[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 3963 Introduced in Senate (IS)]








109th CONGRESS
  2d Session
                                S. 3963

To amend title XVIII of the Social Security Act to provide for improved 
access to cost-effective, quality physical medicine and rehabilitation 
 services under part B of the Medicare program, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 28, 2006

Mr. Thomas (for himself and Mr. Specter) 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 improved 
access to cost-effective, quality physical medicine and rehabilitation 
 services under part B of the Medicare program, 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 ``Access to Physical Medicine and 
Rehabilitation Services Improvement Act of 2006''.

SEC. 2. ACCESS TO PHYSICAL MEDICINE AND REHABILITATION SERVICES 
              PROVIDED INCIDENT TO A PHYSICIAN.

    Section 1862(a)(20) of the Social Security Act (42 U.S.C. 
1395y(a)(20)) is amended by striking ``(other than any licensing 
requirement specified by the Secretary)'' and inserting ``(other than 
any licensing, education, or credentialing requirements specified by 
the Secretary)''.

SEC. 3. COVERAGE OF CERTIFIED ATHLETIC TRAINER SERVICES AND CERTIFIED 
              LYMPHEDEMA THERAPIST SERVICES UNDER PART B OF THE 
              MEDICARE PROGRAM.

    (a) Coverage of Services.--Section 1861 of the Social Security Act 
(42 U.S.C. 1395x) is amended--
            (1) in subsection (s)(2)--
                    (A) in subparagraph (Z), by striking ``and'' at the 
                end;
                    (B) in subparagraph (AA), by adding ``and'' at the 
                end; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(BB) certified athletic trainer services (as defined in 
        subsection (ccc)(1)) and lymphedema therapist services (as 
        defined in subsection (ccc)(3)).''; and
            (2) by adding at the end the following new subsection:

     ``Athletic Trainer Services and Lymphedema Therapist Services

    ``(ccc)(1) The term `athletic trainer services' means services 
performed by a certified athletic trainer (as defined in paragraph (2)) 
under the supervision of a physician (as defined in section 1861(r)), 
which the athletic trainer is legally authorized to perform under State 
law (or the State regulatory mechanism provided by State law) of the 
State in which such services are performed, as would otherwise be 
covered if furnished by a physician (as so defined) or as an incident 
to a physician's professional service, to an individual--
            ``(A) who is under the care of a physician (as so defined); 
        and
            ``(B) with respect to whom a plan prescribing the type, 
        amount, and duration of services that are to be furnished to 
        such individual has been established by a physician (as so 
        defined).
Such term does not include any services for which a facility or other 
provider charges or is paid any amounts with respect to the furnishing 
of such services.
    ``(2) The term `certified athletic trainer' means an individual 
who--
            ``(A) possesses a bachelor's, master's, or doctoral degree 
        which qualifies for licensure or certification as an athletic 
        trainer; and
            ``(B) in the case of an individual performing services in a 
        State that provides for licensure or certification of athletic 
        trainers, is licensed or certified as an athletic trainer in 
        such State.
    ``(3) The term `certified lymphedema therapist services' means 
services performed by a certified lymphedema therapist (as defined in 
paragraph (4)) under the supervision of a physician (as defined by 
paragraph (1) or (3) of section 1861(r)) which the lymphedema therapist 
is legally authorized to perform under State law (or the State 
regulatory mechanism provided by the State law) of the State in which 
such services are performed, as would otherwise be covered if furnished 
by a physician (as so defined) or as incident to a physicians 
professional service, to an individual--
            ``(A) who is under the care of a physician (as so defined); 
        and
            ``(B) with respect to whom a plan prescribing the type, 
        amount, and duration of services that are to be furnished to 
        such individual has been established by a physician (as so 
        defined).
Such term does not include any services for which a facility or other 
provider charges or is paid any amounts with respect to the furnishing 
of such services
    ``(4) The term `certified lymphedema therapist' means an individual 
who--
            ``(A) possesses a current unrestricted license as a health 
        professional in the State in which he or she practices;
            ``(B) after obtaining such a license, has successfully 
        completed 135 hours of Complete Decongestive Therapy coursework 
        which consists of theoretical instruction and practical 
        laboratory work utilizing teaching methods directly aimed at 
        the treatment of lymphatic and vascular disease from a 
        lymphedema training program recognized by the Secretary for 
        purposes of certifying lymphedema therapists; and
            ``(C) in the case of an individual performing services in a 
        State that provides for licensure or certification of 
        lymphedema therapists, is licensed or certified as a lymphedema 
        therapist in such State.''.
    (b) Payment.--
            (1) In general.--Section 1832(a)(2)(B) of the Social 
        Security Act (42 U.S.C. 1395k(a)(2)(B)) is amended by adding at 
        the end the following new clause:
                            ``(v) athletic trainer services and 
                        lymphedema therapist services; and''.
            (2) Amount.--Section 1833(a)(1) of the Social Security Act 
        (42 U.S.C. 1395l(a)(1)) is amended--
                    (A) by striking ``and (V)'' and inserting ``(V)''; 
                and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and (W) with respect to athletic 
                trainer services and lymphedema therapist services 
                under section 1861(s)(2)(BB), the amounts paid shall be 
                80 percent of the lesser of the actual charge for the 
                service or the fee schedule amount under section 1848 
                for the same service performed by a physician''.
    (c) Inclusion of Services in the Therapy Cap.--Services provided by 
a certified athletic trainer or a certified lymphedema therapist (as 
those terms are defined in section 1861(ccc) of the Social Security 
Act, as added by subsection (a)) shall be subject to the limitation on 
payments described in section 1833(g) of such Act (42 U.S.C. 1395l(g)) 
in the same manner those services would be subject to limitation if the 
service had been provided by a physician personally.
    (d) Inclusion of Athletic Trainers and Lymphedema Therapists as 
Practitioners for Assignment of Claims.--Section 1842(b)(18)(C) of the 
Social Security Act (42 U.S.C.1395u(b)(18)(C)) is amended by adding at 
the end the following new clauses:
            ``(vii) A certified athletic trainer (as defined in section 
        1861(ccc)(1)).
            ``(viii) A certified lymphedema therapist (as defined in 
        section 1861(ccc)(2)).''.
    (e) Coverage of Certain Physical Medicine and Rehabilitation 
Services Provided in Rural Health Clinics and Federally Qualified 
Health Centers.--
    Section 1861(aa)(1)(B) of the Social Security Act (42 U.S.C. 
1395x(aa)(1)(B)) is amended by striking ``or by a clinical social 
worker (as defined in subsection (hh)(1))'' and inserting ``, by a 
clinical social worker (as defined in subsection (hh)(1)), by a 
certified athletic trainer (as defined in subsection (ccc)(2)), or by a 
certified lymphedema therapist (as defined in subsection (ccc)(4))''.
    (f) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished on or after January 1, 2007.
                                 <all>