H.R. 7106

119 HR 7106 IH: Enhancing Skilled Nursing Facilities Act
 U.S. House of Representatives
 2026-01-15
 text/xml
 EN
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 I  119th CONGRESS  2d Session  H. R. 7106  IN THE HOUSE OF REPRESENTATIVES   January 15, 2026   Mrs. Kiggans of Virginia  (for herself and  Mrs. Dingell ) 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 streamline care delivery in skilled nursing facilities and nursing facilities under the Medicare and Medicaid programs.
1.
Short title
This Act may be cited as the   Enhancing Skilled Nursing Facilities Act  .
2.
Streamlining care delivery in skilled nursing facilities and nursing facilities
(a)
Medicare
(1)
Certification of post-hospital extended care services
Section 1814(a)(2) of the Social Security Act ( 42 U.S.C. 1395f(a)(2) ) is amended by striking  who does not  and all that follows through  physician,,  and inserting  working in accordance with State law, .
(2)
Supervision requirement in skilled nursing facility services
Section 1819(b)(6)(A) of the Social Security Act ( 42 U.S.C. 1395i–3(b)(6)(A) ) is amended—
(A)
in the header, by striking
Physician supervision   and inserting
Supervision  ; and
(B)
by inserting  or a nurse practitioner or physician assistant, in accordance with State law  after  physician .
(3)
Administration of part B
Section 1842(b)(2)(C) of the Social Security Act ( 42 U.S.C. 1395u(b)(2)(C) ) is amended—
(A)
by inserting  , a nurse practitioner, or a physician assistant  after  a physician ; and
(B)
by striking  and includes a physician assistant acting under the supervision of the physician or a nurse practitioner working in collaboration with that physician, or both .
(4)
Provision of medical and other health services
Section 1861(s)(2)(K)(ii) of the Social Security Act ( 42 U.S.C. 1395x(s)(2)(K)(ii) ) is amended by striking  or clinical nurse specialist (as defined in subsection (aa)(5)) working in collaboration (as defined in subsection (aa)(6)) with a physician (as defined in subsection (r)(1))  and inserting  (as defined in subsection (aa)(5)(A)), or by a clinical nurse specialist (as defined in subsection (aa)(5)(B)) working in collaboration with a physician (as defined in subsection (r)(1)), .
(5)
Scope of services
Section 1819(b)(2)(B) of the Social Security Act ( 42 U.S.C. 1395i–3(b)(2)(B) ) is amended by inserting  (or a nurse practitioner, physician assistant, or clinical nurse specialist working in accordance with State law)  after  attending physician .
(6)
Residents’ rights
Section 1819(c) of the Social Security Act ( 42 U.S.C. 1395i–3(c) ) is amended—
(A)
in paragraph (1)(A)(i), by inserting  nurse practitioner, physician assistant, or clinical nurse specialist working in accordance with State law  after  attending physician ;
(B)
in paragraph (2)(A), in the matter following clause (vi)—
(i)
by inserting  nurse practitioner, physician assistant, or clinical nurse specialist working in accordance with State law  after  resident’s physician ; and
(ii)
by inserting  , nurse practitioner, physician assistant, or clinical nurse specialist working in accordance with State law  after  a physician ; and
(C)
in paragraph (3)(A), by inserting  , nurse practitioner, physician assistant, or clinical nurse specialist working in accordance with State law  after  physician .
(b)
Medicaid
(1)
Certification of skilled nursing facility services and intermediate care facility services
Section 1902(a)(44) of the Social Security Act ( 42 U.S.C. 1396a(a)(44) ) is amended—
(A)
in subparagraph (A)—
(i)
by striking  (or, in the case of skilled nursing facility services or intermediate care facility services  and inserting  (or, in the case of intermediate care facility services ;
(ii)
by striking  physician) certifies  and inserting  physician, or, in the case of skilled nursing facility services, a physician, or a nurse practitioner, a physician assistant, or a clinical nurse specialist working in accordance with State law) certifies ;
(iii)
by striking  a physician, or, in the case of skilled nursing facility services or  and inserting  a physician, or, in the case of ; and
(iv)
by inserting  or, in the case of skilled nursing facility services, a physician, or a nurse practitioner, a physician assistant, or a clinical nurse specialist working in accordance with State law,  before  recertifies ; and
(B)
in subparagraph (B)—
(i)
by striking  skilled nursing facility services or ; and
(ii)
by inserting  , or, in the case of skilled nursing facility services, a physician, or a nurse practitioner, a physician assistant, or a clinical nurse specialist working in accordance with State law  before the semicolon.
(2)
Nursing facility services supervision and clinical records
Section 1919(b)(6)(A) of the Social Security Act ( 42 U.S.C. 1396r(b)(6)(A) ) is amended to read as follows:
(A)
require that the health care of every resident be provided under the supervision of a physician or nurse practitioner or a physician assistant (or, at the option of a State, under the supervision of a clinical nurse specialist);
 .