I 111th CONGRESS 2d Session H. R. 4993 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.

1.

Short title

This Act may be cited as the Home Health Care Planning Improvement Act of 2010.

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.