[Congressional Record Volume 171, Number 201 (Tuesday, December 2, 2025)]
[Senate]
[Pages S8450-S8451]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself and Mr. Blumenthal):
  S. 3296. A bill to amend chapter 81 of title 5, United States Code, 
to cover, for purposes of workers' compensation under such chapter, 
services by physician assistants and nurse practitioners provided to 
injured Federal workers, and for other purposes; to the Committee on 
Homeland Security and Governmental Affairs.
  Ms. COLLINS. Mr. President, I rise today to introduce the Improving 
Access to Workers' Compensation for Injured Federal Workers Act. I am 
pleased that my colleague from Connecticut Senator Blumenthal is my 
lead cosponsor on this bill.
  Our bipartisan bill would allow physician assistants and nurse 
practitioners to certify disabilities and oversee treatment for Federal 
workers with injuries or illnesses that occur on the job, when doing so 
is consistent with the scope of their practice under State law.
  Civil servants bring dedication, competence, and experience to their 
work, and this proposal affords them greater choice over their own 
healthcare in the event that they suffer a work-related injury or 
illness. Federal employees can already select a PA or NP as their 
primary healthcare provider within the Federal Employees Health 
Benefits Program.
  However, and inexplicably, the Federal Employees' Compensation Act 
permits only a physician to make the diagnosis, certify the injury and 
extent of the disability, and to oversee the patient's treatments and 
care when a Federal employee is injured on the job.
  This bill would allow the more than 2 million Federal employees in 
our country, including more than 12,000 Federal employees in the State 
of Maine, the ability to receive their healthcare from the practitioner 
of their choice after a work-related injury. When they can make their 
own choice, they have access to more timely care and continuity of 
care. They are also having the decisions about their healthcare and the 
extent of their disability or illness made by their primary care 
physician who knows them best, who understands their healthcare 
history.
  Mainers, especially in our very rural communities, are often cared 
for by nurse practitioners or physician assistants. They act as their 
primary care providers. Let me give you an example. Jackie Carter and 
Corinne Malenfant are two nurse practitioners with a primary care 
practice in Orland, ME. They have described the challenges they face 
when they treat Federal employees.
  Despite being the chosen healthcare provider of their federally 
employed patients, Jackie and Corinne are not authorized to certify 
their patients' injuries and illnesses and oversee the care for their 
work-related injuries under the Federal Employees' Compensation Act. As 
a result, their patients can experience lengthy delays in starting 
treatment due to the requirement that only a physician can certify the 
injury and oversee the Federal employee's care while in the Workers' 
Compensation Program.
  In some very rural communities, Mr. President--and I suspect this may 
be true in parts of your State as well--there simply aren't any 
physicians who are practicing, or they are unable to accommodate 
additional patients.
  So think about the situation that is created here. A Federal 
employee, who has a primary care provider who is, say, a nurse 
practitioner or a physician assistant, is injured on the job, but 
instead of immediately being able to go to this primary care provider, 
they have to wait until they can get in to see a physician--a physician 
who may be miles away and unable to see them quickly, a physician who 
does not know their history. They can't proceed with getting the 
Federal employee's benefits and healthcare treatments they need to get 
well and return to work. That just makes no sense in rural America 
today.
  It is important to emphasize that this bill defers to State law. It 
would not expand the scope of any practice. Instead, it would simply 
remove a barrier that prevents dedicated healthcare professionals from 
practicing as their State permits them to do.
  NPs and PAs already provide a significant amount of healthcare to 
injured Federal employees, but within the Federal Employees' 
Compensation Act, while they are not currently authorized to certify 
injuries and oversee patient treatment, they are authorized to treat 
injured Federal employees and be reimbursed for their services but only 
in cases where a physician has first certified the injury and continues 
to oversee the treatment. That is redundant, it causes delays, and it 
does not make sense.
  Federal programs have long recognized the importance of nurse 
practitioners and physician assistants. Yet the Federal Employees' 
Compensation Act is an outlier in the restrictive nature of the program 
when it comes to NPs and PAs and their patients. Modernizing the 
Federal Employees' Compensation Act through the reforms contained in 
this legislation would be consistent with the practices of numerous 
other Federal Agencies and programs, including Medicare, the Veterans' 
Administration, the Federal Motor Carrier Safety Administration, the 
Indian Health Service, and the Social Security Administration. They 
don't create this additional barrier.
  In rural communities, NPs and PAs may well be the only provider 
within a reasonable distance. Delaying the certification of injuries or 
illnesses for Federal workers means delays in their care. The longer 
those delays take, the longer before they can get the treatment they 
need to return to their jobs.
  I also want to note that this bill would not increase Federal 
spending. The Congressional Budget Office has found that this bill 
would have an insignificant net effect on direct spending, reasoning 
that while it may increase access to care for injured Federal 
employees, it would be offset by

[[Page S8451]]

enabling them to return to work more quickly and to continue to serve 
the American people.
  Passage of the Improving Access to Workers' Compensation for Injured 
Federal Workers Act is a winner across the board. It simply makes 
common sense. It provides our dedicated Federal employees with 
additional healthcare options when they need it most. It allows NPs and 
PAs to share the knowledge they already have about their patients and 
treat their illnesses and injuries that are work-related in a timely 
fashion.
  I urge all of my colleagues to join Senator Blumenthal and me in 
supporting our bill.
                                 ______