in subsection 
(r)(1)), nurse practitioner, clinical nurse specialist, 
or physician assistant (as those terms are defined in 
subsection (aa)(5))’’; and 
(2) in paragraph (3), by inserting after ‘‘physi-
cian’’ the following: ‘‘(as defined in subsection 
(r)(1)), nurse practitioner, clinical nurse specialist, 
or physician assistant (as those terms are defined in 
subsection (aa)(5)),’’. 
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SEC. 102. PERMITTING NURSE PRACTITIONERS TO SATISFY 
MEDICARE DOCUMENTATION REQUIREMENT 
FOR COVERAGE OF CERTAIN SHOES FOR IN-
DIVIDUALS WITH DIABETES. 
Section 1861(s)(12) of the Social Security Act (42 
U.S.C. 1395x(s)(12)) is amended— 
(1) in subparagraph (A), by inserting ‘‘, nurse 
practitioner, or physician assistant’’ after ‘‘physi-
cian’’; and 
(2) in subparagraph (C), by inserting ‘‘, nurse 
practitioner, or physician assistant’’ after each oc-
currence of ‘‘physician’’. 
SEC. 103. IMPROVEMENTS TO THE ASSIGNMENT OF BENE-
FICIARIES UNDER THE MEDICARE SHARED 
SAVINGS PROGRAM. 
Section 1899(c)(1) of the Social Security Act (42 
U.S.C. 1395jjj(c)(1)) is amended— 
(1) in subparagraph (A), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (B), by striking the period 
at the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(C) in the case of performance years be-
ginning on or after January 1, 2024, primary 
care services provided under this title by an 
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