H.R. 3170 would allow nurse practitioners and physician assistants to diagnose, treat, and certify an injury and extent of disability for the purposes of compensating federal workers under the Federal Employees’ Compensation Act (FECA). Using information from the Department of Labor, CBO expects that nonphysician providers would be compensated at the same rate as physicians and that total benefits provided to injured federal workers would not significantly change. Some people may receive treatment more quickly under the bill, which could increase costs over the 10-year period because some payments to medical providers that would have occurred in 2036 under current law could be paid in 2035. On the other hand, if injured workers receive treatment faster, some may return to work more quickly, which could reduce costs. CBO has no basis to estimate which effect would predominate, but expects that those effects would roughly offset each other. Thus, CBO estimates that enacting H.R. 3170 would affect net direct spending by an insignificant amount.

Although FECA payments are mandatory, the costs are charged back to a claimant’s employing agency and those amounts are paid from the agency’s salaries and expense accounts. Any effect on spending would be subject to future appropriation actions.

The CBO staff contact for this estimate is Meredith Decker. The estimate was reviewed by Christina Hawley Anthony, Deputy Director of Budget Analysis.