New Bill Proposes Tighter Rules for Nerve Tests: Accreditation and Training Mandates on the Horizon

A new piece of legislation, the "Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act of 2025," is looking to change how and where you get certain nerve tests if you're on Medicare. The main idea is this: Medicare would only pay for electrodiagnostic services, like nerve conduction studies and needle electromyography (EMG) tests, if they're done at a "qualified facility." This bill aims to boost the quality of these diagnostic services and clamp down on fraud, but it could also mean some shifts in how easy it is to get these tests.

Getting Zapped: What's Actually Changing for Nerve Tests?

So, what does a "qualified facility" mean? Under this bill, it means a place that's been accredited by an organization hand-picked by the Secretary of Health and Human Services (HHS). The Secretary has two years from the bill's passage to name these accrediting bodies. These organizations will ensure facilities have solid quality assurance programs, use the right equipment, and have properly trained folks doing the tests and reading the results. Think of it like a Good Housekeeping Seal of Approval, but for places that do nerve diagnostics.

There's a particular focus on needle EMGs – those tests where tiny needles help see how your muscles and nerves are working. The bill, amending Section 1834 of the Social Security Act, specifies that the person performing a needle EMG must have at least three months of dedicated training in these studies during a medical residency or fellowship. Alternatively, they could be qualified under an existing rule, specifically section 410.32(b)(2)(iv) of title 42, Code of Federal Regulations, which already recognizes certain specialized physical therapists. The HHS Secretary also gets one year to finalize the nitty-gritty regulations for how this accreditation process will work, including how often facilities need to get re-accredited.

The New Watchdogs: An Advisory Committee Steps In

To help guide all these new rules, the bill calls for a "National Electrodiagnostic Services Advisory Committee" to be set up within two years. This committee will have 9 to 11 members who aren't government employees – a mix of doctors, physical therapists, other healthcare practitioners, and patient representatives. Their job? To give advice on the new requirements, regulations, and which organizations should get the nod to accredit facilities.

The committee's marching orders are pretty clear: they need to focus on cutting down on unnecessary treatments and surgeries, reducing how often people need to be retested, making diagnoses more reliable, tackling new ways waste, fraud, and abuse pop up, and generally improving the quality of care. They'll meet at least twice a year to hash things out. The idea is to have a diverse group of experts and patient voices shaping how these important diagnostic services are delivered.

Real-World Static: What This Means for Your Access and Wallet

Okay, so better quality and less fraud sound good on paper. But what are the potential real-world impacts? For starters, if your local clinic or hospital doesn't get accredited, Medicare might not cover your nerve test there. This could be a bigger deal in rural or underserved areas where there might not be many (or any) accredited options nearby. Imagine needing a nerve test for carpal tunnel or a pinched nerve and finding out you have to travel an extra hour or two to a facility that meets these new standards.

Then there's the cost. Getting accredited isn't usually free. Facilities will likely have to spend time and money to meet these new standards. The question is, who picks up that tab? Will it mean higher costs for the facility, which could then trickle down to patients or insurers? Or could it make it harder for smaller, independent practices to keep offering these services if they can't afford the accreditation process?

The bill gives the HHS Secretary significant power to define what "qualified" means and who gets to do the accrediting. How these rules are written will be crucial. The goal is to ensure quality without accidentally making it super difficult for people to get necessary tests or for well-meaning providers to offer them. It's a balancing act between stricter oversight and maintaining access to care.