I
104TH CONGRESS
1ST SESSION
H. R. 1751
To amend title XVIII of the Social Security Act to provide for increased
medicare reimbursement for physician assistants, to increase the delivery
of health services in health professional shortage areas, and for other
purposes.
IN THE HOUSE OF REPRESENTATIVES
JUNE 6, 1995
Mr. TOWNS (for himself and Mrs. JOHNSON of Connecticut) introduced the
following bill; which was referred to the Committee on Commerce, and
in addition to the Committee on Ways and Means, for a period to be sub-
sequently 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 provide
for increased medicare reimbursement for physician as-
sistants, to increase the delivery of health services in
health professional shortage areas, and for other pur-
poses.
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 ‘‘Physician Assistant
Incentive Act of 1995’’.
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SEC. 2. INCREASED MEDICARE REIMBURSEMENT FOR PHY-
SICIAN ASSISTANTS.
(a) REMOVAL OF RESTRICTION ON SETTINGS.—Sec-
tion 1861(s)(2)(K)(i) of the Social Security Act (42
U.S.C. 1395x(s)(2)(K)(i)) is amended by striking ‘‘(I) in
a hospital’’ and all that follows through ‘‘shortage area,’’.
(b) INCREASED PAYMENT.—
(1) IN GENERAL.—Section 1842(b)(12) of such
Act (42 U.S.C. 1395u(b)(12)) is amended by adding
at the end the following new subparagraph:
‘‘(C) With respect to services described in clause (i)
and (iv) of section 1861(s)(2)(K) (relating to physician as-
sistants)—
‘‘(i) payment under this part may only be made
on an assignment-related basis; and
‘‘(ii) the amounts paid under this part shall be
equal to 80 percent of (I) the lesser of the actual
charge or 85 percent of the fee schedule amount
provided under section 1848 for the same service
provided by a physician who is not a specialist; or
(II) in the case of services as an assistant at sur-
gery, the lesser of the actual charge or 85 percent
of the amount that would otherwise be recognized if
performed by a physician who is serving as an as-
sistant at surgery.’’.
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(2) 
CONFORMING
AMENDMENT.—Section
1842(b)(12)(A) 
of 
such 
Act 
(42 
U.S.C.
1395u(b)(12)(A)) is amended in the matter preced-
ing clause (i) by striking ‘‘(i), (ii),’’ and inserting
‘‘(ii)’’.
(3) 
TECHNICAL
AMENDMENT.—Section
1842(b)(12)(A) 
of 
such 
Act 
(42 
U.S.C.
1395u(b)(12)(A)) is amended in the matter preced-
ing clause (i) by striking ‘‘a physician assistants’’
and inserting ‘‘physician assistants’’.
(c) BONUS PAYMENT FOR SERVICES PROVIDED IN
HEALTH
PROFESSIONAL
SHORTAGE
AREAS.—Section
1833(m) of such Act (42 U.S.C. 1395l(m)) is amended—
(1) by inserting ‘‘(1)’’ after ‘‘(m)’’; and
(2) by adding at the end the following new
paragraph:
‘‘(2) In the case of services of a physician assistant
furnished to an individual, described in paragraph (1), in
an area that is a health professional shortage area as de-
scribed in such paragraph, in addition to the amount oth-
erwise paid under this part, there shall also be paid to
such physician assistant (or to an employer in the cases
described in subparagraph (C) of section 1842(b)(6)) (on
a monthly or quarterly basis) from the Federal Supple-
mentary Medical Insurance Trust Fund an amount equal
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to 10 percent of the payment amount for the service under
this part.’’.
(d) REMOVAL OF RESTRICTION ON EMPLOYMENT
RELATIONSHIP.—Section 1842(b)(6) of such Act (42
U.S.C. 1395u(b)(6)) is amended by adding at the end the
following new sentence: ‘‘For purposes of subparagraph
(C), an employment relationship may include any inde-
pendent contractor arrangement, and employer status
shall be determined in accordance with the law of the
State in which the services described in such subparagraph
are performed.’’.
(e) EFFECTIVE DATE.—The amendments made by
this section shall apply with respect to services furnished
and supplies provided on and after July 1, 1995.
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