I 

110TH CONGRESS 

1ST SESSION H. R. 1774 

To amend title XVIII of the Social Security Act to establish a separate 

definition of outpatient speech-language pathology services under the 

Medicare Program in order that direct payment to speech-language pathologists may be made under the Medicare Program. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 29, 2007 

Mr. BUTTERFIELD (for himself, Mr. INSLEE, Mrs. CAPPS, Mr. FERGUSON, 

and Ms. SCHWARTZ) 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 establish 

a separate definition of outpatient speech-language pathology services under the Medicare Program in order 

that direct payment to speech-language pathologists may 

be made under the Medicare Program. 

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

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1 SECTION 1. MEDICARE SEPARATE DEFINITION OF OUT2 PATIENT SPEECH-LANGUAGE PATHOLOGY 

3 SERVICES. 

4 (a) IN GENERAL.—Section 1861(ll) of the Social Se5 curity Act (42 U.S.C. 1395x(ll)) is amended— 

6 (1) by redesignating paragraphs (2) and (3) as 

7 paragraphs (3) and (4), respectively; and 

8 (2) by inserting after paragraph (1) the fol9 lowing new paragraph: 

10 ‘‘(2) The term ‘outpatient speech-language pa11 thology services’ has the meaning given the term 

12 ‘outpatient physical therapy services’ in subsection 

13 (p), except that in applying such subsection— 

14 ‘‘(A) ‘speech-language pathology’ shall be 

15 substituted for ‘physical therapy’ each place it 

16 appears; and 

17 ‘‘(B) ‘speech-language pathologist’ shall be 

18 substituted for ‘physical therapist’ each place it 

19 appears.’’. 

20 (b) CONFORMING AMENDMENTS.— 

21 (1) Section 1832(a)(2)(C) of the Social Security 

22 Act (42 U.S.C. 1395k(a)(2)(C)) is amended— 

23 (A) by striking ‘‘and outpatient’’ and in24 serting ‘‘, outpatient’’; and 

25 (B) by inserting before the period at the 

26 end the following: ‘‘, and outpatient speech-lanmstockstill on PROD1PC66 with BILLS

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1 guage pathology services (other than services to 

2 which the second sentence of section 1861(p) 

3 applies through the application of section 

4 1861(ll)(2))’’. 

5 (2) Subparagraphs (A) and (B) of section 

6 1833(a)(8) of such Act (42 U.S.C. 1395l(a)(8)) are 

7 each amended by striking ‘‘(which includes out8 patient speech-language pathology services)’’ and in9 serting ‘‘, outpatient speech-language pathology 

10 services,’’. 

11 (3) Section 1833(g)(1) of such Act (42 U.S.C. 

12 1395l(g)(1)) is amended— 

13 (A) by inserting ‘‘and speech-language pa14 thology services of the type described in such 

15 section through the application of section 

16 1861(ll)(2)’’ after ‘‘1861(p)’’; and 

17 (B) by inserting ‘‘and speech-language pa18 thology services’’ after ‘‘and physical therapy 

19 services’’. 

20 (4) The second sentence of section 1835(a) of 

21 such Act (42 U.S.C. 1395n(a)) is amended— 

22 (A) by striking ‘‘section 1861(g)’’ and in23 serting ‘‘subsection (g) or (ll)(2) of section 

24 1861’’ each place it appears; and 

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1 (B) by inserting ‘‘or outpatient speech-lan2 guage pathology services, respectively’’ after 

3 ‘‘occupational therapy services’’. 

4 (5) Section 1861(p) of such Act (42 U.S.C. 

5 1395x(p)) is amended by striking the fourth sen6 tence. 

7 (6) Section 1861(s)(2)(D) of such Act (42 

8 U.S.C. 1395x(s)(2)(D)) is amended by inserting ‘‘, 

9 outpatient speech-language pathology services,’’ after 

10 ‘‘physical therapy services’’. 

11 (7) Section 1862(a)(20) of such Act (42 U.S.C. 

12 1395y(a)(20)) is amended— 

13 (A) by striking ‘‘outpatient occupational 

14 therapy services or outpatient physical therapy 

15 services’’ and inserting ‘‘outpatient physical 

16 therapy services, outpatient speech-language pa17 thology services, or outpatient occupational 

18 therapy services’’; and 

19 (B) by striking ‘‘section 1861(g)’’ and in20 serting ‘‘subsection (g) or (ll)(2) of section 

21 1861’’. 

22 (8) Section 1866(e)(1) of such Act (42 U.S.C. 

23 1395cc(e)(1)) is amended— 

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1 (A) by striking ‘‘section 1861(g)’’ and in2 serting ‘‘subsection (g) or (ll)(2) of section 

3 1861’’ the first two places it appears; 

4 (B) by striking ‘‘therein) or’’ and inserting 

5 ‘‘therein),’’; and 

6 (C) by inserting before the semicolon at 

7 the end the following: ‘‘, or (through the oper8 ation of section 1861(ll)(2)) with respect to the 

9 furnishing of outpatient speech-language pa10 thology’’. 

11 (c) EFFECTIVE DATE.—The amendments made by 

12 this section shall apply to services furnished on or after 

13 January 1, 2008. 

14 (d) CONSTRUCTION.—Nothing in this section shall be 

15 construed to affect existing regulations and policies of the 

16 Centers for Medicare & Medicaid Services that require 

17 physician oversight of care as a condition of payment for 

18 speech-language pathology services under part B of the 

19 medicare program. 

Æ 

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