1.Medicare payment for costs of
expanded advanced practice nurse training programs
(a)Section 1861(v) of
the Social Security Act (42 U.S.C. 1395x(v)) is amended—
(1)in paragraph (1),
by adding at the end the following new subparagraph:
(V)Such reasonable costs shall include
hospital costs described in paragraph (9) for expanded advanced nurse practice
training programs.
;
and
(2)by adding at the
end the following new paragraph:
(9)(A)For purposes of paragraph (1)(V), subject
to subparagraphs (B) and (C), the costs described in this paragraph are
educational costs (including faculty salaries, student stipends (if any),
clinical instruction costs, and other direct and indirect costs) of a hospital
and affiliated schools and settings described in clause (ii)) attributable to
the training of advanced practice nurses—
(i)with the skills necessary to provide
primary and preventive care, transitional care, chronic care management, and
other nursing services appropriate for the population under this title;
and
(ii)through affiliation with one or more
accredited schools of nursing (as defined in section 801 of the Public Health
Service Act) and in partnership with two or more non-hospital community-based
care settings where at least half of all clinical training occurs.
The Secretary may waive the community-based setting
requirement under clause (ii) for clinical training of advanced practice
registered nurses, such as certified registered nurse anesthetists and
certified nurse-midwives, in rural and medically underserved areas.(B)Costs under this paragraph are limited to
costs attributable to an increase in the enrollment and the number of advanced
practice nurse graduates in each education or training program over the
comparable average number from 2006 to 2010 (as determined by the Secretary)
but shall not be offset or take into account tuition, fees, or State or local
government appropriations. The proportion of such costs paid under this
paragraph shall be determined based on the proportion of the total inpatient
days of the hospital attributable to this title.
(C)No payment shall be made under this
paragraph to a hospital unless the hospital has in effect an agreement with the
schools of nursing and settings described in subparagraph (A)(ii) to pay from
such payment to such a school or setting (through the school when the setting
is arranged through the school) the costs of educational activities described
in subparagraph (A) attributable to each.
(D)In this paragraph, the term
advanced practice nurse includes a clinical nurse specialist,
nurse practitioner, certified registered nurse anesthetist, and certified nurse
midwife.
.
(b)The amendments made by subsection (a) shall apply to costs
incurred on or after January 1, 2012.