[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2204 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 2204

  To amend title XVIII of the Social Security Act to provide payment 
  under part A of the Medicare Program on a reasonable cost basis for 
 anesthesia services furnished by an anesthesiologist in certain rural 
 hospitals in the same manner as payments are provided for anesthesia 
    services furnished by anesthesiologist assistants and certified 
            registered nurse anesthetists in such hospitals.


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                    IN THE HOUSE OF REPRESENTATIVES

                             April 30, 2009

 Mr. Cuellar (for himself and Mr. Akin) introduced the following bill; 
         which was referred to the Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
  To amend title XVIII of the Social Security Act to provide payment 
  under part A of the Medicare Program on a reasonable cost basis for 
 anesthesia services furnished by an anesthesiologist in certain rural 
 hospitals in the same manner as payments are provided for anesthesia 
    services furnished by anesthesiologist assistants and certified 
            registered nurse anesthetists in such hospitals.

    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 Rural 
Anesthesiology Act of 2009''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) There is an acknowledged shortage of anesthesia 
        professionals in rural hospitals. Research indicates that 
        surgeons in many rural hospitals are performing and would like 
        to perform more complex surgeries that could be made safer and 
        more practical if anesthesia services were provided by an 
        anesthesiologist.
            (2) As medical doctors and doctors of osteopathy, 
        anesthesiologists are excluded from competing to assure the 
        availability of anesthesia services in certain rural areas 
        because only anesthesiologist assistants and certified 
        registered nurse anesthetists are eligible for special pass-
        through payments under part A of the Medicare program for 
        anesthesia services furnished in certain rural hospitals.
            (3) The Centers for Medicare & Medicaid Services has stated 
        that a statutory change is necessary to allow anesthesiologists 
        to receive payment under part A of the Medicare program on a 
        reasonable cost basis for anesthesia services provided.

SEC. 3. MEDICARE PART A PAYMENT FOR ANESTHESIOLOGIST SERVICES IN 
              CERTAIN RURAL HOSPITALS BASED ON CRNA PASS-THROUGH RULES.

    (a) In General.--Section 1814 of the Social Security Act (42 U.S.C. 
1395f) is amended by adding at the end the following new subsection:

    ``Anesthesiologist Services Provided in Certain Rural Hospitals

    ``(m)(1) Notwithstanding any other provision of this title, 
coverage and payment shall be provided under this part for physicians' 
services that are anesthesia services furnished by a physician who is 
an anesthesiologist in a rural hospital described in paragraph (3) in 
the same manner as payment is made under the exception provided in 
section 9320(k) of the Omnibus Budget Reconciliation Act of 1986, as 
amended by section 6132 of the Omnibus Budget Reconciliation Act of 
1989 (42 U.S.C. 1395k note) (relating to payment on a reasonable cost, 
pass-through basis), for certified registered nurse anesthetist 
services furnished by a certified registered nurse anesthetist in a 
hospital described in such section.
            ``(2) No payment shall be made under any other provision of 
        this title for physicians' services for which payment is made 
        under this subsection.
            ``(3) A rural hospital described in this paragraph is a 
        hospital described in section 9320(k) of the Omnibus Budget 
        Reconciliation Act of 1986, as so amended (42 U.S.C. 1395k 
        note), except that--
                    ``(A) any reference in such section to a `certified 
                registered nurse anesthetist' or `anesthetist' is 
                deemed a reference to a `physician who is an 
                anesthesiologist' or `anesthesiologist', respectively; 
                and
                    ``(B) any reference to `January 1, 1988' or `1987' 
                is deemed a reference to such date and year as the 
                Secretary shall specify.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to services furnished during cost reporting periods beginning on 
or after the date of the enactment of this Act.
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