I 

114TH CONGRESS 

2D SESSION H. R. 4959 

To direct the Secretary of Health and Human Services to conduct a study 

on the designation of surgical health professional shortage areas. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 15, 2016 

Mr. BUCSHON (for himself and Mr. BERA) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To direct the Secretary of Health and Human Services to 

conduct a study on the designation of surgical health 

professional shortage areas. 

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 ‘‘Ensuring Access to 

5 General Surgery Act of 2016’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) According to the Bureau of Health Work9 force, the United States faces a shortage of physi10 cians. 


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1 (2) In order to accurately prepare for future 

2 physician workforce demands, comprehensive, impar3 tial research and high quality data is needed to in4 form dynamic projections of physician workforce 

5 needs. 

6 (3) A variety of factors, including health out7 comes, utilization trends, growing and aging popu8 lations, and delivery system changes, influence work9 force needs and should be considered as part of 

10 flexible projections of workforce needs. 

11 (4) Given the particularly acute needs for sur12 geons in many rural areas, additional efforts to as13 sess adequacy of the current surgeon workforce are 

14 necessary. 

15 SEC. 3. STUDY ON DESIGNATION OF SURGICAL HEALTH 

16 PROFESSIONAL SHORTAGE AREAS. 

17 (a) STUDY.—The Secretary of Health and Human 

18 Services (in this section referred to as the ‘‘Secretary’’) 

19 shall conduct a study on the following matters relating to 

20 access by underserved populations to general surgeons: 

21 (1) Whether the designation of health profes22 sional shortage areas under section 332 of the Pub23 lic Health Service Act (42 U.S.C. 254e) results in 

24 accurate assessments of the adequacy of local genVerDate Sep 11 2014 03:51 Apr 22, 2016 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4959.IH H4959

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1 eral surgeons to address the needs of underserved 

2 populations in urban, suburban, or rural areas. 

3 (2) Whether another measure of access to gen4 eral surgeons by underserved populations, such as 

5 hospital service areas, would provide more accurate 

6 assessments of shortages in the availability of local 

7 general surgeons to meets the needs of those popu8 lations. 

9 (3) The appropriateness of establishing the des10 ignation under such section 332 of surgical health 

11 professional shortage areas (as defined in subsection 

12 (b)). 

13 (b) SURGICAL HEALTH PROFESSIONAL SHORTAGE

14 AREA DEFINED.—For purposes of this section, the term 

15 ‘‘surgical health professional shortage area’’ means, with 

16 respect to an urban, suburban or rural area in the United 

17 States, an area with a population that is underserved by 

18 general surgeons. 

19 (c) DESIGNATION OF SURGICAL HEALTH PROFES20 SIONAL SHORTAGE AREA (SHPSA).— 

21 (1) IN GENERAL.—In carrying out the study 

22 under this section, the Secretary shall consider po23 tential methodologies for the designation of surgical 

24 health professional shortage areas, including— 


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1 (A) the criteria under which areas are des2 ignated as health professional shortage areas 

3 under section 332 of the Public Health Service 

4 Act (42 U.S.C. 254e); and 

5 (B) the methodology described in para6 graph (2). 

7 (2) METHODOLOGY FOR THE DESIGNATION OF

8 A SHPSA.—Among the methodologies considered 

9 under paragraph (1), the Secretary shall analyze the 

10 potential effectiveness and accuracy of the following 

11 methodology: 

12 (A) DEVELOPMENT OF SURGERY SERVICE

13 AREAS.—Development of surgery service areas 

14 through the identification of hospitals with sur15 gery services and the identification of popu16 lations by zip code areas using Medicare patient 

17 origin data. 

18 (B) IDENTIFICATION OF SURGEONS.— 

19 Identification of all actively practicing general 

20 surgeons. 

21 (C) SURGEON TO POPULATION RATIOS.— 

22 Development of general surgeon-to-population 

23 ratios for each surgery service area. 

24 (D) THRESHOLDS.—Determination of 

25 threshold general surgeon-to-population ratios 


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1 for the number of general surgeons necessary to 

2 treat a population for each of the following lev3 els: 

4 (i) Optimal supply of general sur5 geons. 

6 (ii) Adequate supply of general sur7 geons. 

8 (iii) Shortage of general surgeons. 

9 (iv) Critical shortage of general sur10 geons. 

11 (d) CONSULTATION.—In conducting the study under 

12 this section, the Secretary shall consult with relevant 

13 stakeholders with appropriate expertise, including rep14 resentatives of organizations representing surgeons and 

15 patients. 

16 (e) REPORT.—Not later than one year after the date 

17 of the enactment of this Act, the Secretary shall submit 

18 to Congress a report on the study conducted under this 

19 section, including such recommendations for legislation or 

20 administrative action as the Secretary determines appro21 priate. 

Æ 


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