← Back to H.R. 4872
S.Amdt. 3573Senate111th Congress (2009-2011)

S.Amdt. 3573

What it does: Adds SEC. __. IMPROVING CARE PLANNING FOR MEDICARE HOME HEALTH SERVICES at the end of subtitle B of title I
Sponsored by Susan M. CollinsSen. Susan M. Collins (R-ME)
Submitted March 23, 2010

What it changes

1 change to H.R. 4872 · shown in the bill's text

Adds a section

  1. Adds SEC. __. IMPROVING CARE PLANNING FOR MEDICARE HOME HEALTH SERVICES at the end of subtitle B of title I

    Adds a section

    In H.R. 4872 · Placed on Calendar Senate

    (d) Qualifying Hospital Defined.--In this section, the term "qualifying hospital" means a subsection (d) hospital (as defined for purposes of section 1886(d) of the Social Security Act) that is located in a county that ranks, based upon its ranking in age, sex, and race adjusted spending for benefits under parts A and B under title XVIII of such Act per enrollee, within the lowest quartile of such counties in the United States.

    Inserted: SEC. __. IMPROVING CARE PLANNING FOR MEDICARE HOME HEALTH SERVICES.

    Inserted: (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--

    Inserted: (1) by inserting "(as those terms are defined in section 1861(aa)(5))" after "clinical nurse specialist"; and

    Inserted: (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".

    Inserted: (b) Conforming Amendments.--(1) Section 1814(a) of the Social Security Act (42 U.S.C. 1395f(a)), as amended by sections 3108(a)(2) and section 6407 of the Patient Protection and Affordable Care Act, is amended--

    Inserted: (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;

    Inserted: (B) in the second sentence, by inserting "certified nurse-midwife," after "clinical nurse specialist,";

    Inserted: (C) in the third sentence--

    Inserted: (i) by striking "physician certification" and inserting "certification";

    Inserted: (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

    Inserted: (iii) by striking "a physician who" and inserting "a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant who"; and

    Inserted: (D) in the fourth sentence, by inserting ", nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant" after "physician".

    Show 30 more inserted paragraphs

    Inserted: (2) Section 1835(a) of the Social Security Act (42 U.S.C. 1395n(a)), as amended by section 6405 of the Patient Protection and Affordable Care Act, is amended--

    Inserted: (A) in paragraph (2)--

    Inserted: (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

    Inserted: (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";

    Inserted: (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;

    Inserted: (C) in the fourth sentence--

    Inserted: (i) by striking "physician certification" and inserting "certification";

    Inserted: (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

    Inserted: (iii) by striking "a physician who" and inserting "a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant who"; and

    Inserted: (D) in the fifth sentence, by inserting ", nurse practitioner, clinical nurse specialist, certified nurse-midwife, or physician assistant" after "physician".

    Inserted: (3) Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended--

    Inserted: (A) in subsection (m)--

    Inserted: (i) in the matter preceding paragraph (1)--

    Inserted: (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

    Inserted: (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

    Inserted: (ii) in paragraph (3), by inserting "a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant" after "physician"; and

    Inserted: (B) in subsection (o)(2)--

    Inserted: (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

    Inserted: (ii) by inserting ", nurse practitioner, clinical nurse specialist, certified nurse-midwife, physician assistant," after "physician".

    Inserted: (4) Section 1895 of the Social Security Act (42 U.S.C. 1395fff) is amended--

    Inserted: (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

    Inserted: (B) in subsection (e)--

    Inserted: (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

    Inserted: (ii) in paragraph (2)--

    Inserted: (I) in the heading, by striking "Physician certification" and inserting "Rule of construction regarding requirement for certification"; and

    Inserted: (II) by striking "physician".

    Inserted: (c) Requirement of Face-to-Face Encounter.--

    Inserted: (1) Part a.--Section 1814(a)(2)(C) of the Social Security Act, as amended by subsection (b) and section 6407(a) of the Patient Protection and Affordable Care Act, 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) after January 1, 2011, 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".

    Inserted: (2) Part b.--Section 1835(a)(2)(A)(iv) of the Social Security Act, as added by section 6407(a) of the Patient Protection and Affordable Care Act, 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) after January 1, 2011, 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".

    Inserted: (d) Effective Date.--The amendments made by this section shall apply to items and services furnished on or after January 1, 2011.

    Original wording

    At the end of subtitle B of title I, add the following:

Read automatically from the Congressional Record. Check the original before relying on it.

As printed

SA 3573. Ms. COLLINS submitted an amendment intended to be proposed by her to the bill H.R. 4872, to provide for reconciliation pursuant to Title II of the concurrent resolution on the budget for fiscal year 2010 (S. Con. Res. 13); which was ordered to lie on the table; as follows:

At the end of subtitle B of title I, add the following:

SEC. __. 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 sections 3108(a)(2) and section 6407 of the Patient Protection and Affordable Care Act, is amended--

(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 of the Patient Protection and Affordable Care Act, 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) of the Patient Protection and Affordable Care Act, 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) after January 1, 2011, 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) of the Patient Protection and Affordable Care Act, 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) after January 1, 2011, 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, 2011.

Congressional RecordPDF

Legislative Activity

Stay on top of the latest movement without scrolling through every action

Floor Latest Action

Senate amendment submitted

March 23, 2010