S. 1569 – Reading Mode

111th CONGRESS

1st Session

S. 1569

IN THE SENATE OF THE UNITED STATES

August 3, 2009

Ms. Stabenow introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To expand our Nation's Advanced Practice Registered Nurse workforce.

Short title

This Act may be cited as the Medicare Graduate Nursing Education Act.

Medicare payment for costs of expanded advanced practice nurse training programs

(a)

In general

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

(1)

in paragraph (1), by adding at the end the following new subparagraph:

(V)

Such reasonable costs shall include hospital costs described in paragraph (9) for expanded advanced nurse practice training programs.

; and

(2)

by adding at the end the following new paragraph:

(9)

(A)

For purposes of paragraph (1)(V), subject to subparagraphs (B) and (C), the costs described in this paragraph are educational costs (including faculty salaries, student stipends (if any), clinical instruction costs, and other direct and indirect costs) of a hospital and affiliated schools and settings described in clause (ii) attributable to the training of advanced practice nurses—

(i)

with the skills necessary to provide primary and preventive care, transitional care, chronic care management, and other nursing services appropriate for the population under this title; and

(ii)

through affiliation with one or more accredited schools of nursing (as defined in section 801 of the Public Health Service Act) and in partnership with two or more non-hospital community-based care settings where at least half of all clinical training occurs.

The Secretary may waive the community-based setting requirement under clause (ii) for clinical training of advanced practice registered nurses, such as certified registered nurse anesthetists and certified nurse-midwives, in rural and medically underserved areas.

(B)

Costs under this paragraph are limited to costs attributable to an increase in the enrollment and the number of advanced practice nurse graduates in each education or training program over the comparable average number from 2006 to 2010 (as determined by the Secretary) but shall not be offset or take into account tuition, fees, or State or local government appropriations. The proportion of such costs paid under this paragraph shall be determined based on the proportion of the total inpatient days of the hospital attributable to this title.

(C)

No payment shall be made under this paragraph to a hospital unless the hospital has in effect an agreement with the schools of nursing and settings described in subparagraph (A)(ii) to pay from such payment to such a school or setting (through the school when the setting is arranged through the school) the costs of educational activities described in subparagraph (A) attributable to each.

(D)

In this paragraph, the term advanced practice nurse includes a clinical nurse specialist, nurse practitioner, certified registered nurse anesthetist, and certified nurse midwife.

(b)

Effective date

The amendments made by subsection (a) shall apply to costs incurred on or after January 1, 2012.