[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1569 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                S. 1569

  To expand our Nation's Advanced Practice Registered Nurse workforce.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 3, 2009

 Ms. Stabenow introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To expand our Nation's Advanced Practice Registered Nurse workforce.

    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 Graduate Nursing Education 
Act''.

SEC. 2. MEDICARE PAYMENT FOR COSTS OF EXPANDED ADVANCED PRACTICE NURSE 
              TRAINING PROGRAMS.

    (a) In General.--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) Effective Date.--The amendments made by subsection (a) shall 
apply to costs incurred on or after January 1, 2012.
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