S.Amdt. 3108

SA 3108. Ms. COLLINS submitted an amendment intended to be proposed
to amendment SA 2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr.
Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the Internal
Revenue Code of 1986 to modify the first-time homebuyers credit in the
case of members of the Armed Forces and certain other Federal
employees, and for other purposes; which was ordered to lie on the
table; as follows:

On page 816, after line 20, insert the following:

SEC. 3115. IMPROVING CARE PLANNING FOR MEDICARE HOME HEALTH
SERVICES.

(a) In General.--Section 1814(a)(2) of the Social Security
Act (42 U.S.C. 1395f(a)(2)), in the matter preceding
subparagraph (A), is amended--
(1) by inserting ``(as those terms are defined in section
1861(aa)(5))'' after ``clinical nurse specialist''; and
(2) by inserting ``, or in the case of services described
in subparagraph (C), a physician, or a nurse practitioner or
clinical nurse specialist who is working in collaboration
with a physician in accordance with State law, or a certified
nurse-midwife (as defined in section 1861(gg)) as authorized
by State law, or a physician assistant (as defined in section
1861(aa)(5)) under the supervision of a physician'' after
``collaboration with a physician''.
(b) Conforming Amendments.--(1) Section 1814(a) of the
Social Security Act (42 U.S.C. 1395f(a)), as amended by
section 3108(a)(2) and section 6407, is amended--

[[Page S12830]]

