II 109th CONGRESS 1st Session S. 1515 IN THE SENATE OF THE UNITED STATES July 27, 2005 Mr. Inouye introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XIX of the Social Security Act to improve access to advanced practice nurses and physician assistants under the Medicaid Program.

1.

Short title

This Act may be cited as the Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2005.

2.

Improved access to services of advanced practice nurses and physician assistants under State medicaid programs

(a)

Primary care case management

Section 1905(t)(2) of the Social Security Act (42 U.S.C. 1396d(t)(2)) is amended by striking subparagraph (B) and inserting the following: (B)A nurse practitioner (as defined in section 1861(aa)(5)(A)). (C)A certified nurse-midwife (as defined in section 1861(gg)). (D)A physician assistant (as defined in section 1861(aa)(5)(A)). . (b)

Fee-for-Service program

Section 1905(a)(21) of such Act (42 U.S.C. 1396d(a)(21)) is amended— (1)by inserting (A) after (21); (2)by striking services furnished by a certified pediatric nurse practitioner or certified family nurse practitioner (as defined by the Secretary) which the certified pediatric nurse practitioner or certified family nurse practitioner and inserting services furnished by a nurse practitioner (as defined in section 1861(aa)(5)(A)) or by a clinical nurse specialist (as defined in section 1861(aa)(5)(B)) which the nurse practitioner or clinical nurse specialist; (3)by striking the certified pediatric nurse practitioner or certified family nurse practitioner and inserting the nurse practitioner or clinical nurse specialist; and (4)by inserting before the semicolon at the end the following: and (B) services furnished by a physician assistant (as defined in section 1861(aa)(5)) with the supervision of a physician which the physician assistant is legally authorized to perform under State law. (c)

Including in mix of service providers under medicaid managed care organizations

Section 1932(b)(5)(B) of such Act (42 U.S.C. 1396u–2(b)(5)(B)) is amended by inserting , with such mix including nurse practitioners, clinical nurse specialists, physician assistants, certified nurse midwives, and certified registered nurse anesthetists (as defined in section 1861(bb)(2)) after services. (d)

Effective date

The amendments made by this section shall apply to items and services furnished in calendar quarters beginning on or after 90 days after the date of the enactment of this Act, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.