I 
109TH CONGRESS 
2D SESSION 
H. R. 6118 
To amend title XVIII of the Social Security Act to permit a physician 
assistant, when delegated by a physician, to order or provide post-hospital 
extended care services, home health services, and hospice care under 
the Medicare Program. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 20, 2006 
Mr. HAYWORTH introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to permit 
a physician assistant, when delegated by a physician, 
to order or provide post-hospital extended care services, 
home health services, and hospice care under the Medi-
care Program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Physician 
Assistant Continuity of Care Act of 2006’’. 
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SEC. 2. PERMITTING PHYSICIAN ASSISTANTS WHEN DELE-
GATED BY A PHYSICIAN TO ORDER OR PRO-
VIDE POST-HOSPITAL EXTENDED CARE SERV-
ICES, HOME HEALTH SERVICES, AND HOS-
PICE CARE UNDER THE MEDICARE PRO-
GRAM. 
(a) POST-HOSPITAL EXTENDED CARE SERVICES.— 
Section 1814(a)(2) of the Social Security Act (42 U.S.C. 
1395f(a)(2)) is amended, in the matter before subpara-
graph (A)— 
(1) by inserting ‘‘or a physician assistant as 
delegated by a physician’’ after ‘‘a physician’’ the 
first place it appears; and 
(2) by inserting ‘‘a physician assistant as dele-
gated by a physician,’’ after ‘‘a physician,’’ the sec-
ond place it appears. 
(b) HOME HEALTH SERVICES.— 
(1) UNDER PART A.—Section 1814(a)(2)(C) of 
such Act (42 U.S.C. 1395f(a)(2)(C)) is amended— 
(A) by inserting ‘‘by a physician or by a 
physician assistant as delegated by a physi-
cian,’’ after ‘‘established’’; and 
(B) by inserting ‘‘or a physician assistant 
as delegated by a physician’’ after ‘‘a physi-
cian’’ each place it appears. 
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(2) UNDER
PART
B.—Section 1835(a)(2) of 
such Act (42 U.S. C. 1395n(a)(2)) is amended— 
(A) in the matter before subparagraph (A), 
by inserting ‘‘or a physician assistant as dele-
gated by a physician,’’ after ‘‘a physician’’; and 
(B) in each of clauses (ii) and (iii) of sub-
paragraph (A)(ii), by inserting ‘‘or a physician 
assistant as delegated by a physician’’ after ‘‘a 
physician’’. 
(c) HOSPICE CARE.— 
(1) CERTIFICATION OF TERMINAL ILLNESS.— 
Section 1814(a)(7)(A) of such Act is (42 U.S.C. 
1395f(a)(7)(A)) is amended— 
(A) in clause (i)(I), by inserting ‘‘or a phy-
sician assistant as delegated by such attending 
physician’’ after ‘‘nurse practitioner)’’; and 
(B) in clause (ii), by inserting ‘‘or physi-
cian assistant’’ after ‘‘physician’’. 
(2) INCLUDING
PROFESSIONAL
SERVICES
OF 
PHYSICIAN ASSISTANT.—Section 1861(dd)(1)(F) of 
such Act (42 U.S.C. 1395x(dd)(1)(F)) is amended 
by inserting after ‘‘physicians’ services’’ the fol-
lowing: ‘‘and services which would be physicians’ 
services if furnished by a physician (as defined in 
subsection (r)(1)) and which are performed by a 
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physician assistant under the supervision of a physi-
cian (as so defined) and which the physician assist-
ant is legally authorized to perform in the State in 
which the services are performed’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2007. 
Æ 
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