Nursing Organizations Support Reintroduction of ICAN Act

• The ICAN Act (Improving Care and Access to Nurses) has been introduced for a third time in Congress. 
• The measure would give full practice authority to advanced practice registered nurses. 
• Nursing organizations have supported the bill, while physician groups have been opposed. 

Bipartisan legislation that would give full practice authority to advanced practice registered nurses (APRNs) has garnered renewed support from nursing advocacy groups. 

Earlier this month, Oregon Sen. Jeff Merkley and Wyoming Sen. Cynthia Lummis initiated a third attempt to move the Improving Care and Access to Nurses (ICAN) Act through Congress. The measure, now known as S.575, was first introduced in 2022 and again in 2023. 

“As the husband of a nurse, I know just how critical the care provided by nurses is and the valuable impact nurses have on their patients,” Merkley, co-chair of the Senate Nursing Caucus, stated in a news release. “Our bipartisan bill will remove barriers for advanced practice registered nurses and will increase staffing of highly-trained nurses, reduce costs, and improve patient care.” 

Reps. Dave Joyce, Suzanne Bonamici, Lauren Underwood, and Jen Kiggans introduced a companion bill in the House of Representatives.

Why Nursing Groups Support the ICAN Act 

Modernization of policies and practices, improving efficiencies, and expanding access were common themes among the organizations backing the ICAN Act. Cardiac and pulmonary rehabilitation and medical nutrition therapy referrals are among the expanded services the measure would provide, according to the American Nurses Association (ANA). 

Jan Setnor, MSN, CRNA, is president of the American Association of Nurse Anesthesiology (AANA) and retired Air Force Reserve colonel. She said in a statement that the act is a “win-win” for the healthcare system. 

“As a nurse anesthetist and a veteran, I know how important it is that patients have access to timely, high-quality care, and removing these barriers is critical to ensuring that,” Setnor said. “The care that CRNAs provide is foundational to a healthy America, enabling access to critical services including surgical and obstetrical care, particularly in rural and underserved communities. Removing barriers to this care not only increases access but makes the healthcare system more efficient for taxpayers.” 

The American Association of Nurse Practitioners, ANA, and LeadingAge joined AANA in its support.  

AMA Argues ICAN Act is ‘Scope Creep’ 

Since its first iteration, the ICAN Act has drawn opposition from the American Medical Association, which has consistently argued that it constitutes “scope creep.” 

Dr. Sandra Adamson Fryhofer, a past chair of the AMA Board of Trustees, said while moderating a panel in 2023 that the act would “endanger the quality of care received by patients covered by Medicare and Medicaid.” 

“Physician-led teams are best for our patients … Study after study supports the truth we know. Physician-led care teams lead to better and safer care for our patients. NPs are not a replacement for physicians. PAs are not a replacement for physicians,” Fryhofer said, citing a study out of Stanford University and another out of Mississippi. 

The American College of Emergency Physicians is among those that have joined the AMA in advocating against the ICAN Act. 

The Bottom Line

The Improving Care and Access to Nurses (ICAN) Act was recently reintroduced in both the House and Senate with bipartisan support. Proponents argue the measure will eliminate outdated policies and practices while opponents view it as scope creep that will harm patients. 

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