[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1585 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                S. 1585

   To permit pass-through payment for reasonable costs of certified 
  registered nurse anesthetist services in critical access hospitals 
    notwithstanding the reclassification of such hospitals as urban 
 hospitals, including hospitals located in ``Lugar counties'', and for 
              on-call and standby costs for such services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 5, 2009

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

_______________________________________________________________________

                                 A BILL


 
   To permit pass-through payment for reasonable costs of certified 
  registered nurse anesthetist services in critical access hospitals 
    notwithstanding the reclassification of such hospitals as urban 
 hospitals, including hospitals located in ``Lugar counties'', and for 
              on-call and standby costs for such services.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. MEDICARE PASS-THROUGH PAYMENTS FOR CRNA SERVICES.

    (a) Treatment of Critical Access Hospitals as Rural in Determining 
Eligibility for CRNA Pass-through Payments.--Section 9320(k) of the 
Omnibus Budget Reconciliation Act of 1986 (42 U.S.C. 1395k note), as 
added by section 608(c)(2) of the Family Support Act of 1988 and 
amended by section 6132 of the Omnibus Budget Reconciliation Act of 
1989, is amended by adding at the end the following:
            ``(3) Any facility that qualifies as a critical access 
        hospital (as defined in section 1861(mm)(1) of the Social 
        Security Act) shall be treated as being located in a rural area 
        for purposes of paragraph (1) regardless of any geographic 
        reclassification of the facility, including such a 
        reclassification of the county in which the facility is located 
        as an urban county (also popularly known as a Lugar county) 
        under section 1886(d)(8)(B) of the Social Security Act (42 
        U.S.C. 1395ww(d)(8)(B)).''.
    (b) Treatment of Standby and On-Call Costs.--Such section 9320(k), 
as amended by subsection (a), is further amended by adding at the end 
the following:
            ``(4) In determining the reasonable costs incurred by a 
        hospital or critical access hospital for the services of a 
        certified registered nurse anesthetist under this subsection, 
        the Secretary shall include standby costs and on-call costs 
        incurred by the hospital or critical access hospital, 
        respectively, with respect to such nurse anesthetist.''.
    (c) Effective Dates.--
            (1) Treatment of cahs as rural in determining crna pass-
        through eligibility.--The amendment made by subsection (a) 
        shall apply to calendar years beginning on or after the date of 
        the enactment of this Act (regardless of whether the geographic 
        reclassification of a critical access hospital occurred before, 
        on, or after such date).
            (2) Inclusion of standby costs and on-call costs in 
        determining reasonable costs of crna services.--The amendment 
        made by subsection (b) shall apply to costs incurred in cost 
        reporting periods beginning in fiscal years after fiscal year 
        2003.
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