II 

109TH CONGRESS 

2D SESSION S. 2990 

To amend title XVIII of the Social Security Act to restore financial stability 

to Medicare anesthesiology teaching programs for resident physicians. 

IN THE SENATE OF THE UNITED STATES 

MAY 23, 2006 

Mr. VITTER (for himself, Mr. DEWINE, Mr. MARTINEZ, Mr. COBURN, Mr. 

DOMENICI, Mr. TALENT, Mr. BURR, Ms. SNOWE, Mrs. DOLE, and Mr. 

KYL) 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 restore 

financial stability to Medicare anesthesiology teaching 

programs for resident physicians. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicare Teaching An5 esthesiology Funding Restoration Act of 2006’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) The current Medicare payment policy for 

9 Medicare beneficiary services furnished by academic 


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1 anesthesiology programs administered by the Cen2 ters for Medicare & Medicaid Services (CMS) is un3 fair and underpays such programs by 50 percent. In 

4 its 1991 rule change, CMS singled out academic an5 esthesiology programs alone for a reduction in pay6 ment when teaching anesthesiologists supervise resi7 dents in two concurrent cases. This policy change 

8 was unique to anesthesiology and does not affect 

9 other medical specialties or non-physician providers. 

10 (2) The current Medicare payment policy ad11 ministered by CMS for academic anesthesiology pro12 grams is causing significant harm to academic anes13 thesiology programs nationwide by contributing to 

14 an overall decline in the number of such programs. 

15 Before the current policy went into effect in 1994, 

16 there were 162 academic anesthesiology programs 

17 nationwide. Today, 130 academic anesthesiology pro18 grams exist. As such programs close, medical stu19 dents will face diminished opportunities to enter the 

20 specialty of anesthesiology and patients in the 

21 United States will see increased shortages in anes22 thesiology medical care in the operating room and 

23 pain clinics and through critical care medicine. 

24 (3) The current Medicare payment policy ad25 ministered by CMS for academic anesthesiology proVerDate Aug 31 2005 02:28 May 27, 2006 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2990.IS S2990

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1 grams is shortchanging academic anesthesiology pro2 grams an average of $400,000 annually, with some 

3 programs losing in excess of $1 million. As such 

4 Medicare payment decreases continue, academic an5 esthesiology programs are experiencing increasing 

6 difficulty filling faculty appointments and sustaining 

7 research and development of new advances in anes8 thesiology medical care that have previously contrib9 uted to its outstanding patient safety record. 

10 SEC. 3. PURPOSE. 

11 The purpose of this Act is to restore the Medicare 

12 payment policy for academic anesthesiology programs to 

13 the policy administered by the Centers of Medicare & Med14 icaid Services before 1994 in order to— 

15 (1) ensure the financial stability of academic 

16 anesthesiology programs in order to provide suffi17 cient opportunities for physician residents to pursue 

18 the specialty of anesthesiology, so that patients con19 tinue to have access to quality medical care in the 

20 operating room and pain clinics and through critical 

21 care medicine; and 

22 (2) enable the specialty of anesthesiology to 

23 continue making advances in patient safety through 

24 research based in academic programs. 


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1 SEC. 4. SPECIAL PAYMENT RULE FOR TEACHING ANESTHE2 SIOLOGISTS. 

3 Section 1848(a) of the Social Security Act (42 U.S.C. 

4 1395w–4(a)) is amended— 

5 (1) in paragraph (4)(A), by inserting ‘‘except as 

6 provided in paragraph (5),’’ after ‘‘anesthesia 

7 cases,’’; and 

8 (2) by adding at the end the following new 

9 paragraph: 

10 ‘‘(5) SPECIAL RULE FOR TEACHING ANES11 THESIOLOGISTS.—With respect to physicians’ 

12 services furnished on or after January 1, 2007, 

13 in the case of teaching anesthesiologists in14 volved in the training of physician residents in 

15 a single anesthesia case or two concurrent anes16 thesia cases, the fee schedule amount to be ap17 plied shall be 100 percent of the fee schedule 

18 amount otherwise applicable under this section 

19 if the anesthesia services were personally per20 formed by the teaching anesthesiologist alone 

21 and paragraph (4) shall not apply if— 

22 ‘‘(A) the teaching anesthesiologist is 

23 present during all critical or key portions 

24 of the anesthesia service or procedure in25 volved; and 


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1 ‘‘(B) the teaching anesthesiologist (or 

2 another anesthesiologist with whom the 

3 teaching anesthesiologist has entered into 

4 an arrangement) is immediately available 

5 to furnish anesthesia services during the 

6 entire procedure.’’. 

Æ 


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