[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1183 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 1183
To amend title 10, United States Code, to ensure access to qualified
acupuncturist services for military members and military dependents, to
amend title 38, United States Code, to ensure access to acupuncturist
services through the Department of Veterans Affairs, to amend title
XVIII of the Social Security Act to provide for coverage of qualified
acupuncturist services under the Medicare program; to amend the Public
Health Service Act to authorize the appointment of qualified
acupuncturists as officers in the commissioned Regular Corps and the
Ready Reserve Corps of the Public Health Service, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2019
Ms. Judy Chu of California introduced the following bill; which was
referred to the Committee on Energy and Commerce, and in addition to
the Committees on Armed Services, Veterans' Affairs, and Ways and
Means, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title 10, United States Code, to ensure access to qualified
acupuncturist services for military members and military dependents, to
amend title 38, United States Code, to ensure access to acupuncturist
services through the Department of Veterans Affairs, to amend title
XVIII of the Social Security Act to provide for coverage of qualified
acupuncturist services under the Medicare program; to amend the Public
Health Service Act to authorize the appointment of qualified
acupuncturists as officers in the commissioned Regular Corps and the
Ready Reserve Corps of the Public Health Service, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Acupuncture for
Heroes and Seniors Act of 2019''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
Sec. 3. Inclusion of acupuncture services through military health care
system and TRICARE program.
Sec. 4. Acupuncture health services for TRICARE program beneficiaries.
Sec. 5. Appointment of acupuncturists as commissioned officers in the
Armed Forces.
Sec. 6. Inclusion of acupuncturist services at veterans health
facilities.
Sec. 7. Coverage for acupuncturist services under the Medicare program.
Sec. 8. Acupuncturists in the Regular Corps and the Ready Reserve Corps
of the Public Health Service.
SEC. 2. DEFINITIONS.
In this Act, except as otherwise provided:
(1) The term ``qualified acupuncturist services'' means--
(A) acupuncturist services--
(i) that are furnished by a qualified
acupuncturist; and
(ii) which the qualified acupuncturist is
legally authorized to perform under State law;
and
(B) services and supplies that are furnished by a
qualified acupuncturist incident to the services
described in subparagraph (A).
(2) The term ``qualified acupuncturist'' means an
individual who is licensed or certified as an acupuncturist by
a State or, in the case of an individual in a State that does
not provide for such licensure or certification, meets such
criteria (such as accreditation through an appropriate
nationally recognized certification authority for
acupuncturists) as the Secretary of Health and Human Services
may specify. In specifying such requirements, the Secretary may
use the same requirements as those established by such a
certification authority.
(3) The term ``State'' means the 50 States, the District of
Columbia, Puerto Rico, the United States Virgin Islands, Guam,
American Samoa, and the Northern Mariana Islands.
SEC. 3. INCLUSION OF ACUPUNCTURE SERVICES THROUGH MILITARY HEALTH CARE
SYSTEM AND TRICARE PROGRAM.
(a) Members of the Uniformed Services.--
(1) In general.--Chapter 55 of title 10, United States
Code, is amended by inserting after section 1074o the following
new section:
``Sec. 1074p. Provision of acupuncturist services
``In accordance with section 1074(c) of this title, and under
regulations prescribed by the Secretary, members of the uniformed
services entitled to medical care under section 1074 shall be entitled
to qualified acupuncturist services (without the requirement of a
referral) provided in a military medical treatment facility or a
private facility by an acupuncturist who is licensed or certified in
the State in which the facility is located, or, in the case of a
facility in a State that does not provide for such licensure or
certification, meets such criteria (such as accreditation through an
appropriate nationally recognized certification authority for
acupuncturists) as the Secretary may specify. In specifying such
requirements, the Secretary may use the same requirements as those
established by such a certification authority.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 1074o the following new item:
``1074p. Provision of acupuncturist services.''.
(b) TRICARE Program.--Section 1079(a) of title 10, United States
Code, is amended--
(1) in paragraph (12), by inserting ``or paragraph (18)''
after ``except as authorized in paragraph (4)''; and
(2) by adding at the end the following new paragraph:
``(18) Acupuncturist services may be provided without the
requirement of a referral if performed by an acupuncturist who
is licensed or certified in the State in which the services are
furnished, or, in the case of services furnished in a State
that does not provide for such licensure or certification,
meets such criteria (such as accreditation through an
appropriate nationally recognized certification authority for
acupuncturists) as the Secretary may specify. In specifying
such requirements, the Secretary may use the same requirements
as those established by such a certification authority.''.
(c) Effective Date.--The amendments made by this section shall take
effect on the date that is 180 days after the date of the enactment of
this Act.
SEC. 4. ACUPUNCTURE HEALTH SERVICES FOR TRICARE PROGRAM BENEFICIARIES.
