[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4993 Introduced in House (IH)]

111th CONGRESS
  2d Session
                                H. R. 4993

 To amend title XVIII of the Social Security Act to ensure more timely 
  access to home health services for Medicare beneficiaries under the 
                           Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 13, 2010

 Ms. Schwartz (for herself, Mrs. Capps, Mrs. McCarthy of New York, Ms. 
Baldwin, Ms. Shea-Porter, Mr. Braley of Iowa, Mr. Courtney, Ms. Harman, 
 Mr. Farr, Mr. Blumenauer, Mr. Garamendi, Ms. Watson, Ms. Schakowsky, 
 Ms. Pingree of Maine, Mrs. Dahlkemper, Mr. Grijalva, Mr. Perlmutter, 
Ms. DeLauro, and Mr. DeFazio) introduced the following bill; which was 
  referred to the Committee on Ways and Means, and in addition to the 
   Committee on Energy and Commerce, 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 ensure more timely 
  access to home health services for Medicare beneficiaries under the 
                           Medicare Program.

    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 ``Home Health Care Planning 
Improvement Act of 2010''.

SEC. 2. IMPROVING CARE PLANNING FOR MEDICARE HOME HEALTH SERVICES.

    (a) In General.--Section 1814(a)(2) of the Social Security Act (42 
U.S.C. 1395f(a)(2)), in the matter preceding subparagraph (A), is 
amended--
            (1) by inserting ``(as those terms are defined in section 
        1861(aa)(5))'' after ``clinical nurse specialist''; and
            (2) by inserting ``, or in the case of services described 
        in subparagraph (C), a physician, or a nurse practitioner or 
        clinical nurse specialist who is working in collaboration with 
        a physician in accordance with State law, or a certified nurse-
        midwife (as defined in section 1861(gg)) as authorized by State 
        law, or a physician assistant (as defined in section 
        1861(aa)(5)) under the supervision of a physician'' after 
        ``collaboration with a physician''.
    (b) Conforming Amendments.--(1) Section 1814(a) of the Social 
Security Act (42 U.S.C. 1395f(a)) is amended--
            (A) in paragraph (2)(C), by inserting ``, a nurse 
        practitioner, a clinical nurse specialist, a certified nurse-
        midwife, or a physician assistant (as the case may be)'' after 
        ``physician'' each place it appears;
            (B) in the second sentence, by striking ``or clinical nurse 
        specialist'' and inserting ``clinical nurse specialist, 
        certified nurse-midwife, or physician assistant'';
            (C) in the third sentence--
                    (i) by striking ``physician certification'' and 
                inserting ``certification'';
                    (ii) by inserting ``(or on January 1, 2011, in the 
                case of regulations to implement the amendments made by 
                section 2 of the Home Health Care Planning Improvement 
                Act of 2010)'' after ``1981''; and
                    (iii) by striking ``a physician who'' and inserting 
                ``a physician, nurse practitioner, clinical nurse 
                specialist, certified nurse-midwife, or physician 
                assistant who''; and
            (D) in the fourth sentence, by inserting ``, nurse 
        practitioner, clinical nurse specialist, certified nurse-
        midwife, or physician assistant'' after ``physician''.
    (2) Section 1835(a) of the Social Security Act (42 U.S.C. 1395n(a)) 
is amended--
            (A) in paragraph (2)--
                    (i) in the matter preceding subparagraph (A), by 
                inserting ``or, in the case of services described in 
                subparagraph (A), a physician, or a nurse practitioner 
                or clinical nurse specialist (as those terms are 
                defined in 1861(aa)(5)) who is working in collaboration 
                with a physician in accordance with State law, or a 
                certified nurse-midwife (as defined in section 
                1861(gg)) as authorized by State law, or a physician 
                assistant (as defined in section 1861(aa)(5)) under the 
                supervision of a physician'' after ``a physician''; and
                    (ii) in each of clauses (ii) and (iii) of 
                subparagraph (A) by inserting ``, a nurse practitioner, 
                a clinical nurse specialist, a certified nurse-midwife, 
                or a physician assistant (as the case may be)'' after 
                ``physician'';
