Union Calendar No. 454

104TH CONGRESS

2D SESSION H. R. 1791

[Report No. 104–826]

A BILL

To amend title XIX of the Social Security Act to

physicians’ services.make certain technical corrections relating to

SEPTEMBER 24, 1996

Reported with an amendment, committed to the Commitordered to be printed tee of the Whole House on the State of the Union, and
IB

Union Calendar No. 454

104TH CONGRESS

2D SESSION H. R. 1791

[Report No. 104–826]

To amend title XIX of the Social Security Act to make certain technical

corrections relating to physicians’ services.

IN THE HOUSE OF REPRESENTATIVES

JUNE 8, 1995

Mr. BARTON of Texas (for himself, Mr. COLEMAN, Mr. GREENWOOD, Mr.

ACKERMAN, Ms. PRYCE, Mr. DINGELL, Mr. LEACH, Mr. LEVIN, Mr. EMERSON, Mr. SKELTON, Mr. UPTON, Mr. JACOBS, Mr. KIM, Mr. RAHALL,

Mr. KILDEE, Mr. DEUTSCH, Mr. SMITH of New Jersey, Mr. BRYANT of

Texas, Mr. STUPAK, Mr. BARCIA, Mr. FROST, and Mr. BROWN of Ohio)

introduced the following bill; which was referred to the Committee on

Commerce

SEPTEMBER 24, 1996

Additional sponsors: Ms. RIVERS, Mrs. THURMAN, Mrs. JOHNSON of Connecticut, Mr. PASTOR, Mr. GENE GREEN of Texas, Mr. BURR, Mr. EHLERS,

Mr. CARDIN, Mr. KOLBE, Mr. HOEKSTRA, Mr. ROBERTS, Mr. VOLKMER,

Mr. CRAPO, Mr. PETE GEREN of Texas, Mr. MCDERMOTT, Mr. LEWIS

of Georgia, Mr. TRAFICANT, Mr. CANADY of Florida, Mrs. MEEK of Florida, Mr. NEY, Mrs. LINCOLN, Mr. ANDREWS, Mr. HALL of Texas, Mr.

HOKE, Mr. GANSKE, Ms. KAPTUR, Mr. BONIOR, Mr. HANCOCK, Mr. FOX

of Pennsylvania, Ms. DANNER, Mr. HUTCHINSON, Mr. REED, Mr.

WELDON of Florida, Mr. BUNNING of Kentucky, Mr. BARRETT of Wisconsin, Mr. OLVER, Mr. MCCOLLUM, and Mr. NETHERCUTT

SEPTEMBER 24, 1996

Reported with an amendment, committed to the Committee of the Whole

House on the State of the Union, and ordered to be printed

[Strike out all after the enacting clause and insert the part printed in italic]
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A BILL

To amend title XIX of the Social Security Act to make

certain technical corrections relating to physicians’ services.

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 ‘‘Medicaid Certification

5 Act of 1995’’.

6 SEC. 2. TECHNICAL CORRECTIONS RELATING TO PHYSI7 CIANS’ SERVICES.

8 (a) IN GENERAL.—

9 (1) UNIQUE IDENTIFIERS.—Paragraph (59) of

10 section 1902(a) of the Social Security Act (42

11 U.S.C. 1396a(a)) is amended by striking ‘‘subsection

12 (v)’’ and inserting ‘‘subsection (x)’’.

13 (2) EXPENDITURES FOR PHYSICIANS’ SERV14 ICES.—Section 1903(i)(12) of the Social Security

15 Act (42 U.S.C. 1396b(i)(12)) is amended—

16 (A) by amending clause (i) of subpara17 graph (A) to read as follows:

18 ‘‘(i) is certified in family practice or

19 pediatrics by the medical specialty board

20 recognized by the American Board of Med21 ical Specialties for family practice or pedi22 atrics or is certified in family practice or
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1 pediatrics by the medical specialty board

2 recognized by the American Osteopathic

3 Association,’’;

4 (B) by amending clause (i) of subpara5 graph (B) to read as follows:

6 ‘‘(i) is certified in family practice or

7 obstetrics by the medical specialty board

8 recognized by the American Board of Med9 ical Specialties for family practice or ob10 stetrics or is certified in family practice or

11 obstetrics by the medical specialty board

12 recognized by the American Osteopathic

13 Association,’’; and

14 (C) in subparagraphs (A) and (B)—

15 (i) by striking ‘‘or’’ at the end of

16 clause (v);

17 (ii) by redesignating clause (vi) as

18 clause (vii); and

19 (iii) by inserting after clause (v) the

20 following new clause:

21 ‘‘(vi) delivers such services in the

22 emergency department of a hospital par23 ticipating in the State plan approved under

24 this title, or’’.
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1 (b) EFFECTIVE DATE.—The amendments made by

2 subsection (a) shall be effective as if included in the enact3 ment of the Omnibus Budget Reconciliation Act of 1990.

4 SECTION 1. TECHNICAL CORRECTIONS RELATING TO PHY5 SICIANS’ SERVICES.

6 (a) CORRECTING REFERENCE TO UNIQUE IDENTIFIER

7 SYSTEM.—

8 (1) IN GENERAL.—Section 1902(a) of the Social

9 Security Act (42 U.S.C. 1396a(a)) is amended, in the

10 paragraph redesignated as paragraph (59) by section

11 13623(a)(6) of the Omnibus Budget Reconciliation

12 Act of 1993 and inserted by section 4752(c)(1)(C) of

13 the Omnibus Budget Reconciliation Act of 1990, by

14 striking ‘‘subsection (v)’’ and inserting ‘‘subsection

15 (x)’’.

16 (2) EFFECTIVE DATE.—The amendment made by

17 paragraph (1) shall be effective as if included in the

18 enactment of the amendments made by section

19 4752(c)(1) of the Omnibus Budget Reconciliation Act

20 of 1990.

21 (b) CORRECTION IN MINIMUM QUALIFICATIONS FOR

22 BILLING FOR PHYSICIANS’ SERVICES TO CHILDREN AND

23 PREGNANT WOMEN.—

24 (1) IN GENERAL.—Section 1903(i) of the Social

25 Security Act (42 U.S.C. 1396b(i)) is amended, in the
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1 paragraph redesignated as paragraph (12) by section

2 13631(c)(3) of the Omnibus Budget Reconciliation

3 Act of 1993 and inserted by section 4752(a)(2)(B) of

4 the Omnibus Budget Reconciliation Act of 1990—

5 (A) in subparagraph (A)(i), by inserting

6 ‘‘or is certified in family practice or pediatrics

7 by the medical specialty board recognized by the

8 American Osteopathic Association’’ before the

9 comma at the end;

10 (B) in subparagraph (B)(i), by inserting

11 ‘‘or is certified in family practice or obstetrics by

12 the medical specialty board recognized by the

13 American Osteopathic Association’’ before the

14 comma at the end; and

15 (C) in each of subparagraphs (A) and

16 (B)—

17 (i) by striking ‘‘or’’ at the end of clause

18 (v),

19 (ii) in clause (vi), by inserting ‘‘(or

20 certified by the State in accordance with

21 policies of the Secretary)’’ after ‘‘Secretary’’,

22 (iii) by redesignating clause (vi) as

23 clause (vii), and

24 (iv) by inserting after clause (v) the

25 following new clause:
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1 ‘‘(vi) delivers such services in the emer2 gency department of a hospital participat3 ing in the State plan approved under this

4 title, or’’.

5 (2) EFFECTIVE DATE.—The amendments made

6 by paragraph (1) shall apply to physicians’ services

7 furnished on or after January 1, 1992.