This legislation seeks to modernize how physician assistants and nurse practitioners are utilized within healthcare facilities under Medicare. It specifically amends Section 1861(aa) of the Social Security Act to update requirements for facilities that are not physician-directed clinics. The bill mandates that these facilities must have an arrangement with one or more physician assistants or nurse practitioners , ensuring consistency with State and local laws governing their practice. Furthermore, the delivery of health services under these arrangements must strictly adhere to the State's specific laws or regulatory mechanisms for these professionals. This aims to streamline federal regulations with existing state-level scopes of practice, potentially enhancing access to care, particularly in rural areas, by January 1, 2027.