(a) Plan Required.--Not later than 90 days after the date of the
enactment of this Act, the Secretary of Defense shall develop a plan to
provide qualified acupuncturist services, as a permanent part of the
TRICARE program pursuant to the amendments made by section 3, for
covered beneficiaries (as defined in section 1072 of title 10, United
States Code).
(b) Contents of Plan.--The plan shall require that a contract
entered into under section 1097 of title 10, United States Code, for
the delivery of health care services shall--
(1) include the delivery of qualified acupuncturist
services;
(2) require that qualified acupuncturist services may be
provided only by a qualified acupuncturist; and
(3) provide clarity on the process that a covered
beneficiary must use to select and have direct access to a
qualified acupuncturist (without the requirement of a
referral).
(c) Implementation of Plan.--The plan developed under subsection
(a) shall provide for implementation of the plan to begin not later
than 270 days after the date of enactment of this Act.
(d) Submission.--The Secretary shall submit to Congress the plan
developed under subsection (a).
SEC. 5. APPOINTMENT OF ACUPUNCTURISTS AS COMMISSIONED OFFICERS IN THE
ARMED FORCES.
(a) Army.--Section 7068 of title 10, United States Code, is
amended--
(1) by inserting ``(a) Medical Service Corps.--'' before
``There is'';
(2) in paragraph (5)--
(A) in subparagraph (D), by striking ``and'';
(B) by redesignating subparagraph (E) as
subparagraph (F); and
(C) by inserting after subparagraph (D) the
following new subparagraph:
``(E) the Acupuncture Section; and''; and
(3) by adding at the end the following new subsection:
``(b) Appointment of Acupuncturists.--Acupuncturists who are
qualified under regulations prescribed by the Secretary of the Army may
be appointed as commissioned officers in the Acupuncture Section of the
Medical Service Corps of the Army. Such regulations shall require such
acupuncturists to be licensed or certified in the State in which the
services are furnished, or, in the case of services furnished in a
State that does not provide for such licensure or certification, meets
such criteria (such as accreditation through an appropriate nationally
recognized certification authority for acupuncturists) as the Secretary
of the Army may specify. In specifying such requirements, the Secretary
may use the same requirements as those established by such a
certification authority.''.
(b) Navy.--
(1) In general.--Chapter 809 of such title is amended by
inserting after section 8079 the following new section:
``Sec. 8080. Appointment of acupuncturists in the Medical Service Corps
``Acupuncturists who are qualified under regulations prescribed by
the Secretary of the Navy may be appointed as commissioned officers in
the Medical Service Corps of the Navy. Such regulations shall require
such acupuncturists to be licensed or certified in the State in which
the services are furnished, or, in the case of services furnished in a
State that does not provide for such licensure or certification, meets
such criteria (such as accreditation through an appropriate nationally
recognized certification authority for acupuncturists) as the Secretary
of the Navy may specify. In specifying such requirements, the Secretary
may use the same requirements as those established by such a
certification authority.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 8079 the following new item:
``8080. Appointment of acupuncturists in the Medical Service Corps.''.
(c) Air Force.--Section 9067(f) of such title is amended--
(1) by striking ``physician assistant functions and
chiropractic functions'' and inserting ``physician assistant
functions, chiropractic functions, and acupuncturist
functions''; and
(2) by adding at the end the following new sentence:
``Biomedical service officers may be referred to as the
specific career designation, including chiropractic services
officer and acupuncturist services officer.''.
(d) Regulations.--The regulations required to be prescribed by the
amendments made by this section shall be prescribed not later than 120
days after the date of the enactment of this Act.
SEC. 6. INCLUSION OF ACUPUNCTURIST SERVICES AT VETERANS HEALTH
FACILITIES.
(a) Acupuncturist Services.--
(1) In general.--Subchapter II of chapter 17 of title 38,
United States Code, is amended by adding at the end the
following new section:
``Sec. 1720J. Provision of acupuncturist services
``(a) In General.--The Secretary shall carry out a program to
provide acupuncturist services to veterans enrolled in the health care
system established under section 1705(a) of this title (without the
requirement of a referral).
``(b) Locations.--The program under subsection (a) shall be carried
out at in at least one facility of the Department in each Veterans
Integrated Service Network. In selecting such facilities, the Secretary
shall ensure that the program is carried out in both urban and rural
areas.
``(c) Services Available.--The Secretary shall ensure that the
acupuncturist services available under the program are able to address,
at a minimum, the following:
``(1) Chronic and acute pain.
``(2) Cancer pain.
``(3) Postoperative nausea and vomiting.
``(4) Postsurgical gastroparesis syndrome.
``(5) Opioid-induced constipation.
``(6) Opioid-induced pruritus.
``(7) Chemotherapy-induced neuropathy.
