H.R. 4122 would allow nurse practitioners and physician assistants to prescribe treatments for claimants under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Currently, only physicians may provide those medical services.
Nurse practitioners and physician assistants can provide most medical services under EEOICPA. The bill would expand their authority by enabling them to prescribe treatments without needing approval from a physician, which could increase the amount of care provided. Conversely, enacting the bill could reduce costs by eliminating the need for a physician to cosign—a service for which physicians can bill the program—and by enabling the program to pay for medical services at the lower rate that applies to nurse practitioners and physician assistants. On net, CBO estimates that direct spending for health care under EEOICPA would change by less than $500,000 over the 2026-2036 period.
The CBO staff contact for this estimate is David Rafferty. The estimate was reviewed by Christina Hawley Anthony, Deputy Director of Budget Analysis.
