Rural Health Clinic Burden Reduction Act
This bill makes a series of changes to requirements that apply to rural health clinics under Medicare.
For example, the bill allows rural health clinics that are not directed by physicians to enter into arrangements with physician assistants or nurse practitioners that generally comply with state laws (regarding scope of practice), rather than other specific requirements.
It also specifies that rural health clinics (1) need only have prompt access to clinical laboratory services (as opposed to having to directly provide these services); (2) must be located in a non-urban area with a population that is less than 50,000; (3) may contract with (as opposed to employ) physician assistants or nurse practitioners; and (4) may primarily provide mental health services if located in a designated mental health professional shortage area.
[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 198 Introduced in Senate (IS)]
<DOC>
118th CONGRESS
1st Session
S. 198
To amend title XVIII of the Social Security Act to modernize provisions
relating to rural health clinics under Medicare.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 1, 2023
Mr. Barrasso (for himself, Mr. Bennet, Mrs. Blackburn, and Ms. Smith)
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 modernize provisions
relating to rural health clinics under Medicare.
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 ``Rural Health Clinic Burden Reduction
Act''.
SEC. 2. MODERNIZING PHYSICIAN, PHYSICIAN ASSISTANT, AND NURSE
PRACTITIONER UTILIZATION REQUIREMENTS.
Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa))
is amended--
(1) in paragraph (2)(B), by striking ``has an arrangement''
and all that follows through the first semicolon and inserting
``meets the requirements described in paragraph (8);''; and
(2) by adding at the end the following new paragraph:
``(8) Requirements for Certain Facilities Described.--For purposes
of paragraph (2)(B), with respect to a facility which is not a
physician-directed clinic, the following requirements are described in
this paragraph:
``(A) Arrangement.--The facility has an arrangement
consistent with the provisions of State and local law relative
to the practice, performance, and delivery of health services,
with one or more physician assistants (as defined in paragraph
(5)(A)) or one or more nurse practitioners (as defined in such
paragraph).
``(B) Practice and oversight requirements.--The delivery of
health services under such arrangement shall be in accordance
with State law or the State regulatory mechanism governing the
practice of physician assistants or nurse practitioners.''.
SEC. 3. REMOVING OUTDATED LABORATORY REQUIREMENTS.
Section 1861(aa)(2)(G) of the Social Security Act (42 U.S.C.
1395x(aa)(2)(G)) is amended by striking ``, including clinical
laboratory services'' and all that follows through ``additional
diagnostic services'' and inserting the following: ``and has prompt
access to clinical laboratory services and additional diagnostic
services''.
SEC. 4. ALLOWING RURAL HEALTH CLINICS THE FLEXIBILITY TO CONTRACT WITH
PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS.
Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)),
in the first sentence of the flush matter following paragraph (2), is
amended by inserting ``or contracts with'' after ``(iii) employs''.
SEC. 5. URBANIZED AREA FIX.
Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)),
in the first sentence of the flush matter following paragraph (2), is
amended by striking ``(i) is located in an area that is not an
urbanized area'' and inserting ``(i) is located in an area that is not
in an urban area of 50,000 or more''.
SEC. 6. EXCEPTION TO BEHAVIORAL HEALTH LIMITATION.
Section 1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa)),
in the first sentence of the flush matter following paragraph (2), is
amended by inserting the following before the period: ``, except in the
case where the facility is located in an area that is designated (under
section 332(a)(1)(A) of the Public Health Service Act) as a mental
health professional shortage area''.
SEC. 7. EFFECTIVE DATE.
This Act and the amendments made by this Act shall take effect on
January 1, 2024, and shall apply to items and services furnished on or
after such date.
<all>
Introduced in Senate
Read twice and referred to the Committee on Finance.
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