I 

109TH CONGRESS 

2D SESSION H. R. 5246 

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

to Medicare anesthesiology teaching programs for resident physicians. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 27, 2006 

Mr. SHAW (for himself and Mr. SESSIONS) 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 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: 


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1 (1) The current Medicare payment policy for 

2 Medicare beneficiary services furnished by academic 

3 anesthesiology programs administered by the Cen4 ters for Medicare & Medicaid Services (CMS) is un5 fair and underpays such programs by 50 percent. In 

6 its 1991 rule change, CMS singled out academic an7 esthesiology programs alone for a reduction in pay8 ment when teaching anesthesiologists supervise resi9 dents in two concurrent cases. This policy change 

10 was unique to anesthesiology and does not affect 

11 other medical specialties or non-physician providers. 

12 (2) The current Medicare payment policy ad13 ministered by CMS for academic anesthesiology pro14 grams is causing significant harm to academic anes15 thesiology programs nationwide by contributing to 

16 an overall decline in the number of such programs. 

17 Before the current policy went into effect in 1994, 

18 there were 162 academic anesthesiology programs 

19 nationwide. Today, 130 academic anesthesiology pro20 grams exist. As such programs close, medical stu21 dents will face diminished opportunities to enter the 

22 specialty of anesthesiology and patients in the 

23 United States will see increased shortages in anes24 thesiology medical care in the operating room and 

25 pain clinics and through critical care medicine. 


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1 (3) The current Medicare payment policy ad2 ministered by CMS for academic anesthesiology pro3 grams is shortchanging academic anesthesiology pro4 grams an average of $400,000 annually, with some 

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

6 Medicare payment decreases continue, academic an7 esthesiology programs are experiencing increasing 

8 difficulty filling faculty appointments and sustaining 

9 research and development of new advances in anes10 thesiology medical care that have previously contrib11 uted to its outstanding patient safety record. 

12 SEC. 3. PURPOSE. 

13 The purpose of this Act is to restore the Medicare 

14 payment policy for academic anesthesiology programs to 

15 the policy administered by the Centers of Medicare & Med16 icaid Services before 1994 in order to— 

17 (1) ensure the financial stability of academic 

18 anesthesiology programs in order to provide suffi19 cient opportunities for physician residents to pursue 

20 the specialty of anesthesiology, so that patients con21 tinue to have access to quality medical care in the 

22 operating room and pain clinics and through critical 

23 care medicine; and 


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1 (2) enable the specialty of anesthesiology to 

2 continue making advances in patient safety through 

3 research based in academic programs. 

4 SEC. 4. SPECIAL PAYMENT RULE FOR TEACHING ANESTHE5 SIOLOGISTS. 

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

7 1395w–4(a)) is amended— 

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

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

10 cases,’’; and 

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

12 paragraph: 

13 ‘‘(5) SPECIAL RULE FOR TEACHING ANES14 THESIOLOGISTS.—With respect to physicians’ 

15 services furnished on or after January 1, 2007, 

16 in the case of teaching anesthesiologists in17 volved in the training of physician residents in 

18 a single anesthesia case or two concurrent anes19 thesia cases, the fee schedule amount to be ap20 plied shall be 100 percent of the fee schedule 

21 amount otherwise applicable under this section 

22 if the anesthesia services were personally per23 formed by the teaching anesthesiologist alone 

24 and paragraph (4) shall not apply if— 


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1 ‘‘(A) the teaching anesthesiologist is 

2 present during all critical or key portions 

3 of the anesthesia service or procedure in4 volved; and 

5 ‘‘(B) the teaching anesthesiologist (or 

6 another anesthesiologist with whom the 

7 teaching anesthesiologist has entered into 

8 an arrangement) is immediately available 

9 to furnish anesthesia services during the 

10 entire procedure.’’. 

Æ 


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