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    <updateDate>2019-11-15T21:55:06Z</updateDate>
    <updateDateIncludingText>2019-11-15T21:55:06Z</updateDateIncludingText>
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    <introducedDate>2009-01-26</introducedDate>
    <congress>111</congress>
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        <chamber>Senate</chamber>
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            <name>Referred to</name>
            <date>2009-01-26T21:15:30Z</date>
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            <name>Finance Committee</name>
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        <text>Read twice and referred to the Committee on Finance.</text>
        <type>IntroReferral</type>
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      <item>
        <actionDate>2009-01-26</actionDate>
        <text>Sponsor introductory remarks on measure. (CR S835-836)</text>
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          <name>Library of Congress</name>
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        <actionDate>2009-01-26</actionDate>
        <text>Introduced in Senate</text>
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    <sponsors>
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        <bioguideId>G000386</bioguideId>
        <fullName>Sen. Grassley, Chuck [R-IA]</fullName>
        <firstName>Charles</firstName>
        <lastName>Grassley</lastName>
        <party>R</party>
        <state>IA</state>
        <middleName>E.</middleName>
        <isByRequest>N</isByRequest>
      </item>
    </sponsors>
    <cosponsors>
      <item>
        <bioguideId>C001035</bioguideId>
        <fullName>Sen. Collins, Susan M. [R-ME]</fullName>
        <firstName>Susan</firstName>
        <lastName>Collins</lastName>
        <party>R</party>
        <state>ME</state>
        <middleName>M.</middleName>
        <sponsorshipDate>2009-04-29</sponsorshipDate>
        <isOriginalCosponsor>False</isOriginalCosponsor>
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    </cosponsors>
    <policyArea>
      <name>Health</name>
    </policyArea>
    <subjects>
      <legislativeSubjects>
        <item>
          <name>Health care costs and insurance</name>
        </item>
        <item>
          <name>Health care coverage and access</name>
        </item>
        <item>
          <name>Health facilities and institutions</name>
        </item>
        <item>
          <name>Health personnel</name>
        </item>
        <item>
          <name>Home and outpatient care</name>
        </item>
        <item>
          <name>Hospital care</name>
        </item>
        <item>
          <name>Long-term, rehabilitative, and terminal care</name>
        </item>
        <item>
          <name>Medicare</name>
        </item>
        <item>
          <name>Public contracts and procurement</name>
        </item>
        <item>
          <name>Rural conditions and development</name>
        </item>
      </legislativeSubjects>
      <policyArea>
        <name>Health</name>
      </policyArea>
    </subjects>
    <summaries>
      <summary>
        <versionCode>00</versionCode>
        <actionDate>2009-01-26</actionDate>
        <actionDesc>Introduced in Senate</actionDesc>
        <updateDate>2009-02-13T21:02:31Z</updateDate>
        <text><![CDATA[ <p>Medicare Rural Health Access Improvement Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act to: (1) extend Medicare flex grants; (2) revise requirements for the Medicare-dependent hospital (MDH) program; (3) revise the Medicare inpatient hospital payment adjustment for low-volume hospitals; (4) eliminate temporarily the disproportionate share hospital (DSH) adjustment cap; and (5) extend and revise the Medicare hold harmless provision under the prospective payment system (PPS) for hospital outpatient department (HOPD) services for certain hospitals.</p> <p>Revises requirements for the treatment of rural sole community hospitals and Medicare dependent, small rural hospitals under the PPS for HOPD services. </p> <p>Provides for recognition of equality of physician work in all geographic areas under the Medicare physician fee schedule.</p> <p></p> <p>Revises the practice expense geographic adjustment under the Medicare physician fee schedule.</p> <p>Extends the treatment of certain physician pathology services, and increased Medicare payments for rural ground ambulance services.</p> <p></p> <p>Directs the Secretary of Health and Human Services to set $92 as the maximum rate of payment per visit in 2010 for independent rural health clinics.</p> <p>Requires the Secretary to exempt from competitive acquisition requirements rural areas and small metropolitan statistical areas (MSAs) with a population of 600,000 or less.</p> <p>Permits physician assistants to order post-hospital extended care services. Recognizes attending physician assistants as attending physicians for the purpose of serving hospice patients.</p> <p><br> </p>]]></text>
      </summary>
    </summaries>
    <title>Medicare Rural Health Access Improvement Act of 2009</title>
    <titles>
      <item>
        <titleType>Short Titles as Introduced</titleType>
        <title>Medicare Rural Health Access Improvement Act of 2009</title>
      </item>
      <item>
        <titleType>Display Title</titleType>
        <title>Medicare Rural Health Access Improvement Act of 2009</title>
      </item>
      <item>
        <titleType>Official Title as Introduced</titleType>
        <title>A bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas.</title>
      </item>
    </titles>
    <textVersions>
      <item>
        <type>Introduced in Senate</type>
        <date>2009-01-26T05:00:00Z</date>
        <formats>
          <item>
            <url>https://www.govinfo.gov/content/pkg/BILLS-111s318is/xml/BILLS-111s318is.xml</url>
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    <latestAction>
      <actionDate>2009-01-26</actionDate>
      <text>Read twice and referred to the Committee on Finance.</text>
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    <dc:language>EN</dc:language>
    <dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
    <dc:contributor>Congressional Research Service, Library of Congress</dc:contributor>
    <dc:description>This file contains bill summaries and statuses for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.</dc:description>
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