I 
109TH CONGRESS 
2D SESSION 
H. R. 5246 
To amend title XVIII of the Social Security Act to restore financial stability 
to Medicare anesthesiology teaching programs for resident physicians. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 27, 2006 
Mr. SHAW (for himself and Mr. SESSIONS) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committee on Ways and Means, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to restore 
financial stability to Medicare anesthesiology teaching 
programs for resident physicians. 
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 Teaching An-
esthesiology Funding Restoration Act of 2006’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) The current Medicare payment policy for 
Medicare beneficiary services furnished by academic 
anesthesiology programs administered by the Cen-
ters for Medicare & Medicaid Services (CMS) is un-
fair and underpays such programs by 50 percent. In 
its 1991 rule change, CMS singled out academic an-
esthesiology programs alone for a reduction in pay-
ment when teaching anesthesiologists supervise resi-
dents in two concurrent cases. This policy change 
was unique to anesthesiology and does not affect 
other medical specialties or non-physician providers. 
(2) The current Medicare payment policy ad-
ministered by CMS for academic anesthesiology pro-
grams is causing significant harm to academic anes-
thesiology programs nationwide by contributing to 
an overall decline in the number of such programs. 
Before the current policy went into effect in 1994, 
there were 162 academic anesthesiology programs 
nationwide. Today, 130 academic anesthesiology pro-
grams exist. As such programs close, medical stu-
dents will face diminished opportunities to enter the 
specialty of anesthesiology and patients in the 
United States will see increased shortages in anes-
thesiology medical care in the operating room and 
pain clinics and through critical care medicine. 
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(3) The current Medicare payment policy ad-
ministered by CMS for academic anesthesiology pro-
grams is shortchanging academic anesthesiology pro-
grams an average of $400,000 annually, with some 
programs losing in excess of $1 million. As such 
Medicare payment decreases continue, academic an-
esthesiology programs are experiencing increasing 
difficulty filling faculty appointments and sustaining 
research and development of new advances in anes-
thesiology medical care that have previously contrib-
uted to its outstanding patient safety record. 
SEC. 3. PURPOSE. 
The purpose of this Act is to restore the Medicare 
payment policy for academic anesthesiology programs to 
the policy administered by the Centers of Medicare & Med-
icaid Services before 1994 in order to— 
(1) ensure the financial stability of academic 
anesthesiology programs in order to provide suffi-
cient opportunities for physician residents to pursue 
the specialty of anesthesiology, so that patients con-
tinue to have access to quality medical care in the 
operating room and pain clinics and through critical 
care medicine; and 
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(2) enable the specialty of anesthesiology to 
continue making advances in patient safety through 
research based in academic programs. 
SEC. 4. SPECIAL PAYMENT RULE FOR TEACHING ANESTHE-
SIOLOGISTS. 
Section 1848(a) of the Social Security Act (42 U.S.C. 
1395w–4(a)) is amended— 
(1) in paragraph (4)(A), by inserting ‘‘except as 
provided in paragraph (5),’’ after ‘‘anesthesia 
cases,’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(5) SPECIAL RULE FOR TEACHING ANES-
THESIOLOGISTS.—With respect to physicians’ 
services furnished on or after January 1, 2007, 
in the case of teaching anesthesiologists in-
volved in the training of physician residents in 
a single anesthesia case or two concurrent anes-
thesia cases, the fee schedule amount to be ap-
plied shall be 100 percent of the fee schedule 
amount otherwise applicable under this section 
if the anesthesia services were personally per-
formed by the teaching anesthesiologist alone 
and paragraph (4) shall not apply if— 
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