[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 371 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                 S. 371

    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

                           February 27, 1997

Mr. Grassley (for himself, Mr. Conrad, and Mr. Hollings) 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 
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.--
            (1) In general.--Section 1842(b)(12) of the Social Security 
        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) of section 
1861(s)(2)(K), and in clause (iv) of that section (but only with 
respect to services and supplies furnished as an incident to physician 
assistant services)--
            ``(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 the 
        Social Security Act (42 U.S.C. 1395u(b)(12)(A)) is amended in 
        the matter preceding clause (i) by striking ``clauses (i)'' 
        through ``nurse practitioners)'' and inserting the following: 
        ``clause (ii) of section 1861(s)(2)(K), and in clause (iv) of 
        that section (but only with respect to services and supplies 
        furnished as an incident to nurse practitioner services)''.
    (c) Bonus Payment for Services Provided in Health Professional 
Shortage Areas.--Section 1833(m) of the Social Security 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 that paragraph, in addition 
to the amount otherwise paid under this part, there shall also be paid 
to the physician assistant (or to an employer in the case of services 
described in section 1842(b)(6)(C)), 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 the Social Security Act (42 U.S.C. 1395u(b)(6)) is 
amended by adding at the end the following: ``For purposes of 
subparagraph (C), an employment relationship includes any independent 
contractor arrangement, and employer status shall be determined in 
accordance with the law of the State in which the services referred to 
in that 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, 1997.
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