[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 894 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 894

    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 HOUSE OF REPRESENTATIVES

                           February 27, 1997

Mr. Towns (for himself and Mrs. Johnson of Connecticut) introduced the 
following bill; which was referred to the Committee on Commerce, and in 
    addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 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 
1997''.

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.--Section 1842(b)(12) of such Act (42 U.S.C. 
1395u(b)(12)) is amended--
            (1) in the matter preceding clause (i) of subparagraph (A), 
        by striking ``clauses'' and all that follows through 
        ``practitioners)'' and inserting ``clause (ii) of section 
        1861(s)(2)(K) (relating to nurse practitioners), and clause 
        (iv) of such section insofar as it relates to clause (ii) of 
        such section''; and
            (2) by adding at the end the following new subparagraph:
    ``(C) With respect to services described in clause (i) of section 
1861(s)(2)(K) (relating to physician assistants), and clause (iv) of 
such section insofar as it relates to clause (i) of such section--
            ``(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.''.
    (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 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 clause (C) of the 
first sentence of this paragraph, 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 clause are performed.''.
    (e) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished and supplies provided on and 
after January 1, 1998.
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