Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025
The Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025 would change Medicare rules (title XVIII of the Social Security Act) to broaden how certain rural health clinics can deliver care through physician assistants (PAs) and nurse practitioners (NPs). Instead of requiring a facility to be “physician-directed,” the bill would allow facilities that are not physician-directed to still furnish services if they meet new requirements described in a new paragraph. Specifically, such facilities must have an arrangement with PAs or NPs and must deliver and supervise services in a way that complies with state laws governing PA/NP practice and oversight. The changes would take effect for items and services furnished on or after January 1, 2027. In short, the bill aims to expand the use of PAs and NPs in rural clinics by allowing non-physician-directed facilities to operate under state-law-based arrangements, potentially improving access to care for rural Medicare beneficiaries while preserving state-based professional oversight.
Key Points
- 1The bill adds a new paragraph (8) to section 1861(aa) to specify requirements for facilities that are not physician-directed clinics.
- 2For such facilities, the arrangement must be with one or more physician assistants or one or more nurse practitioners.
- 3The delivery of health services under that arrangement must comply with state law or the state regulatory mechanism governing the practice of physician assistants or nurse practitioners.
- 4The new requirements replace the prior language that referenced “an arrangement” without these specifics, effectively broadening the types of facilities that can provide services with PA/NP leadership (subject to state rules).
- 5Effective date: the changes apply to items and services furnished on or after January 1, 2027.