[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 198 Introduced in Senate (IS)]

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118th CONGRESS
  1st Session
                                 S. 198

To amend title XVIII of the Social Security Act to modernize provisions 
            relating to rural health clinics under Medicare.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            February 1, 2023

 Mr. Barrasso (for himself, Mr. Bennet, Mrs. Blackburn, and Ms. Smith) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to modernize provisions 
            relating to rural health clinics under Medicare.

    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 ``Rural Health Clinic Burden Reduction 
Act''.

SEC. 2. MODERNIZING PHYSICIAN, PHYSICIAN ASSISTANT, AND NURSE 
              PRACTITIONER UTILIZATION REQUIREMENTS.

    Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)) 
is amended--
            (1) in paragraph (2)(B), by striking ``has an arrangement'' 
        and all that follows through the first semicolon and inserting 
        ``meets the requirements described in paragraph (8);''; and
            (2) by adding at the end the following new paragraph:
    ``(8) Requirements for Certain Facilities Described.--For purposes 
of paragraph (2)(B), with respect to a facility which is not a 
physician-directed clinic, the following requirements are described in 
this paragraph:
            ``(A) Arrangement.--The facility has an arrangement 
        consistent with the provisions of State and local law relative 
        to the practice, performance, and delivery of health services, 
        with one or more physician assistants (as defined in paragraph 
        (5)(A)) or one or more nurse practitioners (as defined in such 
        paragraph).
            ``(B) Practice and oversight requirements.--The delivery of 
        health services under such arrangement shall be in accordance 
        with State law or the State regulatory mechanism governing the 
        practice of physician assistants or nurse practitioners.''.

SEC. 3. REMOVING OUTDATED LABORATORY REQUIREMENTS.

    Section 1861(aa)(2)(G) of the Social Security Act (42 U.S.C. 
1395x(aa)(2)(G)) is amended by striking ``, including clinical 
laboratory services'' and all that follows through ``additional 
diagnostic services'' and inserting the following: ``and has prompt 
access to clinical laboratory services and additional diagnostic 
services''.

SEC. 4. ALLOWING RURAL HEALTH CLINICS THE FLEXIBILITY TO CONTRACT WITH 
              PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS.

    Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)), 
in the first sentence of the flush matter following paragraph (2), is 
amended by inserting ``or contracts with'' after ``(iii) employs''.

SEC. 5. URBANIZED AREA FIX.

    Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)), 
in the first sentence of the flush matter following paragraph (2), is 
amended by striking ``(i) is located in an area that is not an 
urbanized area'' and inserting ``(i) is located in an area that is not 
in an urban area of 50,000 or more''.

SEC. 6. EXCEPTION TO BEHAVIORAL HEALTH LIMITATION.

    Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)), 
in the first sentence of the flush matter following paragraph (2), is 
amended by inserting the following before the period: ``, except in the 
case where the facility is located in an area that is designated (under 
section 332(a)(1)(A) of the Public Health Service Act) as a mental 
health professional shortage area''.

SEC. 7. EFFECTIVE DATE.

    This Act and the amendments made by this Act shall take effect on 
January 1, 2024, and shall apply to items and services furnished on or 
after such date.
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