I 

118TH CONGRESS 

1ST SESSION H. R. 5256 

To amend title XVIII of the Social Security Act to provide payment under 

part A of the Medicare Program on a reasonable cost basis for anesthesia 

services furnished by an anesthesiologist in certain rural hospitals in 

the same manner as payments are provided for anesthesia services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

AUGUST 22, 2023 

Mr. MOOLENAAR (for himself and Mr. HUFFMAN) introduced the following 

bill; which was referred to the Committee on Ways and Means 

A BILL 

To amend title XVIII of the Social Security Act to provide 

payment under part A of the Medicare Program on a 

reasonable cost basis for anesthesia services furnished 

by an anesthesiologist in certain rural hospitals in the 

same manner as payments are provided for anesthesia 

services furnished by anesthesiologist assistants and certified registered nurse anesthetists in such hospitals, and 

for other purposes. 

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. SHORT TITLE. 

2 This Act may be cited as the ‘‘Medicare Access to 

3 Rural Anesthesiology Act of 2023’’. 

4 SEC. 2. MEDICARE PART A PAYMENT FOR ANESTHESIOL5 OGIST SERVICES IN CERTAIN RURAL HOS6 PITALS BASED ON CRNA PASS-THROUGH 

7 RULES. 

8 (a) IN GENERAL.—Section 1814 of the Social Secu9 rity Act (42 U.S.C. 1395f) is amended by adding at the 

10 end the following new subsection: 

11 ‘‘Anesthesiologist Services Provided in Certain Rural 

12 Hospitals 

13 ‘‘(m)(1) Notwithstanding any other provision of this 

14 title, coverage and payment shall be provided under this 

15 part for physicians’ services that are anesthesia services 

16 furnished by a physician who is an anesthesiologist in a 

17 rural hospital described in paragraph (3) in the same 

18 manner as payment is made under the exception provided 

19 in section 9320(k) of the Omnibus Budget Reconciliation 

20 Act of 1986, as amended by section 6132 of the Omnibus 

21 Budget Reconciliation Act of 1989 (42 U.S.C. 1395k 

22 note) (relating to payment on a reasonable cost, pass23 through basis), for certified registered nurse anesthetist 

24 services furnished by a certified registered nurse anes25 thetist in a hospital described in such section. 


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1 ‘‘(2) No payment shall be made under any other pro2 vision of this title for physicians’ services for which pay3 ment is made under this subsection. 

4 ‘‘(3) A rural hospital described in this paragraph is 

5 a hospital described in section 9320(k) of the Omnibus 

6 Budget Reconciliation Act of 1986, as so amended (42 

7 U.S.C. 1395k note), except that— 

8 ‘‘(A) any reference in such section to a ‘cer9 tified registered nurse anesthetist’ or ‘anesthetist’ is 

10 deemed a reference to a ‘physician who is an anes11 thesiologist’ or ‘anesthesiologist’, respectively; and 

12 ‘‘(B) any reference to ‘January 1, 1988’ or 

13 ‘1987’ is deemed a reference to such date and year 

14 as the Secretary shall specify.’’. 

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

16 subsection (a) shall apply to services furnished during cost 

17 reporting periods beginning on or after the date of the 

18 enactment of this Act. 

Æ 


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