HR 1825 IH1S 
nurse specialist, certified nurse-midwife, or phy-
sician assistant who’’; and 
(4) in the fourth sentence, by inserting ‘‘, nurse 
practitioner, clinical nurse specialist, certified nurse- 
midwife, or physician assistant’’ after ‘‘physician’’. 
(b) PART B PROVISIONS.—Section 1835(a) of the So-
cial Security Act (42 U.S.C. 1395n(a)) is amended— 
(1) in paragraph (2)— 
(A) in the matter preceding subparagraph 
(A), by inserting ‘‘, a nurse practitioner or clin-
ical nurse specialist (as those terms are defined 
in 1861(aa)(5)) who is working in collaboration 
with a physician in accordance with State law, 
a certified nurse-midwife (as defined in section 
1861(gg)) as authorized by State law, or a phy-
sician 
assistant 
(as 
defined 
in 
section 
1861(aa)(5)) under the supervision of a physi-
cian’’ after ‘‘1866(j)’’; and 
(B) in subparagraph (A)— 
(i) in each of clauses (ii) and (iii) of 
subparagraph (A), by inserting ‘‘, a nurse 
practitioner, a clinical nurse specialist, a 
certified nurse-midwife, or a physician as-
sistant (as the case may be)’’ after ‘‘physi-
cian’’; and 
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HR 1825 IH1S 
(ii) in clause (iv), by striking ‘‘after 
January 1, 2010’’ and all that follows 
through ‘‘face-to-face encounter’’ and in-
serting ‘‘made by a physician after Janu-
ary 1, 2010, or by a nurse practitioner, 
clinical nurse specialist, certified nurse- 
midwife, or physician assistant (as the case 
may be) after January 1, 2018, prior to 
making such certification the physician, 
nurse practitioner, clinical nurse specialist, 
certified nurse-midwife, or physician assist-
ant must document that the physician, 
nurse practitioner, clinical nurse specialist, 
certified nurse-midwife, or physician assist-
ant has had a face-to-face encounter’’; 
(2) in the third sentence, by inserting ‘‘, nurse 
practitioner, clinical nurse specialist, certified nurse- 
midwife, or physician assistant (as the case may 
be)’’ after ‘‘physician’’; 
(3) in the fourth sentence— 
(A) by striking ‘‘physician certification’’ 
and inserting ‘‘certification’’; 
(B) by inserting ‘‘(or on January 1, 2018, 
in the case of regulations to implement the 
amendments made by section 2 of the Home 
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HR 1825 IH1S 
Health Care Planning Improvement Act of 
2017)’’ after ‘‘1981’’; and 
(C) by striking ‘‘a physician who’’ and in-
serting ‘‘a physician, nurse practitioner, clinical 
nurse specialist, certified nurse-midwife, or phy-
sician assistant who’’; and 
(4) in the fifth sentence, by inserting ‘‘, nurse 
practitioner, clinical nurse specialist, certified nurse- 
midwife, or physician assistant’’ after ‘‘physician’’. 
(c) DEFINITION PROVISIONS.— 
(1) 
HOME
HEALTH
SERVICES.—Section 
1861(m) of the Social Security Act (42 U.S.C. 
1395x(m)) is amended— 
(A) in the matter preceding paragraph 
(1)— 
(i) by inserting ‘‘, a nurse practitioner 
or a clinical nurse specialist (as those 
terms are defined in subsection (aa)(5)), a 
certified nurse-midwife (as defined in sec-
tion 1861(gg)), or a physician assistant (as 
defined in subsection (aa)(5))’’ after ‘‘phy-
sician’’ the first place it appears; and 
(ii) by inserting ‘‘, a nurse practi-
tioner, a clinical nurse specialist, a cer-
tified nurse-midwife, or a physician assist-
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HR 1825 IH1S 
ant’’ after ‘‘physician’’ the second place it 
appears; and 
(B) in paragraph (3), by inserting ‘‘, a 
nurse practitioner, a clinical nurse specialist, a 
certified nurse-midwife, or a physician assist-
ant’’ after ‘‘physician’’. 
(2) 
HOME
HEALTH
AGENCY.—Section 
1861(o)(2) of the Social Security Act (42 U.S.C. 
1395x(o)(2)) is amended— 
(A) by inserting ‘‘, nurse practitioners or 
clinical nurse specialists (as those terms are de-
fined in subsection (aa)(5)), certified nurse-mid-
wives (as defined in section 1861(gg)), or physi-
cian assistants (as defined in subsection 
(aa)(5))’’ after ‘‘physicians’’; and 
(B) by inserting ‘‘, nurse practitioner, clin-
ical nurse specialist, certified nurse-midwife, 
physician assistant,’’ after ‘‘physician’’. 
(d) HOME HEALTH PROSPECTIVE PAYMENT SYSTEM 
PROVISIONS.—Section 1895 of the Social Security Act (42 
U.S.C. 1395fff) is amended— 
(1) in subsection (c)(1), by inserting ‘‘, the 
nurse practitioner or clinical nurse specialist (as 
those terms are defined in section 1861(aa)(5)), the 
certified nurse-midwife (as defined in section 
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HR 1825 IH1S 
1861(gg)), or the physician assistant (as defined in 
section 1861(aa)(5)),’’ after ‘‘physician’’; and 
(2) in subsection (e)— 
(A) in paragraph (1)(A), by inserting ‘‘, a 
nurse practitioner or clinical nurse specialist (as 
those terms are defined in section 1861(aa)(5)), 
a certified nurse-midwife (as defined in section 
1861(gg)), or a physician assistant (as defined 
in section 1861(aa)(5))’’ after ‘‘physician’’; and 
(B) in paragraph (2)— 
(i) in the heading, by striking ‘‘PHY-
SICIAN
CERTIFICATION’’ 
and 
inserting 
‘‘RULE OF CONSTRUCTION REGARDING RE-
QUIREMENT FOR CERTIFICATION’’; and 
(ii) by striking ‘‘physician’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2018. 
Æ 
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