            (B) in the third sentence, by inserting ``, nurse 
        practitioner, clinical nurse specialist, certified nurse-
        midwife, or physician assistant (as the case may be)'' after 
        physician;
            (C) in the fourth sentence--
                    (i) by striking ``physician certification'' and 
                inserting ``certification'';
                    (ii) by inserting ``(or on January 1, 2011, in the 
                case of regulations to implement the amendments made by 
                section 2 of the Home Health Care Planning Improvement 
                Act of 2010)'' after ``1981''; and
                    (iii) by striking ``a physician who'' and inserting 
                ``a physician, nurse practitioner, clinical nurse 
                specialist, certified nurse-midwife, or physician 
                assistant who''; and
            (D) in the fifth sentence, by inserting ``, nurse 
        practitioner, clinical nurse specialist, certified nurse-
        midwife, or physician assistant'' after ``physician''.
    (3) Section 1861 of the Social Security Act (42 U.S.C. 1395x) is 
amended--
            (A) in subsection (m)--
                    (i) in the matter preceding paragraph (1)--
                            (I) by inserting ``a nurse practitioner or 
                        a clinical nurse specialist (as those terms are 
                        defined in subsection (aa)(5)), a certified 
                        nurse-midwife (as defined in section 1861(gg)), 
                        or a physician assistant (as defined in 
                        subsection (aa)(5)),'' after ``physician'' the 
                        first place it appears; and
                            (II) by inserting ``a nurse practitioner, a 
                        clinical nurse specialist, a certified nurse-
                        midwife, or a physician assistant'' after 
                        ``physician'' the second place it appears; and
                    (ii) in paragraph (3), by inserting ``, a nurse 
                practitioner, a clinical nurse specialist, a certified 
                nurse-midwife, or a physician assistant'' after 
                ``physician''; and
            (B) in subsection (o)(2)--
                    (i) by inserting ``, nurse practitioners or 
                clinical nurse specialists (as those terms are defined 
                in subsection (aa)(5)), certified nurse-midwives (as 
                defined in section 1861(gg)), or physician assistants 
                (as defined in subsection (aa)(5))'' after 
                ``physicians''; and
                    (ii) by inserting ``, nurse practitioner, clinical 
                nurse specialist, certified nurse-midwife, physician 
                assistant,'' after ``physician''.
    (4) Section 1895 of the Social Security Act (42 U.S.C. 1395fff) is 
amended--
            (A) in subsection (c)(1), by inserting ``, the nurse 
        practitioner or clinical nurse specialist (as those terms are 
        defined in section 1861(aa)(5)), the certified nurse-midwife 
        (as defined in section 1861(gg)), or the physician assistant 
        (as defined in section 1861(aa)(5)),'' after ``physician''; and
            (B) in subsection (e)--
                    (i) in paragraph (1)(A), by inserting ``, a nurse 
                practitioner or clinical nurse specialist (as those 
                terms are defined in section 1861(aa)(5)), a certified 
                nurse-midwife (as defined in section 1861(gg)), or a 
                physician assistant (as defined in section 
                1861(aa)(5))'' after ``physician''; and
                    (ii) in paragraph (2)--
                            (I) in the heading, by striking ``Physician 
                        certification'' and inserting ``Rule of 
                        construction regarding requirement for 
                        certification''; and
                            (II) by striking ``physician''.
    (c) Rule of Construction.--Nothing in the amendments made by this 
section shall be construed as affecting the scope of practice 
authorized under State law of a certified nurse-midwife (as defined in 
section 1861(gg) of the Social Security Act) or a nurse practitioner, 
clinical nurse specialist, or physician assistant (as such terms are 
defined in section 1861(aa)(5) of such Act).
    (d) Effective Date.--The amendments made by this section shall 
apply to items and services furnished on or after January 1, 2011.
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