(A) in paragraph (2)(C), by inserting ``, a nurse
practitioner, a clinical nurse specialist, a certified nurse-
midwife, or a physician assistant (as the case may be)''
after ``physician'' each place it appears;
(B) in the second sentence, by inserting ``certified nurse-
midwife,'' after ``clinical nurse specialist,'';
(C) in the third sentence--
(i) by striking ``physician certification'' and inserting
``certification'';
(ii) by inserting ``(or on January 1, 2008, in the case of
regulations to implement the amendments made by section 3115
of the Patient Protection and Affordable Care Act)'' after
``1981''; and
(iii) by striking ``a physician who'' and inserting ``a
physician, nurse practitioner, clinical nurse specialist,
certified nurse-midwife, or physician assistant who''; and
(D) in the fourth sentence, by inserting ``, nurse
practitioner, clinical nurse specialist, certified nurse-
midwife, or physician assistant'' after ``physician''.
(2) Section 1835(a) of the Social Security Act (42 U.S.C.
1395n(a)), as amended by section 6405, is amended--
(A) in paragraph (2)--
(i) in the matter preceding subparagraph (A), by striking
``or an eligible professional under section 1848(k)(3)(B)''
and inserting ``, an eligible professional under section
1848(k)(3)(B), or a nurse practitioner or clinical nurse
specialist (as those terms are defined in 1861(aa)(5)) who is
working in collaboration with a physician enrolled under
section 1866(j) or such an eligible professional in
accordance with State law, or a certified nurse-midwife (as
defined in section 1861(gg)) as authorized by State law, or a
physician assistant (as defined in section 1861(aa)(5)) under
the supervision of a physician so enrolled or such an
eligible professional''; and
(ii) in each of clauses (ii) and (iii) of subparagraph (A)
by inserting ``, a nurse practitioner, a clinical nurse
specialist, a certified nurse-midwife, or a physician
assistant (as the case may be)'' after ``physician'';
(B) in the third sentence, by inserting ``, nurse
practitioner, clinical nurse specialist, certified nurse-
midwife, or physician assistant (as the case may be)'' after
physician;
(C) in the fourth sentence--
(i) by striking ``physician certification'' and inserting
``certification'';
(ii) by inserting ``(or on January 1, 2008, in the case of
regulations to implement the amendments made by section 3115
of the Patient Protection and Affordable Care Act)'' after
``1981''; and
(iii) by striking ``a physician who'' and inserting ``a
physician, nurse practitioner, clinical nurse specialist,
certified nurse-midwife, or physician assistant who''; and
(D) in the fifth sentence, by inserting ``, nurse
practitioner, clinical nurse specialist, certified nurse-
midwife, or physician assistant'' after ``physician''.
(3) Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended--
(A) in subsection (m)--
(i) in the matter preceding paragraph (1)--
(I) by inserting ``a nurse practitioner or a clinical nurse
specialist (as those terms are defined in subsection
(aa)(5)), a certified nurse-midwife (as defined in section
1861(gg)), or a physician assistant (as defined in subsection
(aa)(5))'' after ``physician'' the first place it appears;
and
(II) by inserting ``a nurse practitioner, a clinical nurse
specialist, a certified nurse-midwife, or a physician
assistant'' after ``physician'' the second place it appears;
and
(ii) in paragraph (3), by inserting ``a nurse practitioner,
a clinical nurse specialist, a certified nurse-midwife, or a
physician assistant'' after ``physician''; and
(B) in subsection (o)(2)--
(i) by inserting ``, nurse practitioners or clinical nurse
specialists (as those terms are defined in subsection
(aa)(5)), certified nurse-midwives (as defined in section
1861(gg)), or physician assistants (as defined in subsection
(aa)(5))'' after ``physicians''; and
(ii) by inserting ``, nurse practitioner, clinical nurse
specialist, certified nurse-midwife, physician assistant,''
after ``physician''.
(4) Section 1895 of the Social Security Act (42 U.S.C.
1395fff) is amended--
(A) in subsection (c)(1), by inserting ``, the nurse
practitioner or clinical nurse specialist (as those terms are
defined in section 1861(aa)(5)), the certified nurse-midwife
(as defined in section 1861(gg)), or the physician assistant
(as defined in section 1861(aa)(5)),'' after ``physician'';
and
(B) in subsection (e)--
(i) in paragraph (1)(A), by inserting ``, a nurse
practitioner or clinical nurse specialist (as those terms are
defined in section 1861(aa)(5)), a certified nurse-midwife
(as defined in section 1861(gg)), or a physician assistant
(as defined in section 1861(aa)(5))'' after ``physician'';
and
(ii) in paragraph (2)--
(I) in the heading, by striking ``Physician certification''
and inserting ``Rule of construction regarding requirement
for certification''; and
(II) by striking ``physician''.
(c) Requirement of Face-to-Face Encounter.--
(1) Part a.--Section 1814(a)(2)(C) of the Social Security
Act, as amended by subsection (b) and section 6407(a), is
further amended by striking ``, and, in the case of a
certification made by a physician'' and all that follows
through ``face-to-face encounter'' and inserting ``, and, in
the case of a certification made by a physician after January
1, 2010, or by a nurse practitioner, clinical nurse
specialist, certified nurse-midwife, or physician assistant
(as the case may be), prior to making such certification the
physician, nurse practitioner, clinical nurse specialist,
certified nurse-midwife, or physician assistant must document
that the physician, nurse practitioner, clinical nurse
specialist, certified nurse-midwife, or physician assistant
himself or herself has had a face-to-face encounter''.
(2) Part b.--Section 1835(a)(2)(A)(iv) of the Social
Security Act, as added by section 6407(a), is amended by
striking ``after January 1, 2010'' and all that follows
through ``face-to-face encounter'' and inserting ``made by a
physician after January 1, 2010, or by a nurse practitioner,
clinical nurse specialist, certified nurse-midwife, or
physician assistant (as the case may be), prior to making
such certification the physician, nurse practitioner,
clinical nurse specialist, certified nurse-midwife, or
physician assistant must document that the physician, nurse
practitioner, clinical nurse specialist, certified nurse-
midwife, or physician assistant has had a face-to-face
encounter''.
(d) Effective Date.--The amendments made by this section
shall apply to items and services furnished on or after
January 1, 2010.
______