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104TH CONGRESS

1ST SESSION H. R. 1746

To amend titles XVIII and XIX of the Social Security Act to permit coverage

of outpatient physical therapy services under the medicare and medicaid

programs without a physician’s referral, and to establish a Physical

Therapy Advisory Council in the Department of Health and Human

Services.

IN THE HOUSE OF REPRESENTATIVES

JUNE 6, 1996

Mr. JEFFERSON introduced the following bill; which was referred to the Committee on 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 titles XVIII and XIX of the Social Security Act

to permit coverage of outpatient physical therapy services

under the medicare and medicaid programs without a

physician’s referral, and to establish a Physical Therapy

Advisory Council in the Department of Health and

Human Services.

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. COVERAGE OF PHYSICAL THERAPY SERVICES

2 UNDER MEDICARE WITHOUT PHYSICIAN’S

3 REFERRAL.

4 (a) IN GENERAL.—

5 (1) SERVICES FURNISHED BY OR UNDER AR6 RANGEMENT WITH CLINICS AND OTHER INSTITU7 TIONS.—Section 1861(p)(1) of the Social Security

8 Act (42 U.S.C. 1395x(p)(1)) is amended by insert9 ing before ‘‘and’’ the following: ‘‘without regard to

10 whether or not the individual is furnished the serv11 ices pursuant to a referral by the physician,’’.

12 (2) SERVICES FURNISHED BY INDEPENDENT

13 PHYSICAL THERAPISTS.—The second sentence of

14 section 1861(p) of such Act (42 U.S.C. 1395x(p)) is

15 amended by striking the period at the end and in16 serting the following: ‘‘, except that the Secretary

17 may not include in such conditions a provision limit18 ing coverage of such services to services furnished

19 pursuant to a referral by a physician.’’.

20 (b) EFFECTIVE DATE.—The amendments made by

21 subsection (a) shall apply to services furnished on or after

22 October 1, 1995.
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1 SEC. 2. COVERAGE OF PHYSICAL THERAPY SERVICES

2 UNDER STATE MEDICAID PLANS WITHOUT

3 PHYSICIAN’S REFERRAL.

4 (a) IN GENERAL.—Section 1905(a)(11) of the Social

5 Security Act (42 U.S.C. 1396d(a)(11)) is amended by

6 striking the semicolon at the end and inserting the follow7 ing: ‘‘, without regard to whether or not the services are

8 furnished pursuant to a referral by a physician.’’.

9 (b) EFFECTIVE DATE.—The amendment made by

10 subsection (a) shall apply to calendar quarters beginning

11 on or after October 1, 1995.

12 SEC. 3. PHYSICAL THERAPY ADVISORY COUNCIL.

13 (a) ESTABLISHMENT.—There is hereby established in

14 the Department of Health and Human Services the Phys15 ical Therapy Advisory Council (hereafter in this section

16 referred to as the ‘‘Council’’).

17 (b) MEMBERSHIP.—

18 (1) IN GENERAL.—The Council shall consist of

19 individuals appointed by the Secretary of Health and

20 Human Services (hereafter in this section referred to

21 as the ‘‘Secretary’’), in such number as the Sec22 retary considers appropriate, who meet such criteria

23 as the Secretary may establish. Members shall serve

24 at the pleasure of the Secretary.
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1 (2) DEADLINE FOR APPOINTMENT.—The Sec2 retary shall appoint the initial members of the Coun3 cil not later than October 1, 1995.

4 (3) NO COMPENSATION FOR SERVICES.—Mem5 bers of the Council shall serve without pay, but shall

6 receive travel expenses, including per diem in lieu of

7 subsistence, in accordance with sections 5702 and

8 5703 of title 5, United States Code.

9 (c) DUTIES.—The Council shall advise the Secretary

10 on matters relating to the practice of physical therapy and

11 reimbursement for physical therapy services, and shall

12 conduct such studies and submit such reports as the Sec13 retary may require.

14 (d) ANNUAL REPORT ON ACTIVITIES.—Not later

15 than March 1 of each year (beginning with 1997), the

16 Council shall submit a report to the Secretary describing

17 its activities during the previous year.

18 (e) NO TERMINATION.—Section 14(a)(2)(B) of the

19 Federal Advisory Committee Act (5 U.S.C. App.; relating

20 to the termination of advisory committees) shall not apply

21 to the Council.

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