``(8) Aromatase inhibitor-associated joint pain.
``(9) Neck dissection-related pain and dysfunction.
``(10) Stress management.
``(11) Mental health conditions.
``(12) Substance abuse.
``(13) Symptoms relating to traumatic brain injury and
post-traumatic stress.
``(d) Administration.--(1) The Secretary shall carry out the
program through--
``(A) qualified acupuncturists appointed as employees of
the Department located at medical centers and clinics of the
Department; and
``(B) through contract qualified acupuncturists if--
``(i) the Secretary is unable to make appointments
described in subparagraph (A);
``(ii) a patient requires specialty care that an
employee under such subparagraph is not able to provide
to the patient; or
``(iii) there is an emergency that requires the use
of such a contract acupuncturist.
``(2) The Secretary shall provide training and materials to health
care providers of the Department who provide primary care to veterans
to explain the benefits of acupuncturist services.
``(3) In this section, the term `qualified acupuncturist' means,
with respect to the furnishing of services in a State, an individual
who licensed or certified in the State in which the services are
furnished, or, in the case of services furnished in a State that does
not provide for such licensure or certification, meets such criteria
(such as accreditation through an appropriate nationally recognized
certification authority for acupuncturists) as the Secretary may
specify. In specifying such requirements, the Secretary may use the
same requirements as those established by such a certification
authority.
``(e) Regulations.--The Secretary shall prescribe regulations to
carry out this section.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 1720I the following new section:
``1720J. Provision of acupuncturist services.''.
(3) Conforming amendment.--Section 1701(6) of such title is
amended by adding at the end the following new subparagraph:
``(H) Acupuncturist services in accordance with
section 1720J of this title.''.
(b) Advisory Committee.--
(1) In general.--Subchapter III of chapter 5 of such title
is amended by adding at the end the following new section:
``Sec. 547. Advisory committee on acupuncturist services
``(a) Acupuncture Advisory Committee.--(1) The Secretary shall
establish an advisory committee to be known as the `Advisory Committee
on Acupuncturist Services' (in this section referred to as the
`Committee') to provide the Secretary with assistance and advice in the
development and implementation of the program established by section
1720J of this title.
``(2) The Committee shall consist of members appointed by the
Secretary from the general public, including--
``(A) not fewer than five practicing acupuncturists, of
which at least four shall be State licensed acupuncturists;
``(B) one veteran from each of the Armed Forces;
``(C) not fewer than two representatives from veterans
service organizations; and
``(D) a representative of the Department of Defense.
``(b) Duties.--The Committee shall--
``(1) review and evaluate the ability of a veteran to
access an acupuncturist at facilities of the Department;
``(2) advise the Secretary with respect to--
``(A) protocols governing direct access to
acupuncture care;
``(B) protocols governing the scope of practice of
acupuncture practitioners;
``(C) the definitions of services to be provided by
acupuncturists; and
``(D) such other matters the Secretary determines
appropriate; and
``(3) upon the determination of the Secretary that the
program of acupuncturist services under section 1720H of this
title has been fully implemented, submit to the Secretary a
report containing the evaluation of the Committee of the
implementation of such program.
``(c) Chairman.--The Secretary shall designate one member of the
Committee to serve as the chairman of the Committee.
``(d) Meetings.--The Committee shall meet at the call of the
Chairman, but not fewer than three times during each fiscal year,
beginning in the fiscal year following the fiscal year in which this
section is enacted.
``(e) Report.--Following the date on which the Committee submits to
the Secretary the report under subsection (b)(4), the Secretary shall
submit to the Committees on Veterans' Affairs of the Senate and the
House of Representatives a report containing the following:
``(1) A copy of the Committee report, together with the
comments of the Secretary on the report.
``(2) An explanation of the criteria and rationale that the
Secretary used to determine that the program of acupuncturist
services under section 1720J of this title was fully
implemented, as described in such subsection (b)(4).
``(3) The views of the Secretary regarding the future
implementation of such program.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 546 the following new item:
``547. Advisory committee on acupuncturist services.''.
(c) Conforming Amendments.--
(1) Authority for appointments.--Section 7401(1) of title
38, United States Code, is amended by inserting
``acupuncturists,'' after ``chiropractors,''.
(2) Period of appointments.--Section 7403 of such title is
amended by adding at the end the following new subparagraph:
``(I) Acupuncturists.''.
(3) Pay.--
(A) Scale.--Section 7404 of such title is amended--
(i) in subsection (a)(2), by inserting ``,
acupuncturists,'' after ``physicians''; and
(ii) in the list in subsection (b), by
inserting ``, ACUPUNCTURIST,'' after
``PHYSICIAN''.
