I 
111TH CONGRESS 
1ST SESSION H. R. 1077 
To amend title XVIII of the Social Security Act to provide for Medicare 
coverage of services of qualified respiratory therapists performed under 
the general supervision of a physician. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 13, 2009 
Mr. ROSS (for himself, Mr. LEWIS of Georgia, and Mr. AKIN) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for Medicare coverage of services of qualified respiratory 
therapists performed under the general supervision of 
a physician. 
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 ‘‘Medicare Respiratory 
Therapy Initiative Act of 2009’’. 
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SEC. 2. MEDICARE COVERAGE OF SERVICES OF QUALIFIED 
RESPIRATORY 
THERAPISTS 
PERFORMED 
UNDER THE GENERAL SUPERVISION OF A 
PHYSICIAN. 
(a) IN GENERAL.—Section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x) is amended— 
(1) in subsection (s)(2)— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (DD); 
(B) by adding ‘‘and’’ at the end of sub-
paragraph (EE); and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(FF) respiratory therapy services which would 
be physicians’ services if furnished by a physician 
(as defined in subsection (r)(1)) for the diagnosis 
and treatment of respiratory illnesses and which are 
performed by a respiratory therapist (as defined in 
subsection (hhh)) under the general supervision of a 
physician and which the respiratory therapist is le-
gally authorized to perform by the State in which 
the services are performed, but only if no facility or 
other provider charges or is paid any amounts with 
respect to the furnishing of such services.’’; and 
(2) by adding at the end the following new sub-
section: 
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‘‘Respiratory Therapist 
‘‘(hhh) For purposes of subsection (s)(2)(FF) and 
section 1833(a)(1)(X) only, the term ‘respiratory thera-
pist’ means an individual who— 
‘‘(1) is credentialed by a national credentialing 
board recognized by the Secretary; 
‘‘(2)(A) is licensed to practice respiratory ther-
apy in the State in which the respiratory therapy 
services are performed, or 
‘‘(B) in the case of an individual in a State 
which does not provide for such licensure, is legally 
authorized to perform respiratory therapy services 
(in the State in which the individual performed such 
services) under State law (or the State regulatory 
mechanism provided by State law); 
‘‘(3) is a registered respiratory therapist; and 
‘‘(4) holds a bachelor’s degree.’’. 
(b) PAYMENT.—Section 1833(a)(1) of such Act (42 
U.S.C. 1395l(a)(1)) is amended— 
(1) by striking ‘‘and’’ before ‘‘(W)’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘(X) with respect to services described 
in section 1861(s)(2)(FF) (relating to services fur-
nished by a respiratory therapist) that are furnished 
by a respiratory therapist (as defined in section 
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1861(hhh)), the amount paid shall be equal to 80 
percent of the lesser of the actual charge for the 
services or 85 percent of the fee schedule amount 
provided under section 1848 for the same services if 
furnished by a physician’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2010. 
Æ 
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