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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public" slc-id="S1-KEL23091-X3D-2T-VP8"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>118 S198 IS: Rural Health Clinic Burden Reduction Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2023-02-01</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress>118th CONGRESS</congress><session>1st Session</session><legis-num>S. 198</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20230201">February 1, 2023</action-date><action-desc><sponsor name-id="S317">Mr. Barrasso</sponsor> (for himself, <cosponsor name-id="S330">Mr. Bennet</cosponsor>, <cosponsor name-id="S396">Mrs. Blackburn</cosponsor>, and <cosponsor name-id="S394">Ms. Smith</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSFI00">Committee on Finance</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To amend title XVIII of the Social Security Act to modernize provisions relating to rural health clinics under Medicare.</official-title></form><legis-body display-enacting-clause="yes-display-enacting-clause"><section section-type="section-one" id="S1"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Rural Health Clinic Burden Reduction Act</short-title></quote>.</text></section><section id="id24BF1092848D400EB19CBE2BCB9F95F2"><enum>2.</enum><header>Modernizing physician, physician assistant, and nurse practitioner utilization requirements</header><text display-inline="no-display-inline">Section 1861(aa) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)</external-xref>) is amended—</text><paragraph id="id59BE9DA2CC6946B593482C518768443B"><enum>(1)</enum><text>in paragraph (2)(B), by striking <quote>has an arrangement</quote> and all that follows through the first semicolon and inserting <quote>meets the requirements described in paragraph (8);</quote>; and</text></paragraph><paragraph id="id325D3F10709042849836F8CD8AEF222A"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idF85C7103F4BB4E1E9706E113FFA5314A"><paragraph id="idCCD4F12065F64FF485A832E253A9BA49" indent="up1"><enum>(8)</enum><header>Requirements for certain facilities described</header><text>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:</text><subparagraph id="id64A661FF5A1C44D6959FC277BD22A49C"><enum>(A)</enum><header>Arrangement</header><text>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).</text></subparagraph><subparagraph id="id2FF55F57CAEB41948FC70A17874C750B"><enum>(B)</enum><header>Practice and oversight requirements</header><text>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.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="idF45C574D41304CE4AB7F7AD279C92818"><enum>3.</enum><header>Removing outdated laboratory requirements</header><text display-inline="no-display-inline">Section 1861(aa)(2)(G) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)(2)(G)</external-xref>) is amended by striking <quote>, including clinical laboratory services</quote> and all that follows through <quote>additional diagnostic services</quote> and inserting the following: <quote>and has prompt access to clinical laboratory services and additional diagnostic services</quote>.</text></section><section id="id5ee2f9d24de54fd1ae02e6fc285221c3"><enum>4.</enum><header>Allowing rural health clinics the flexibility to contract with physician assistants and nurse practitioners</header><text display-inline="no-display-inline">Section 1861(aa) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)</external-xref>), in the first sentence of the flush matter following paragraph (2), is amended by inserting <quote>or contracts with</quote> after <quote>(iii) employs</quote>.</text></section><section id="idE8541F46A98247D9BA61611C0E33D67B"><enum>5.</enum><header>Urbanized area fix</header><text display-inline="no-display-inline">Section 1861(aa) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)</external-xref>), in the first sentence of the flush matter following paragraph (2), is amended by striking <quote>(i) is located in an area that is not an urbanized area</quote> and inserting <quote>(i) is located in an area that is not in an urban area of 50,000 or more</quote>.</text></section><section id="idC2C9149817C64E3F93CFD7875CBC9E5D"><enum>6.</enum><header>Exception to behavioral health limitation</header><text display-inline="no-display-inline">Section 1861(aa) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)</external-xref>), in the first sentence of the flush matter following paragraph (2), is amended by inserting the following before the period: <quote>, 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</quote>.</text></section><section id="id72A95931C88A4609A5AE32C150B2C653"><enum>7.</enum><header>Effective date</header><text display-inline="no-display-inline">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.</text></section></legis-body></bill> 

