1.This Act may be cited as the
Athletic Trainers’ Equal Access to
Medicare Act of 2011
.
2.Access to
physical medicine and rehabilitation services provided incident to a
physicianSection 1862(a)(20)
of the Social Security Act (42 U.S.C. 1395y(a)(20)) is amended by striking
(other than any licensing requirement specified by the
Secretary)
and inserting (other than any licensing, education,
or credentialing requirements specified by the Secretary)
.
3.Coverage of
certified athletic trainer services under part B of the Medicare
program
(a)Section 1861 of the
Social Security Act (42 U.S.C. 1395x) is amended—
(1)in subsection
(s)(2)—
(A)in subparagraph (EE), by striking
and
at the end;
(B)in subparagraph
(FF), by adding and
at the end; and
(C)by adding at the
end the following new subparagraph:
(GG)certified athletic trainer services (as
defined in subsection (iii)(1));
;
and
(2)by adding at the end the following new
subsection:
(iii)Certified Athletic Trainer Services(1)The term certified athletic trainer
services means services performed by a certified athletic trainer (as
defined in paragraph (2)) under the supervision of a physician (as defined in
subsection (r)), which the athletic trainer is legally authorized to perform
under State law (or the State regulatory mechanism provided by State law) of
the State in which such services are performed, as would otherwise be covered
if furnished by a physician (as so defined) or as an incident to a physician’s
professional service, to an individual—
(A)who is under the care of a physician (as so
defined); and
(B)with respect to whom a plan prescribing the
type, amount, and duration of services that are to be furnished to such
individual has been established by a physician (as so defined).
Such term
does not include any services for which a facility or other provider charges or
is paid any amounts with respect to the furnishing of such services.(2)The term certified athletic
trainer means an individual who—
(A)in the case of an individual
performing services in a State that provides for licensure or certification of
athletic trainers, is licensed or certified as an athletic trainer in such
State; or
(B)in the case of an individual
performing services in a State that does not provide for licensure or
certification of athletic trainers, possesses a bachelors, master’s or doctoral
degree which qualifies for certification as an athletic trainer, and, has
successfully passed a national certification examination for Athletic Trainers
recognized by the
Secretary.
.
(b)
(1)Section 1832(a)(2)(B)
of such Act (42 U.S.C. 1395k(a)(2)(B)) is amended by adding at the end the
following new clause:
(v)certified athletic trainer
services;
.
(2)Section 1833(a)(1) of such Act (42 U.S.C.
1395l(a)(1)) is amended—
(A)by striking and
before
(Z)
; and
(B)by inserting
before the semicolon at the end the following: , and (AA) with respect
to certified athletic trainer services under section 1861(s)(2)(GG), the
amounts paid shall be 80 percent of the lesser of the actual charge for the
service or the fee schedule amount under section 1848 for the same service
performed by a physician
.
(3)The first sentence of section 1842(b)(6) of such Act (42
U.S.C. 1395u(b)(6)) is amended—
(A)by striking
and
before (H)
; and
(B)by inserting
before ; but nothing
the following: , and (I) in the case
of certified athletic trainer services, payment shall be made to the physician,
clinic, or hospital that employs the athletic trainer involved
.
(c)Inclusion of
services in the therapy capSection 1833(g)(1) of such Act (42 U.S.C.
1395l(g)(1)) is amended—
(1)by striking
and physical therapy
and inserting physical
therapy
; and
(2)by inserting after
or as incident to physicians’ services,
the following:
and certified athletic trainer services
.
(d)Inclusion of
athletic trainers as practitioners for assignment of claimsSection 1842(b)(18)(C) of such Act (42
U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new
clause:
(vii)A certified athletic trainer (as defined in
section
1861(iii)(1)).
.
(e)Coverage of
certain physical medicine and rehabilitation services provided in rural health
clinics and federally qualified health centersSection 1861(aa)(1)(B) of such Act (42
U.S.C. 1395x(aa)(1)(B)) is amended—
(1)by striking
or
before by a clinical social worker
; and
(2)by inserting after
subsection (hh)(1)),
the following: by a certified
athletic trainer (as defined in subsection (iii)(2))
.
(f)The amendments made by
this section shall apply with respect to services furnished on or after January
1, 2012.