[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5246 Introduced in House (IH)]







109th CONGRESS
  2d Session
                                H. R. 5246

 To amend title XVIII of the Social Security Act to restore financial 
  stability to Medicare anesthesiology teaching programs for resident 
                              physicians.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 27, 2006

Mr. Shaw (for himself and Mr. Sessions) introduced the following bill; 
  which was referred to the Committee on Energy and 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 restore financial 
  stability to Medicare anesthesiology teaching programs for resident 
                              physicians.

    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 Teaching Anesthesiology 
Funding Restoration Act of 2006''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The current Medicare payment policy for Medicare 
        beneficiary services furnished by academic anesthesiology 
        programs administered by the Centers for Medicare & Medicaid 
        Services (CMS) is unfair and underpays such programs by 50 
        percent. In its 1991 rule change, CMS singled out academic 
        anesthesiology programs alone for a reduction in payment when 
        teaching anesthesiologists supervise residents in two 
        concurrent cases. This policy change was unique to 
        anesthesiology and does not affect other medical specialties or 
        non-physician providers.
            (2) The current Medicare payment policy administered by CMS 
        for academic anesthesiology programs is causing significant 
        harm to academic anesthesiology programs nationwide by 
        contributing to an overall decline in the number of such 
        programs. Before the current policy went into effect in 1994, 
        there were 162 academic anesthesiology programs nationwide. 
        Today, 130 academic anesthesiology programs exist. As such 
        programs close, medical students will face diminished 
        opportunities to enter the specialty of anesthesiology and 
        patients in the United States will see increased shortages in 
        anesthesiology medical care in the operating room and pain 
        clinics and through critical care medicine.
            (3) The current Medicare payment policy administered by CMS 
        for academic anesthesiology programs is shortchanging academic 
        anesthesiology programs an average of $400,000 annually, with 
        some programs losing in excess of $1 million. As such Medicare 
        payment decreases continue, academic anesthesiology programs 
        are experiencing increasing difficulty filling faculty 
        appointments and sustaining research and development of new 
        advances in anesthesiology medical care that have previously 
        contributed to its outstanding patient safety record.

SEC. 3. PURPOSE.

    The purpose of this Act is to restore the Medicare payment policy 
for academic anesthesiology programs to the policy administered by the 
Centers of Medicare & Medicaid Services before 1994 in order to--
            (1) ensure the financial stability of academic 
        anesthesiology programs in order to provide sufficient 
        opportunities for physician residents to pursue the specialty 
        of anesthesiology, so that patients continue to have access to 
        quality medical care in the operating room and pain clinics and 
        through critical care medicine; and
            (2) enable the specialty of anesthesiology to continue 
        making advances in patient safety through research based in 
        academic programs.

SEC. 4. SPECIAL PAYMENT RULE FOR TEACHING ANESTHESIOLOGISTS.

    Section 1848(a) of the Social Security Act (42 U.S.C. 1395w-4(a)) 
is amended--
            (1) in paragraph (4)(A), by inserting ``except as provided 
        in paragraph (5),'' after ``anesthesia cases,''; and
            (2) by adding at the end the following new paragraph:
                    ``(5) Special rule for teaching 
                anesthesiologists.--With respect to physicians' 
                services furnished on or after January 1, 2007, in the 
                case of teaching anesthesiologists involved in the 
                training of physician residents in a single anesthesia 
                case or two concurrent anesthesia cases, the fee 
                schedule amount to be applied shall be 100 percent of 
                the fee schedule amount otherwise applicable under this 
                section if the anesthesia services were personally 
                performed by the teaching anesthesiologist alone and 
                paragraph (4) shall not apply if--
                            ``(A) the teaching anesthesiologist is 
                        present during all critical or key portions of 
                        the anesthesia service or procedure involved; 
                        and
                            ``(B) the teaching anesthesiologist (or 
                        another anesthesiologist with whom the teaching 
                        anesthesiologist has entered into an 
                        arrangement) is immediately available to 
                        furnish anesthesia services during the entire 
                        procedure.''.
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