S. 5Senate117th Congress (2021-2023)In Committee

A bill to amend title XVIII of the Social Security Act to ensure appropriate supervision requirements for outpatient physical therapy and outpatient occupational therapy.

Introduced November 17, 2022

AI-Generated Summary

Updated February 8, 2026 at 6:25 PM UTC

The bill changes the Social Security Act to make sure that the federal government does not set supervision rules for outpatient physical therapy or occupational therapy that conflict with a state’s own rules. It adds language to the payment and definition sections saying the Secretary cannot impose a different supervision requirement than what state law requires. The changes apply to Medicare‑covered outpatient PT and OT services and take effect on July 1, 2023.

Key Provisions

  • Amends the payment provision (Section 1834(v)(1)) to state the Secretary may not impose a supervision requirement that differs from applicable state law.
  • Amends the definition provision (Section 1861(p)) to include the same restriction on imposing supervision requirements that differ from state law.
  • Sets the effective date of these amendments as July 1, 2023.
  • Allows the Secretary to implement the changes through program instructions or other methods.

Legislative Activity

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1 earlier action
SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance.

November 17, 2022

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SenateIntro Referral

Introduced in Senate

November 17, 2022

SenateIntro Referral

Read twice and referred to the Committee on Finance.

November 17, 2022

Floor Debate

10 members

What members said about S. 5 on the floor

5 Republicans5 Democrats
Joseph D. Morelle
Rep. Joseph D. MorelleD-NY-25 · Feb 5, 2021

Madam Speaker, by direction of the Committee on Rules, I call up House Resolution 101 and ask for its immediate consideration. Madam Speaker, for the purpose of debate only, I yield the customary 30…

Michael C. Burgess
Rep. Michael C. BurgessR-TX-26 · Feb 5, 2021

Madam Speaker, I thank the gentleman for yielding me the customary 30 minutes, and I yield myself such time as I may consume. Madam Speaker, today's rule deems the Senate version of the budget…

Jason Smith
Rep. Jason SmithR-MO-8 · Feb 5, 2021

Madam Speaker, in Missouri, we have this phrase that says: You are all hat and no cattle. That is what this legislation is. It is all hat and no cattle. We just had the Speaker speak right before me…

Earl Blumenauer
Rep. Earl BlumenauerD-OR-3 · Feb 5, 2021

Madam Speaker, I appreciate the gentleman's courtesy as I appreciate his words. This is a step in a long process. There are ample opportunities for bipartisanship. I am hopeful that after years of…

Nancy Pelosi
Rep. Nancy PelosiD-CA-12 · Feb 5, 2021

Madam Speaker, I thank Mr. Morelle, the gentleman from New York and distinguished member of the Committee on Rules, among other committees of the House, for bringing this important rule to the floor.…

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Michelle Steel
Rep. Michelle SteelR-CA-48 · Feb 5, 2021

Madam Speaker, I rise in opposition to the previous question. If the previous question is defeated, Republicans will amend this rule to immediately consider H.R. 682, the Reopen Schools Act. This…

Kat Cammack
Rep. Kat CammackR-FL-3 · Feb 5, 2021

Madam Speaker, I thank the gentleman for yielding. Madam Speaker, I rise before you today in opposition to this rule. Since we began this new Congress in January--and I realize that I am new here--I…

Teresa Leger Fernandez
Rep. Teresa Leger FernandezD-NM-3 · Feb 5, 2021

Madam Speaker, I urge my colleagues to vote for the budget rule and resolution because Americans cannot wait any longer for us to rescue our economy and our health. We are the Congress of the United…

Ted Budd
Rep. Ted BuddR-NC-13 · Feb 5, 2021

Madam Speaker, I thank the gentleman from Texas for yielding. Madam Speaker, lifesaving COVID vaccines are going to waste. Seniors and frontline workers in my State, the State of North Carolina, have…

Ami Bera
Rep. Ami BeraD-CA-7 · Feb 5, 2021

Madam Speaker, I rise to speak in support of this budget resolution, and I speak as a doctor. This virus doesn't know whether you are Democrat or Republican. This virus doesn't know the color of your…

Bill Text

Latest available legislative text

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Introduced in SenateIssued November 17, 2022

II

117th CONGRESS

2d Session

S. 5

IN THE SENATE OF THE UNITED STATES

November 17, 2022

Mr. Carper (for himself and Mr. Barrasso) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to ensure appropriate supervision requirements for outpatient physical therapy and outpatient occupational therapy.

1.

Ensuring appropriate supervision requirements for outpatient physical therapy and outpatient occupational therapy

(a)

In general

(1)

Payment

Section 1834(v)(1) of the Social Security Act (42 U.S.C. 1395m(v)(1)) is amended, in the second sentence (as amended by subsection (a)), by inserting , but in no case shall the Secretary impose a supervision requirement on such services that is different than any such requirement under applicable State law before the period at the end.

(2)

Definition

Section 1861(p) of the Social Security Act, is amended, in the first sentence of the flush matter following subparagraph (4)(B), by inserting , but in no case may those conditions impose a supervision requirement that is different than any such requirement under applicable State law after as the Secretary may find necessary.

(3)

Effective date

The amendments made this subsection shall take effect on July 1, 2023.

(b)

Implementation

Notwithstanding any other provision of law, the Secretary may implement the provisions of, and the amendments made by, this section by program instruction or otherwise.