H.R. 1137

Athletic Trainers' Equal Access to Medicare Act of 2009

Latest
Raw Text PDF XML

I

111th CONGRESS

1st Session

H. R. 1137

IN THE HOUSE OF REPRESENTATIVES

February 23, 2009

Mr. Towns introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on 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 XVIII of the Social Security Act to provide improved access to physical medicine and rehabilitation services under part B of the Medicare Program, and for other purposes.

1.

Short title

This Act may be cited as the Athletic Trainers’ Equal Access to Medicare Act of 2009.

2.

Access to physical medicine and rehabilitation services provided incident to a physician

Section 1862(a)(20) of the Social Security Act (42 U.S.C. 1395y(a)(20)) is amended by striking (other than any licensing requirement specified by the Secretary) and inserting (other than any licensing, education, or credentialing requirements specified by the Secretary).

3.

Coverage of certified athletic trainer services under part B of the Medicare program

(a)

Coverage of services

Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended—

(1)

in subsection (s)(2)—

(A)

in subparagraph (DD), by striking and at the end;

(B)

in subparagraph (EE), by adding and at the end; and

(C)

by adding at the end the following new subparagraph:

(FF)

certified athletic trainer services (as defined in subsection (hhh)(1));

; and

(2)

by adding at the end the following new subsection:

(hhh)

Certified Athletic Trainer Services

(1)

The term certified athletic trainer services means services performed by a certified athletic trainer (as defined in paragraph (2)) under the supervision of a physician (as defined in subsection (r)), which the athletic trainer is legally authorized to perform under State law (or the State regulatory mechanism provided by State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician (as so defined) or as an incident to a physician’s professional service, to an individual—

(A)

who is under the care of a physician (as so defined); and

(B)

with respect to whom a plan prescribing the type, amount, and duration of services that are to be furnished to such individual has been established by a physician (as so defined).

Such term does not include any services for which a facility or other provider charges or is paid any amounts with respect to the furnishing of such services.
(2)

The term certified athletic trainer means an individual who—

(A)

in the case of an individual performing services in a State that provides for licensure or certification of athletic trainers, is licensed or certified as an athletic trainer in such State; or

(B)

in the case of an individual performing services in a State that does not provide for licensure or certification of athletic trainers, possesses a bachelors, master’s or doctoral degree which qualifies for certification as an athletic trainer, and, has successfully passed a national certification examination for Athletic Trainers recognized by the Secretary.

.

(b)

Payment

(1)

In general

Section 1832(a)(2)(B) of such Act (42 U.S.C. 1395k(a)(2)(B)) is amended by adding at the end the following new clause:

(v)

certified athletic trainer services;

.

(2)

Amount

Section 1833(a)(1) of such Act (42 U.S.C. 1395l(a)(1)) is amended—

(A)

by striking and before (W); and

(B)

by inserting before the semicolon at the end the following: , and (X) with respect to certified athletic trainer services under section 1861(s)(2)(FF), the amounts paid shall be 80 percent of the lesser of the actual charge for the service or the fee schedule amount under section 1848 for the same service performed by a physician.

(3)

Payment to employer

The first sentence of section 1842(b)(6) of such Act (42 U.S.C. 1395u(b)(6)) is amended—

(A)

by striking and before (H); and

(B)

by inserting before ; but nothing the following: , and (I) in the case of certified athletic trainer services, payment shall be made to the physician, clinic, or hospital that employs the athletic trainer involved.

(c)

Inclusion of services in the therapy cap

Section 1833(g)(1) of such Act (42 U.S.C. 1395l(g)(1)) is amended—

(1)

by striking and before physical therapy; and

(2)

by inserting after or as incident to physicians’ services, the following: and certified athletic trainer services.

(d)

Inclusion of athletic trainers as practitioners for assignment of claims

Section 1842(b)(18)(C) of such Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new clause:

(vii)

A certified athletic trainer (as defined in section 1861(hhh)(1)).

.

(e)

Coverage of certain physical medicine and rehabilitation services provided in rural health clinics and federally qualified health centers

Section 1861(aa)(1)(B) of such Act (42 U.S.C. 1395x(aa)(1)(B)) is amended—

(1)

by striking or before by a clinical social worker; and

(2)

by inserting after subsection (hh)(1)), the following: by a certified athletic trainer (as defined in subsection (hhh)(2)).

(f)

Effective date

The amendments made by this section shall apply with respect to services furnished on or after January 1, 2010.