[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4651 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 4651

  To amend the Federal Employees' Compensation Act to cover services 
 provided to injured Federal workers by physician assistants and nurse 
                 practitioners, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 13, 2007

 Mr. Hare (for himself and Mr. Souder) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend the Federal Employees' Compensation Act to cover services 
 provided to injured Federal workers by physician assistants and nurse 
                 practitioners, 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 ``Improving Access to Workers' 
Compensation for Injured Federal Workers Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Medical services and supplies provided by physician 
        assistants (PAs), nurse practitioners (NPs), clinical nurse 
        specialists (CNSs), certified nurse midwives (CNMs), and 
        certified registered nurse anesthetists (CRNAs), are not 
        included in the definition of ``medical, surgical, and hospital 
        services and supplies'' in the Federal Employees' Compensation 
        Act (5 U.S.C. 8101 et seq.). PAs, NPs, CNSs, CNMs, and CRNAs 
        are not included in the definition of ``physician'' in such 
        Act, and claims signed by PAs, NPs, CNSs, CNMs, and CRNAs have 
        been denied by the Office of Workers' Compensation Programs of 
        the Department of Labor.
            (2) In some rural areas where many of these providers are 
        the only full-time providers of care, injured Federal workers 
        may have to travel more than 100 miles to receive care that is 
        reimbursable.
            (3) In some cases, Federal workers have been advised to use 
        hospital emergency rooms for non-emergency care, rather than 
        receiving care after hours at local clinics where many of these 
        providers are the only health care professionals on-site.
            (4) PAs, NPs, CNSs, and CNMs are covered providers within 
        Medicare, Medicaid, Tri-Care, and most private insurance plans.
            (5) PAs, NPs, and CNMs are legally regulated in all 50 
        States, the District of Columbia, and Guam.
            (6) All 50 States, the District of Columbia, and Guam 
        authorize physicians to delegate prescriptive privileges to the 
        PAs they supervise, authorize NPs to prescribe medications 
        under their own signature, and 48 States, the District of 
        Columbia, American Samoa, and Guam provide prescriptive 
        authority to CNMs.
            (7) PAs and NPs work in virtually every area of medicine 
        and surgery and are also employed by the Federal government to 
        provide medical care, including by the Department of Veterans 
        Affairs, the Department of Defense, and the Public and Indian 
        Health Services.
            (8) CNSs have clinical nursing expertise in diagnosis and 
        provide direct care to prevent, remediate, or alleviate illness 
        and promote health. CNSs practice in hospitals, clinics, 
        nursing homes, and other community-based settings.
            (9) CNMs provide vital care to pregnant Federal workers who 
        are injured on the job.
            (10) CRNAs, the oldest of the advanced nursing specialties, 
        administer more than 65 percent of all anesthetics given to 
        patients each year, and are the sole providers of anesthetics 
        in 85 percent of rural hospitals.
            (11) CRNAs work in almost every setting in which anesthesia 
        is given, including operating rooms, dental offices, pain 
        clinics, and ambulatory surgical settings.
            (12) Amending the Federal Employees' Compensation Act to 
        recognize PAs and NPs as covered providers will bring this Act 
        in line with the overwhelming majority of State workers' 
        compensation programs, which recognize PAs and NPs as covered 
        providers.
            (13) The exclusion of PAs, NPs, CNSs, CNMs, and CRNAs from 
        the category of covered providers under the Federal Employees' 
        Compensation Act limits patients' access to medical care, 
        services, and supplies, disrupts continuity of care, and 
        creates unnecessary costs for the Office of Workers' 
        Compensation Programs.

SEC. 3. INCLUSION OF PHYSICIAN ASSISTANTS AND ADVANCED PRACTICE 
              REGISTERED NURSES IN FEDERAL EMPLOYEES' COMPENSATION ACT.

    (a) Inclusion.--Section 8101 of title 5, United States Code, is 
amended--
            (1) in paragraph (3), by inserting ``other eligible 
        providers,'' after ``chiropractors,'';
            (2) by striking ``and'' at the end of paragraphs (18) and 
        (19);
            (3) by striking the period at the end of paragraph (20) and 
        inserting ``; and''; and
            (4) by adding at the end the following:
            ``(21) `other eligible provider' means a physician 
        assistant, nurse practitioner, clinical nurse specialist, 
        certified nurse midwife, or certified registered nurse 
        anesthetist, within the scope of their practice as defined by 
        State law, or as credentialed by the Federal government.''.
    (b) Conforming Amendments.--Chapter 81 of title 5, United States 
Code, is amended--
            (1) in section 8103(a)--
                    (A) in the matter preceding paragraph (1), by 
                inserting ``or other eligible provider'' after 
                ``physician'';
                    (B) in paragraph (3), by inserting ``or other 
                eligible providers'' after ``physicians''; and
                    (C) in the matter following paragraph (3), by 
                inserting ``or other eligible provider'' after 
                ``physician'';
            (2) in section 8121(6), by inserting ``or other eligible 
        provider'' after ``physician''; and
            (3) in section 8123(a)--
                    (A) in the second sentence, by inserting ``or other 
                eligible provider'' after ``physician''; and
                    (B) in the third sentence, by striking ``of the 
                employee'' and inserting ``or other eligible provider 
                of the employee''.

SEC. 4. EFFECTIVE DATE.

    The amendments made by this section shall apply beginning on the 
first day of the second Federal fiscal year quarter that begins on or 
after the date of the enactment of this Act.
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