[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 63 Introduced in Senate (IS)]







111th CONGRESS
  1st Session
                                 S. 63

  To amend title XIX of the Social Security Act to improve access to 
 advanced practice nurses and physician assistants under the Medicaid 
                                Program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 6, 2009

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

_______________________________________________________________________

                                 A BILL


 
  To amend title XIX of the Social Security Act to improve access to 
 advanced practice nurses and physician assistants under the Medicaid 
                                Program.

    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 ``Medicaid Advanced Practice Nurses 
and Physician Assistants Access Act of 2009''.

SEC. 2. IMPROVED ACCESS TO SERVICES OF ADVANCED PRACTICE NURSES AND 
              PHYSICIAN ASSISTANTS UNDER STATE MEDICAID PROGRAMS.

    (a) Primary Care Case Management.--Section 1905(t)(2) of the Social 
Security Act (42 U.S.C. 1396d(t)(2)) is amended by striking 
subparagraph (B) and inserting the following:
            ``(B) A nurse practitioner (as defined in section 
        1861(aa)(5)(A)).
            ``(C) A certified nurse-midwife (as defined in section 
        1861(gg)).
            ``(D) A physician assistant (as defined in section 
        1861(aa)(5)(A)).''.
    (b) Fee-for-Service Program.--Section 1905(a)(21) of such Act (42 
U.S.C. 1396d(a)(21)) is amended--
            (1) by inserting ``(A)'' after ``(21)'';
            (2) by striking ``services furnished by a certified 
        pediatric nurse practitioner or certified family nurse 
        practitioner (as defined by the Secretary) which the certified 
        pediatric nurse practitioner or certified family nurse 
        practitioner'' and inserting ``services furnished by a nurse 
        practitioner (as defined in section 1861(aa)(5)(A)) or by a 
        clinical nurse specialist (as defined in section 
        1861(aa)(5)(B)) which the nurse practitioner or clinical nurse 
        specialist'';
            (3) by striking ``the certified pediatric nurse 
        practitioner or certified family nurse practitioner'' and 
        inserting ``the nurse practitioner or clinical nurse 
        specialist''; and
            (4) by inserting before the semicolon at the end the 
        following: ``and (B) services furnished by a physician 
        assistant (as defined in section 1861(aa)(5)) with the 
        supervision of a physician which the physician assistant is 
        legally authorized to perform under State law''.
    (c) Including in Mix of Service Providers Under Medicaid Managed 
Care Organizations.--Section 1932(b)(5)(B) of such Act (42 U.S.C. 
1396u-2(b)(5)(B)) is amended by inserting ``, with such mix including 
nurse practitioners, clinical nurse specialists, physician assistants, 
certified nurse midwives, and certified registered nurse anesthetists 
(as defined in section 1861(bb)(2))'' after ``services''.
    (d) Effective Date.--The amendments made by this section shall 
apply to items and services furnished in calendar quarters beginning on 
or after 90 days after the date of the enactment of this Act, without 
regard to whether or not final regulations to carry out such amendments 
have been promulgated by such date.
                                 <all>