119-HR-7106 Journalist Public Summary

Headline Summary

Let qualified nurse practitioners and physician assistants, consistent with state law, handle more supervising, certifying, and billing tasks in Medicare- and Medicaid-covered nursing facilities to reduce delays and streamline care.

What It Does

The Enhancing Skilled Nursing Facilities Act updates Medicare and Medicaid rules so that, where state law allows, nurse practitioners (NPs), physician assistants (PAs), and in some cases clinical nurse specialists (CNSs) can supervise residents’ care, certify and recertify stays, sign required documents, and bill for certain services in skilled nursing facilities (SNFs) and nursing facilities. It also clarifies residents’ rights and care‑planning language to recognize these clinicians alongside physicians.

• Lets NPs and PAs (and, for some Medicaid provisions, CNSs) supervise care in facilities when permitted by state law.
• Allows NPs/PAs to certify and recertify SNF stays and services that previously required a physician signature.
• Aligns Medicare Part B billing language so NPs/PAs can be paid directly for covered services they provide in these settings.
• Updates “attending physician” and residents’ rights provisions so care teams can include NPs/PAs/CNSs explicitly.
• Does not override state scope‑of‑practice rules—state law still governs what each clinician may do.

Who’s For It

• Sponsors: Reps. Jennifer Kiggans (R‑VA) and Debbie Dingell (D‑MI), signaling bipartisan interest in easing staffing pressures and paperwork in nursing facilities.
• Supportive arguments you’ll hear: faster care decisions (fewer waiting periods for physician sign‑offs), better coverage during off‑hours and in rural areas, and letting clinicians practice at the top of their training.
• Likely backers in the debate: many long‑term care operators and organizations representing advanced practice clinicians (NPs/PAs/CNSs) who favor streamlined federal rules.

Who’s Against It

• Skeptics’ concerns: patient safety and care coordination if physician oversight is reduced; preference for physician‑led teams in complex cases.
• Potential opponents: some physician groups and medical societies that traditionally resist expanding non‑physician authority without clear guardrails.
• Operational worry from some facilities: navigating differing state rules could still create compliance complexity.

What’s Next

Status as of January 15, 2026: introduced in the House and referred to the Committees on Energy and Commerce and Ways and Means. Next steps typically include committee hearings and markups; if approved, a House floor vote, then Senate consideration, and finally the President’s signature if both chambers pass the same text.