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105TH CONGRESS
1ST SESSION
H. R. 894
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
FEBRUARY 27, 1997
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 1997’’.
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.—Section 1842(b)(12) of
such Act (42 U.S.C. 1395u(b)(12)) is amended—
(1) in the matter preceding clause (i) of sub-
paragraph (A), by striking ‘‘clauses’’ and all that
follows 
through 
‘‘practitioners)’’ 
and 
inserting
‘‘clause (ii) of section 1861(s)(2)(K) (relating to
nurse practitioners), and clause (iv) of such section
insofar as it relates to clause (ii) of such section’’;
and
(2) by adding at the end the following new sub-
paragraph:
‘‘(C) With respect to services described in clause (i)
of section 1861(s)(2)(K) (relating to physician assistants),
and clause (iv) of such section insofar as it relates to
clause (i) of such section—
‘‘(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.’’.
(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 as-
sistant furnished to an individual described in para-
graph (1) in an area that is a health professional
shortage area described in such paragraph, in addi-
tion to the amount otherwise paid under this part,
there shall also be paid to such physician assistant
(or to an employer in the cases described in subpara-
graph (C) of section 1842(b)(6)) (on a monthly or
quarterly basis) from the Federal Supplementary
Medical Insurance Trust Fund an amount equal 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 clause (C) of the
first sentence of this paragraph, an employment relation-
ship may include any independent contractor arrange-
ment, and employer status shall be determined in accord-
ance with the law of the State in which the services de-
scribed in such clause are performed.’’.
(e) EFFECTIVE DATE.—The amendments made by
this section shall apply with respect to services furnished
and supplies provided on and after January 1, 1998.
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