[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5286 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 5286

   To provide for a study of anesthesia services furnished under the 
  Medicare Program, and to expand arrangements under which certified 
        registered nurse anesthetists may furnish such services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 25, 2000

 Mr. Weldon of Florida (for himself and Mr. Green of Texas) introduced 
  the following bill; which was referred to the Committee on Ways and 
Means, and in addition to the Committee on Commerce, 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 provide for a study of anesthesia services furnished under the 
  Medicare Program, and to expand arrangements under which certified 
        registered nurse anesthetists may furnish such services.

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

SECTION 1. STUDY AND REPORT ON ANESTHESIA SERVICES UNDER THE MEDICARE 
              PROGRAM; MODIFICATION OF REGULATIONS REGARDING 
              SUPERVISION OF CERTIFIED REGISTERED NURSE ANESTHETISTS.

    (a) Study.--(1) The Secretary of Health and Human Services shall 
conduct a multistate comparative study of mortality and adverse outcome 
rates of medicare patients by providers of anesthesia services and by 
type of such providers. In conducting the study, the Secretary shall 
develop comparative outcome data for a representative sample of 
medicare patients based on the complexity of the anesthesia services 
furnished to such patients.
    (2) In conducting the study, the Secretary shall consult with 
appropriate national professional organizations with respect to the 
methodology, and shall use medicare operating room reimbursement claims 
data verified by sampling of actual patient records.
    (b) Report.--Not later than January 1, 2005, the Secretary shall 
submit to Congress a report containing the results of the study 
conducted under subsection (a).
    (c) Promulgation of Revised Regulations.--
            (1) In general.--Pending the completion of the study under 
        subsection (a), the Secretary of Health and Human Services 
        shall revise any regulations establishing conditions of 
        participation under the medicare program for hospitals and 
        ambulatory surgical centers under title XVIII of the Social 
        Security Act relating to anesthesia services furnished under 
        such program to provide that nurse anesthetists may furnish 
        anesthesia services as follows:
                    (A) Under the medical direction of an immediately 
                available anesthesiologist.
                    (B) Under the supervision of an immediately 
                available physician.
                    (C) If not under subparagraph (A) or (B), then 
                under a written collaboration agreement with an 
                immediately available physician or physician group that 
                is (i) experienced in the administration of anesthesia 
                and (ii) credentialed by the hospital or ambulatory 
                surgical center to participate in such collaboration.
            (2) Definitions.--In this subsection:
                    (A) The term ``medical direction'' has the meaning 
                given that term in regulation promulgated by the 
                Secretary pursuant to section 1887(a)(1)(A) of the 
                Social Security Act (42 U.S.C. 1395xx(a)(1)(A)).
                    (B) The term ``supervision'' means the medical 
                management of the anesthesia services furnished.
                    (C) The term ``collaboration'' means joint 
                management by a physician and a nurse anesthetist of 
                anesthesia services furnished pursuant to a jointly-
                developed written agreement that defines the respective 
                role of the collaborating parties, consistent with the 
                respective levels of their education, training, and 
                experience in furnishing such services.
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