Bill Summary
The "Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025" seeks to update the utilization requirements for physicians, physician assistants, and nurse practitioners under the Social Security Act. The legislation amends Section 1861(aa) to simplify the criteria for certain healthcare facilities that are not physician-directed clinics. It eliminates outdated language regarding arrangements and establishes new requirements for these facilities to ensure compliance with state laws concerning healthcare delivery. Specifically, it mandates that such facilities maintain appropriate arrangements with physician assistants or nurse practitioners, adhering to state regulations for their practice. The act is set to take effect on January 1, 2027, impacting healthcare services provided from that date onward.
Possible Impacts
The "Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025" could affect people in the following ways:
1. **Increased Access to Healthcare in Rural Areas**: By modernizing the utilization requirements for physician assistants (PAs) and nurse practitioners (NPs), the legislation may allow these healthcare providers to practice more independently in rural areas where physicians are scarce. This can lead to improved access to medical services for residents in these regions, potentially resulting in better health outcomes and reduced travel times for patients seeking care.
2. **Enhanced Health Services Delivery**: The amendments may streamline the arrangement and oversight requirements for healthcare facilities that employ PAs and NPs. This could lead to a more efficient delivery of health services, allowing for quicker appointments and less bureaucratic overhead. As a result, patients may experience shorter wait times for consultations and treatments, improving their overall healthcare experience.
3. **Quality of Care and Compliance with State Laws**: By ensuring that the delivery of health services by PAs and NPs is in accordance with state laws and regulations, the legislation may enhance the quality of care provided. Patients can feel more confident that the care they receive meets established standards, thus fostering trust in their healthcare providers. Additionally, this focus on compliance could also reduce legal risks for healthcare facilities and providers, promoting a safer healthcare environment.
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5199 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 5199
To amend title XVIII of the Social Security Act to modernize physician,
physician assistant, and nurse practitioner utilization requirements.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 8, 2025
Mr. Mann (for himself, Ms. Tokuda, Mr. Zinke, Mr. Ciscomani, Mr.
Johnson of Georgia, Mr. Fields, Mr. Mannion, Mr. Thompson of
Mississippi, Mr. Costa, Mr. Baird, Mr. Valadao, Mr. Pappas, Ms.
Boebert, and Mr. Smith of Nebraska) 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 title XVIII of the Social Security Act to modernize physician,
physician assistant, and nurse practitioner utilization requirements.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Modernizing Rural Physician
Assistant and Nurse Practitioner Utilization Act of 2025''.
SEC. 2. MODERNIZING PHYSICIAN, PHYSICIAN ASSISTANT, AND NURSE
PRACTITIONER UTILIZATION REQUIREMENTS.
Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa))
is amended--
(1) in paragraph (2)(B), by striking ``has an arrangement''
and all that follows through the first semicolon and inserting
``meets the requirements described in paragraph (8);''; and
(2) by adding at the end the following new paragraph:
``(8) Requirements for certain facilities described.--For
purposes of paragraph (2)(B), with respect to a facility which
is not a physician-directed clinic, the following requirements
are described in this paragraph:
``(A) Arrangement.--The facility has an arrangement
consistent with the provisions of State and local law
relative to the practice, performance, and delivery of
health services, with one or more physician assistants
(as defined in paragraph (5)(A)) or one or more nurse
practitioners (as defined in such paragraph).
``(B) Practice and oversight requirements.--The
delivery of health services under such arrangement
shall be in accordance with State law or the State
regulatory mechanism governing the practice of
physician assistants or nurse practitioners.''.
SEC. 3. EFFECTIVE DATE.
This Act and the amendments made by this Act shall take effect on
January 1, 2027, and shall apply to items and services furnished on or
after such date.
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