[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 834 Introduced in Senate (IS)]

103d CONGRESS
  1st Session
                                 S. 834

    To amend title XVIII of the Social Security Act to provide for 
increased medicare reimbursement for physician assistants, to increase 
the delivery of health services in health professional shortage areas, 
                        and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

               April 28 (legislative day, April 19), 1993

  Mr. Grassley (for himself and Mr. Conrad) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
    To amend title XVIII of the Social Security Act to provide for 
increased medicare reimbursement for physician assistants, to increase 
the delivery of health services in health professional shortage areas, 
                        and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Physician Assistant Incentive Act of 
1993''.

SEC. 2. INCREASED MEDICARE REIMBURSEMENT FOR PHYSICIAN ASSISTANTS.

    (a) In General.--Section 1842(b)(12) of the Social Security Act (42 
U.S.C. 1395u(b)(12)) is amended--
            (1) by striking ``a physician assistants'' in subparagraph 
        (A) and inserting ``physician assistants'';
            (2) by striking ``65 percent'' in subclause (I) of 
        subparagraph (A)(ii) and inserting ``applicable percentage (as 
        defined in subparagraph (B))'';
            (3) by striking subclause (II) of subparagraph (A)(ii) and 
        inserting the following new subclause:
                    ``(II) in other cases, for services of a physician 
                assistant the applicable percentage (as so defined) of 
                the fee schedule amount specified in section 1848, or 
                for services of a nurse practitioner the fee schedule 
                amount specified in such section, for the same service 
                performed by a physician who is not a specialist.''; 
                and
            (4) by striking subparagraph (B) and inserting the 
        following new subparagraph:
    ``(B) In subparagraph (A)(ii), the term `applicable percentage' 
means--
            ``(i) 97 percent in the case of services performed by 
        physician assistants, and
            ``(ii) 65 percent in the case of services performed by 
        nurse practitioners.''.
    (b) Bonus Payment for Services Provided in Health Professional 
Shortage Areas.--Section 1833(m) of such Act (42 U.S.C. 1395l(m)) is 
amended--
            (1) by inserting ``(1)'' after ``(m)''; and
            (2) by adding at the end the following new paragraph:
    ``(2) In the case of services of a physician assistant furnished--
            ``(A) to an individual described in paragraph (1),
            ``(B) in a health professional shortage area as described 
        in such paragraph,
in addition to the amount otherwise paid under this part, there shall 
also be paid to such physician assistant (or to an employer in the 
cases described in clause (C) of section 1842(b)(6)) (on a monthly or 
quarterly basis) from the Federal Supplementary Medical Trust Fund an 
amount equal to 10 percent of the payment amount for the service under 
this part.''.
    (c) Removal of Restriction on Employment Relationship.--Section 
1842(b)(6) of such Act (42 U.S.C. 1395u(b)(6)) is amended by adding at 
the end the following new sentence: ``For purposes of clause (C), an 
employment relationship may include any independent contractor 
arrangement, and an employer status shall be determined in accordance 
with the law of the State in which the services described in such 
clause are performed.''.
    (d) Removal of Restriction on Settings.--Section 1861(s)(2)(K)(i) 
of such Act (42 U.S.C. 1395x(s)(2)(K)(i)) is amended by striking ``(I) 
in a hospital'' and all that follows through ``shortage area''.
    (e) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after July 1, 1993.

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