[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5270 Introduced in House (IH)]

111th CONGRESS
  2d Session
                                H. R. 5270

  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

                              May 11, 2010

Mr. Hare (for himself, Mr. George Miller of California, and Mr. Souder) 
 introduced the following bill; which was referred to the Committee on 
                          Education and Labor

_______________________________________________________________________

                                 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, CRNAs, and CNMs are covered providers 
        within Medicare, Medicaid, Tri-Care, and most private insurance 
        plans.
            (5) PAs, NPs, CRNAs, 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; 48 States, the District of Columbia, 
        American Samoa, and Guam provide prescriptive authority to 
        CNMs; and CRNAs have prescriptive authority in 28 states (and 
        the District of Columbia) and order and administer anesthesia 
        medication and provide anesthesia and interventional pain 
        management services in all 50 states and the District of 
        Columbia.
            (7) PAs, NPs, and CRNAs 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 practice nurse 
        specialties, administer approximately 32 million anesthetics to 
        patients each year in the U.S., and in some States are the sole 
        providers of anesthetics in nearly 100 percent of rural 
        hospitals.
            (11) CRNAs work in almost every setting in which anesthesia 
        is given, including operating rooms, dental offices, pain 
        clinics, ambulatory surgical settings, and provide 
        interventional pain management service.
            (12) Amending the Federal Employees' Compensation Act to 
        recognize PAs, NPs, CRNAs, CNSs, and CNMs as covered providers 
        will bring this Act in line with the overwhelming majority of 
        State workers' compensation programs, which recognize each of 
        these providers 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.
                                 <all>