SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Access to 
Rural Anesthesiology Act of 2009’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) There is an acknowledged shortage of anes-
thesia professionals in rural hospitals. Research indi-
cates that surgeons in many rural hospitals are per-
forming and would like to perform more complex 
surgeries that could be made safer and more prac-
tical if anesthesia services were provided by an anes-
thesiologist. 
(2) As medical doctors and doctors of osteop-
athy, anesthesiologists are excluded from competing 
to assure the availability of anesthesia services in 
certain rural areas because only anesthesiologist as-
sistants and certified registered nurse anesthetists 
are eligible for special pass-through payments under 
part A of the Medicare program for anesthesia serv-
ices furnished in certain rural hospitals. 
(3) The Centers for Medicare & Medicaid Serv-
ices has stated that a statutory change is necessary 
to allow anesthesiologists to receive payment under 
part A of the Medicare program on a reasonable cost 
basis for anesthesia services provided. 
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SEC. 3. MEDICARE PART A PAYMENT FOR ANESTHESIOL-
OGIST SERVICES IN CERTAIN RURAL HOS-
PITALS BASED ON CRNA PASS-THROUGH 
RULES. 
(a) IN GENERAL.—Section 1814 of the Social Secu-
rity Act (42 U.S.C. 1395f) is amended by adding at the 
end the following new subsection: 
‘‘Anesthesiologist Services Provided in Certain Rural 
Hospitals 
‘‘(m)(1) Notwithstanding any other provision of this 
title, coverage and payment shall be provided under this 
part for physicians’ services that are anesthesia services 
furnished by a physician who is an anesthesiologist in a 
rural hospital described in paragraph (3) in the same 
manner as payment is made under the exception provided 
in section 9320(k) of the Omnibus Budget Reconciliation 
Act of 1986, as amended by section 6132 of the Omnibus 
Budget Reconciliation Act of 1989 (42 U.S.C. 1395k 
note) (relating to payment on a reasonable cost, pass- 
through basis), for certified registered nurse anesthetist 
services furnished by a certified registered nurse anes-
thetist in a hospital described in such section. 
‘‘(2) No payment shall be made under any 
other provision of this title for physicians’ services 
for which payment is made under this subsection. 
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‘‘(3) A rural hospital described in this para-
graph is a hospital described in section 9320(k) of 
the Omnibus Budget Reconciliation Act of 1986, as 
so amended (42 U.S.C. 1395k note), except that— 
‘‘(A) any reference in such section to a 
‘certified registered nurse anesthetist’ or ‘anes-
thetist’ is deemed a reference to a ‘physician 
who is an anesthesiologist’ or ‘anesthesiologist’, 
respectively; and 
‘‘(B) any reference to ‘January 1, 1988’ or 
‘1987’ is deemed a reference to such date and 
year as the Secretary shall specify.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to services furnished during cost 
reporting periods beginning on or after the date of the 
enactment of this Act. 
Æ 
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