Which act determining NP reimbursement by Medicare was enacted first?

The Budget Reconciliation Act was the earliest piece of legislation among the options listed that directly addressed reimbursement for nurse practitioners (NPs) through Medicare. This act, originally passed in the 1990s, set the stage for changes in how Medicare calculated and provided reimbursement rates for various healthcare providers, including NPs.

The significance of this act lies in its focus on adjusting financial provisions within Medicare and influencing broader healthcare reform. It helped establish the framework for subsequent legislation that further refined NP reimbursement.

In contrast, the other acts mentioned either came later or focused on additional reforms or improvements to existing programs, thereby building on the foundation established by the Budget Reconciliation Act. This historical context supports the understanding of the evolving nature of healthcare legislation and its impact on NP reimbursement policies.