I 
111TH CONGRESS 
2D SESSION 
H. R. 5270 
To amend the Federal Employees’ Compensation Act to cover services pro-
vided to injured Federal workers by physician assistants and nurse prac-
titioners, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 11, 2010 
Mr. HARE (for himself, Mr. GEORGE MILLER of California, and Mr. SOUDER) 
introduced the following bill; which was referred to the Committee on 
Education and Labor 
A BILL 
To amend the Federal Employees’ Compensation Act to cover 
services provided to injured Federal workers by physician 
assistants and nurse practitioners, 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 ‘‘Improving Access to 
Workers’ Compensation for Injured Federal Workers 
Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) Medical services and supplies provided by 
physician assistants (PAs), nurse practitioners 
(NPs), clinical nurse specialists (CNSs), certified 
nurse midwives (CNMs), and certified registered 
nurse anesthetists (CRNAs), are not included in the 
definition of ‘‘medical, surgical, and hospital services 
and supplies’’ in the Federal Employees’ Compensa-
tion Act (5 U.S.C. 8101 et seq.). PAs, NPs, CNSs, 
CNMs, and CRNAs are not included in the defini-
tion of ‘‘physician’’ in such Act, and claims signed 
by PAs, NPs, CNSs, CNMs, and CRNAs have been 
denied by the Office of Workers’ Compensation Pro-
grams of the Department of Labor. 
(2) In some rural areas where many of these 
providers are the only full-time providers of care, in-
jured Federal workers may have to travel more than 
100 miles to receive care that is reimbursable. 
(3) In some cases, Federal workers have been 
advised to use hospital emergency rooms for non- 
emergency care, rather than receiving care after 
hours at local clinics where many of these providers 
are the only health care professionals on site. 
(4) PAs, NPs, CNSs, CRNAs, and CNMs are 
covered providers within Medicare, Medicaid, Tri- 
Care, and most private insurance plans. 
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(5) PAs, NPs, CRNAs, and CNMs are legally 
regulated in all 50 States, the District of Columbia, 
and Guam. 
(6) All 50 States, the District of Columbia, and 
Guam authorize physicians to delegate prescriptive 
privileges to the PAs they supervise, authorize NPs 
to prescribe medications under their own signature; 
48 States, the District of Columbia, American 
Samoa, and Guam provide prescriptive authority to 
CNMs; and CRNAs have prescriptive authority in 
28 states (and the District of Columbia) and order 
and administer anesthesia medication and provide 
anesthesia and interventional pain management serv-
ices in all 50 states and the District of Columbia. 
(7) PAs, NPs, and CRNAs work in virtually 
every area of medicine and surgery and are also em-
ployed by the Federal Government to provide med-
ical care, including by the Department of Veterans 
Affairs, the Department of Defense, and the Public 
and Indian Health Services. 
(8) CNSs have clinical nursing expertise in di-
agnosis and provide direct care to prevent, reme-
diate, or alleviate illness and promote health. CNSs 
practice in hospitals, clinics, nursing homes, and 
other community-based settings. 
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(9) CNMs provide vital care to pregnant Fed-
eral workers who are injured on the job. 
(10) CRNAs, the oldest of the advanced prac-
tice nurse specialties, administer approximately 32 
million anesthetics to patients each year in the U.S., 
and in some States are the sole providers of anes-
thetics in nearly 100 percent of rural hospitals. 
(11) CRNAs work in almost every setting in 
which anesthesia is given, including operating rooms, 
dental offices, pain clinics, ambulatory surgical set-
tings, and provide interventional pain management 
service. 
(12) Amending the Federal Employees’ Com-
pensation Act to recognize PAs, NPs, CRNAs, 
CNSs, and CNMs as covered providers will bring 
this Act in line with the overwhelming majority of 
State workers’ compensation programs, which recog-
nize each of these providers as covered providers. 
(13) The exclusion of PAs, NPs, CNSs, CNMs, 
and CRNAs from the category of covered providers 
under the Federal Employees’ Compensation Act 
limits patients’ access to medical care, services, and 
supplies, disrupts continuity of care, and creates un-
necessary costs for the Office of Workers’ Com-
pensation Programs. 
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SEC. 3. INCLUSION OF PHYSICIAN ASSISTANTS AND AD-
VANCED PRACTICE REGISTERED NURSES IN 
FEDERAL EMPLOYEES’ COMPENSATION ACT. 
(a) INCLUSION.—Section 8101 of title 5, United 
States Code, is amended— 
(1) in paragraph (3), by inserting ‘‘other eligi-
ble providers,’’ after ‘‘chiropractors,’’; 
(2) by striking ‘‘and’’ at the end of paragraphs 
(18) and (19); 
(3) by striking the period at the end of para-
graph (20) and inserting ‘‘; and’’; and 
(4) by adding at the end the following: 
‘‘(21) ‘other eligible provider’ means a physician 
assistant, nurse practitioner, clinical nurse specialist, 
certified nurse midwife, or certified registered nurse 
anesthetist, within the scope of their practice as de-
fined by State law, or as credentialed by the Federal 
government.’’. 
(b) CONFORMING AMENDMENTS.—Chapter 81 of 
title 5, United States Code, is amended— 
(1) in section 8103(a)— 
(A) in the matter preceding paragraph (1), 
by inserting ‘‘or other eligible provider’’ after 
‘‘physician’’; 
(B) in paragraph (3), by inserting ‘‘or 
other eligible providers’’ after ‘‘physicians’’; and 
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(C) in the matter following paragraph (3), 
by inserting ‘‘or other eligible provider’’ after 
‘‘physician’’; 
(2) in section 8121(6), by inserting ‘‘or other 
eligible provider’’ after ‘‘physician’’; and 
(3) in section 8123(a)— 
(A) in the second sentence, by inserting 
‘‘or other eligible provider’’ after ‘‘physician’’; 
and 
(B) in the third sentence, by striking ‘‘of 
the employee’’ and inserting ‘‘or other eligible 
provider of the employee’’. 
SEC. 4. EFFECTIVE DATE. 
The amendments made by this section shall apply be-
ginning on the first day of the second Federal fiscal year 
quarter that begins on or after the date of the enactment 
of this Act. 
Æ 
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