(B) Treatment.--Section 7431 of title 38, United
States Code, is amended by adding at the end the
following new subsection:
``(i) Treatment of Acupuncturists.--For purposes of this
subchapter, an acupuncturist is deemed to be a physician.''.
(4) Malpractice and negligence suits.--Section 7316(a)(2)
of such title is amended by inserting ``acupuncturist,'' after
``chiropractor,''.
(5) Hours and conditions.--Section 7421(b) of such title is
amended by adding at the end the following new paragraph:
``(9) Acupuncturists.''.
(6) Effective date.--The amendments made by paragraph (4)
apply with respect to services provided on or after the date
that is 270 days after the date of enactment of this Act.
SEC. 7. COVERAGE FOR ACUPUNCTURIST SERVICES UNDER THE MEDICARE PROGRAM.
(a) In General.--Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended--
(1) in subsection (s)(2)--
(A) by striking ``and'' at the end of subparagraph
(GG);
(B) by adding ``and'' at the end of subparagraph
(HH); and
(C) by adding at the end the following new
subparagraph:
``(II) qualified acupuncturist services (as defined in
subsection (jjj)(1));''; and
(2) by adding at the end the following new subsection:
``Qualified Acupuncturist Services
``(jjj)(1) The term `qualified acupuncturist services' means such
services furnished by a qualified acupuncturist (as defined in
paragraph (2)), and such services and supplies furnished as an incident
to services furnished by the qualified acupuncturist, as the qualified
acupuncturist is legally authorized to perform under State law.
``(2) The term `qualified acupuncturist' has the meaning given such
term in section 2 of the Acupuncture for Heroes and Seniors Act of
2019.''.
(b) Payment Rules.--
(1) Payment under physician fee schedule.--Section
1848(j)(3) of the Social Security Act (42 U.S.C. 1395w-4(j)(3))
is amended by inserting ``(2)(GG),'' before ``(3),''.
(2) Separate payment for services of institutional
providers.--Section 1833(a)(2)(B) of the Social Security Act
(42 U.S.C. 1395l(a)(2)(B)) is amended--
(A) in clause (i), by inserting ``and in the case
of qualified acupuncturist services,'' after ``1999,'';
(B) in clause (ii), by inserting ``or in the case
of qualified acupuncturist services,'' after ``1999,'';
and
(C) in clause (iii), by inserting ``(other than
qualified acupuncturist services)'' after ``such
services''.
(3) Qualified acupuncturist treatment as a practitioner.--
Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C.
1395u(b)(18)(C)) is amended by adding at the end the following
new clause:
``(vii) A qualified acupuncturist (as defined in section
1861(jjj)(2)).''.
(4) Separate billing for acupuncturist services furnished
in an inpatient hospital setting.--Section 1861(b)(4) of the
Social Security Act (42 U.S.C. 1395x(b)(4)) is amended by
inserting ``qualified acupuncturist services,'' after
``qualified psychologist services,''.
(c) Effective Date.--The amendments made by this section apply with
respect to services furnished on or after the date that is 270 days
after the date of enactment of this Act.
SEC. 8. ACUPUNCTURISTS IN THE REGULAR CORPS AND THE READY RESERVE CORPS
OF THE PUBLIC HEALTH SERVICE.
(a) Authorization of Appointment.--Section 207 of the Public Health
Service Act (42 U.S.C. 209) is amended--
(1) in subsection (a)(1), by inserting ``acupuncture,''
after ``nursing,''; and
(2) by adding at the end the following:
``(j) Appointment of Qualified Acupuncturists.--
``(1) Eligibility.--Acupuncturists shall be eligible for
appointment as officers in the commissioned Regular Corps and
the Ready Reserve Corps of the Public Health Service.
``(2) Qualification; training, equipment, and
preparation.--The Secretary shall ensure that acupuncturists in
the commissioned Regular Corps and in the Ready Reserve Corps--
``(A) are qualified acupuncturists (as defined in
section 2 of the Acupuncture for Heroes and Seniors Act
of 2019); and
``(B) are trained, equipped, and otherwise prepared
to fulfill applicable public health and emergency
response service responsibilities in the Commissioned
Corps.''.
(b) Required Placement.--
(1) In general.--Not later than 90 days after the date of
enactment of this Act, the Secretary of Health and Human
Services shall ensure the appointment of no fewer than 6
acupuncturists into the commissioned Regular Corps and the
Ready Reserve Corps of the Public Health Service.
(2) Reports.--Not later than 120 days after the date of
enactment of this Act, and quarterly thereafter, the Surgeon
General of the Public Health Service shall submit to the
Committee on Energy and Commerce of the House of
Representatives and the Committee on Health, Education, Labor,
and Pensions of the Senate a report on all measures taken by
the President, the Surgeon General, and the Secretary of Health
and Human Services to carry out the provisions of this section,
including the amendments made by this section.
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