I 
114TH CONGRESS 
2D SESSION 
H. R. 4959 
To direct the Secretary of Health and Human Services to conduct a study 
on the designation of surgical health professional shortage areas. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 15, 2016 
Mr. BUCSHON (for himself and Mr. BERA) introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To direct the Secretary of Health and Human Services to 
conduct a study on the designation of surgical health 
professional shortage areas. 
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 ‘‘Ensuring Access to 
General Surgery Act of 2016’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) According to the Bureau of Health Work-
force, the United States faces a shortage of physi-
cians. 
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(2) In order to accurately prepare for future 
physician workforce demands, comprehensive, impar-
tial research and high quality data is needed to in-
form dynamic projections of physician workforce 
needs. 
(3) A variety of factors, including health out-
comes, utilization trends, growing and aging popu-
lations, and delivery system changes, influence work-
force needs and should be considered as part of 
flexible projections of workforce needs. 
(4) Given the particularly acute needs for sur-
geons in many rural areas, additional efforts to as-
sess adequacy of the current surgeon workforce are 
necessary. 
SEC. 3. STUDY ON DESIGNATION OF SURGICAL HEALTH 
PROFESSIONAL SHORTAGE AREAS. 
(a) STUDY.—The Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) 
shall conduct a study on the following matters relating to 
access by underserved populations to general surgeons: 
(1) Whether the designation of health profes-
sional shortage areas under section 332 of the Pub-
lic Health Service Act (42 U.S.C. 254e) results in 
accurate assessments of the adequacy of local gen-
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eral surgeons to address the needs of underserved 
populations in urban, suburban, or rural areas. 
(2) Whether another measure of access to gen-
eral surgeons by underserved populations, such as 
hospital service areas, would provide more accurate 
assessments of shortages in the availability of local 
general surgeons to meets the needs of those popu-
lations. 
(3) The appropriateness of establishing the des-
ignation under such section 332 of surgical health 
professional shortage areas (as defined in subsection 
(b)). 
(b) SURGICAL HEALTH PROFESSIONAL SHORTAGE 
AREA DEFINED.—For purposes of this section, the term 
‘‘surgical health professional shortage area’’ means, with 
respect to an urban, suburban or rural area in the United 
States, an area with a population that is underserved by 
general surgeons. 
(c) DESIGNATION OF SURGICAL HEALTH PROFES-
SIONAL SHORTAGE AREA (SHPSA).— 
(1) IN GENERAL.—In carrying out the study 
under this section, the Secretary shall consider po-
tential methodologies for the designation of surgical 
health professional shortage areas, including— 
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(A) the criteria under which areas are des-
ignated as health professional shortage areas 
under section 332 of the Public Health Service 
Act (42 U.S.C. 254e); and 
(B) the methodology described in para-
graph (2). 
(2) METHODOLOGY FOR THE DESIGNATION OF 
A
SHPSA.—Among the methodologies considered 
under paragraph (1), the Secretary shall analyze the 
potential effectiveness and accuracy of the following 
methodology: 
(A) DEVELOPMENT OF SURGERY SERVICE 
AREAS.—Development of surgery service areas 
through the identification of hospitals with sur-
gery services and the identification of popu-
lations by zip code areas using Medicare patient 
origin data. 
(B) IDENTIFICATION
OF
SURGEONS.— 
Identification of all actively practicing general 
surgeons. 
(C) SURGEON TO POPULATION RATIOS.— 
Development of general surgeon-to-population 
ratios for each surgery service area. 
(D) 
THRESHOLDS.—Determination 
of 
threshold general surgeon-to-population ratios 
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for the number of general surgeons necessary to 
treat a population for each of the following lev-
els: 
(i) Optimal supply of general sur-
geons. 
(ii) Adequate supply of general sur-
geons. 
(iii) Shortage of general surgeons. 
(iv) Critical shortage of general sur-
geons. 
(d) CONSULTATION.—In conducting the study under 
this section, the Secretary shall consult with relevant 
stakeholders with appropriate expertise, including rep-
resentatives of organizations representing surgeons and 
patients. 
(e) REPORT.—Not later than one year after the date 
of the enactment of this Act, the Secretary shall submit 
to Congress a report on the study conducted under this 
section, including such recommendations for legislation or 
administrative action as the Secretary determines appro-
priate. 
Æ 
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