II 111th CONGRESS 1st Session S. 1585 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.

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.