[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[S. 1263 Introduced in Senate (IS)]







104th CONGRESS
  1st Session
                                S. 1263

To direct the Secretary of Health and Human Services to revise existing 
 regulations concerning the conditions of payment under part B of the 
medicare program relating to anesthesia services furnished by certified 
         registered nurse anesthetists, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

           September 20 (legislative day, September 5), 1995

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

_______________________________________________________________________

                                 A BILL


 
To direct the Secretary of Health and Human Services to revise existing 
 regulations concerning the conditions of payment under part B of the 
medicare program relating to anesthesia services furnished by certified 
         registered nurse anesthetists, 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 ``Medicare Anesthesia Services Reform 
Act''.
SEC. 2. REVISION OF CONDITIONS OF PAYMENT TO FOSTER CONSISTENCY WITH 
              STATE SUPERVISION STANDARDS.

    (a) Promulgation of Revised Regulations.--The Secretary of Health 
and Human Services shall revise any regulations describing the 
conditions under which payment may be made for anesthesia services 
under the medicare program under title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.) to provide that payment may be made under the 
medicare program for anesthesia services furnished in a hospital or an 
ambulatory surgical center by a certified registered nurse anesthetist 
who, under the law of the State in which the service is furnished, is 
permitted to administer anesthesia services without supervision by the 
physician performing the operation or the anesthesiologist.
    (b) Effective Date.--The revisions to the regulations referred to 
in subsection (a) shall apply with respect to anesthesia services 
furnished on or after January 1, 1996.

SEC. 3. ENSURING PAYMENT FOR PHYSICIAN AND CERTIFIED REGISTERED NURSE 
              ANESTHETIST FOR JOINTLY FURNISHED SINGLE CASE ANESTHESIA 
              SERVICES.

    (a)  Payment to Physician.--Section 1848(a)(4) of the Social 
Security Act (42 U.S.C. 1395w-4(a)(4)) is amended by adding at the end 
the following new subparagraph:
                    ``(C) Payment for single case.--Notwithstanding 
                section 1862(a)(1)(A), with respect to physicians' 
                services consisting of the furnishing of anesthesia 
                services for a single case that are furnished jointly 
                with a certified registered nurse anesthetist, if the 
                carrier determines that the use of both the physician 
                and the nurse anesthetist to furnish the anesthesia 
                service was not medically necessary, the fee schedule 
                amount to be applied shall be equal to 50 percent of 
                the fee schedule amount otherwise applicable under this 
                section if the anesthesia service were personally 
                performed by the physician alone.''.
    (b) Payment to CRNA.--Section 1833(l)(4)(B) of such Act (42 U.S.C. 
1395l(l)(4)(B)) is amended by adding at the end the following new 
clause:
    ``(iv) Notwithstanding section 1862(a)(1)(A), in the case of 
services of a certified registered nurse anesthetist consisting of the 
furnishing of anesthesia services for a single case that are furnished 
jointly with a physician, if the carrier determines that the use of 
both the physician and the nurse anesthetist to furnish the anesthesia 
service was not medically necessary, the fee schedule amount shall be 
equal to 50 percent of the fee schedule amount otherwise applicable 
under this section if the anesthesia service were personally performed 
by the physician alone.''.
    (c) Effective Date.--The amendments made by subsections (a) and (b) 
shall apply with respect to services furnished on or after January 1, 
1996.
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