Athletic Trainers' Equal Access to Medicare Act of 2011

Athletic Trainers' Equal Access to Medicare Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act to provide for: (1) access to outpatient occupational and physical therapy services provided incident to a physician's professional services if furnished by an educated or credentialed therapist who does not have a license; and (2) coverage of certified athletic trainer services under part B (Supplementary Medical Insurance) of Medicare, including those provided in rural health clinics and federally qualified health centers.

[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2785 Introduced in House (IH)]

112th CONGRESS
  1st Session
                                H. R. 2785

  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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 1, 2011

  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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Athletic Trainers' Equal Access to 
Medicare Act of 2011''.

SEC. 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)''.

SEC. 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 (EE), by striking ``and'' at 
                the end;
                    (B) in subparagraph (FF), by adding ``and'' at the 
                end; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(GG) certified athletic trainer services (as defined in 
        subsection (iii)(1));''; and
            (2) by adding at the end the following new subsection:

                 ``Certified Athletic Trainer Services

    ``(iii)(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 ``(Z)''; and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and (AA) with respect to certified 
                athletic trainer services under section 1861(s)(2)(GG), 
                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 physical therapy'' and inserting 
        ``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(iii)(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 (iii)(2))''.
    (f) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished on or after January 1, 2012.
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