[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1846 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 1846

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


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 29, 2007

  Mr. Towns 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 provide improved 
access to 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 ``Medicare Access to Physical Medicine 
and Rehabilitation Services Improvement Act of 2007''.

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:

``Certified Athletic Trainer Services and Lymphedema Therapist Services

    ``(ccc)(1) The term `certified 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 
subsection (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) 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; or
            ``(B) in the case of an individual performing services in a 
        State that does not provide for licensure or certification of 
        athletic trainers, possesses a bachelors, master's or doctoral 
        degree which qualifies for certification as an athletic 
        trainer, and, has successfully passed a national certification 
        examination for Athletic Trainers recognized by the Secretary.
    ``(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 subsection (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 the individual 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 such Act (42 
        U.S.C. 1395k(a)(2)(B)) is amended by adding at the end the 
        following new clause:
                            ``(v) certified athletic trainer services 
                        and lymphedema therapist services;''.
            (2) Amount.--Section 1833(a)(1) of such 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 certified 
                athletic trainer services and certified 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''.
            (3) Payment to employer.--The first sentence of section 
        1842(b)(6) of such Act (42 U.S.C. 1395u(b)(6)) is amended--
                    (A) by striking ``and'' before ``(H)''; and
                    (B) by inserting before ``; but nothing'' the 
                following: ``, and (H) in the case of certified 
                athletic trainer services and lymphedema therapist 
                services, payment shall be made to the physician, 
                clinic, or hospital that employs the athletic trainer 
                or lymphedema therapist involved''.
    (c) Inclusion of Services in the Therapy Cap.--Section 1833(g)(1) 
of such Act (42 U.S.C. 1395l(g)(1)) is amended--
            (1) by striking ``and'' before ``physical therapy''; and
            (2) by inserting after ``or as incident to physicians' 
        services,'' the following: ``and certified athletic trainer 
        services and certified lymphedema therapist services''.
    (d) Inclusion of Athletic Trainers and Lymphedema Therapists as 
Practitioners for Assignment of Claims.--Section 1842(b)(18)(C) of such 
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 such Act (42 U.S.C. 
1395x(aa)(1)(B)) is amended--
            (1) by striking ``or'' before ``by a clinical social 
        worker''; and
            (2) by inserting after ``subsection (hh)(1)),'' the 
        following: ``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, 2008.
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