[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[S. 863 Introduced in Senate (IS)]







104th CONGRESS
  1st Session
                                 S. 863

    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

                 May 25 (legislative day, May 15), 1995

  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 
1995''.

SEC. 2. INCREASED MEDICARE REIMBURSEMENT FOR PHYSICIAN ASSISTANTS.

    (a) Removal of Restriction on Settings.--Section 1861(s)(2)(K)(i) 
of the Social Security 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,''.
    (b) Increased Payment.--
            (1) In general.--Section 1842(b)(12) of such Act (42 U.S.C. 
        1395u(b)(12)) is amended by adding at the end the following new 
        subparagraph:
    ``(C) With respect to services described in clause (i) and (iv) of 
section 1861(s)(2)(K) (relating to physician assistants)--
            ``(i) payment under this part may only be made on an 
        assignment-related basis; and
            ``(ii) the amounts paid under this part shall be equal to 
        80 percent of (I) the lesser of the actual charge or 85 percent 
        of the fee schedule amount provided under section 1848 for the 
        same service provided by a physician who is not a specialist; 
        or (II) in the case of services as an assistant at surgery, the 
        lesser of the actual charge or 85 percent of the amount that 
        would otherwise be recognized if performed by a physician who 
        is serving as an assistant at surgery.''.
            (2) Conforming amendment.--Section 1842(b)(12)(A) of such 
        Act (42 U.S.C. 1395u(b)(12)(A)) is amended in the matter 
        preceding clause (i) by striking ``(i), (ii),'' and inserting 
        ``(ii)''.
            (3) Technical amendment.--Section 1842(b)(12)(A) of such 
        Act (42 U.S.C. 1395u(b)(12)(A)) is amended in the matter 
        preceding clause (i) by striking ``a physician assistants'' and 
        inserting ``physician assistants''.
    (c) 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 to 
an individual, described in paragraph (1), in an area that is 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 subparagraph (C) of section 1842(b)(6)) (on a monthly or quarterly 
basis) from the Federal Supplementary Medical Insurance Trust Fund an 
amount equal to 10 percent of the payment amount for the service under 
this part.''.
    (d) 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 subparagraph (C), 
an employment relationship may include any independent contractor 
arrangement, and employer status shall be determined in accordance with 
the law of the State in which the services described in such 
subparagraph are performed.''.
    (e) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished and supplies provided on and 
after July 1, 1995.
                                 <all>