Rural Health Clinic Burden Reduction Act

I 118TH CONGRESS 1ST SESSION H. R. 3730 To amend title XVIII of the Social Security Act to modernize provisions relating to rural health clinics under Medicare. IN THE HOUSE OF REPRESENTATIVES MAY 25, 2023 Mr. SMITH of Nebraska (for himself, Mr. BLUMENAUER, Mr. ARMSTRONG, and Ms. TOKUDA) 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 provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to modernize provisions relating to rural health clinics under Medicare. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Rural Health Clinic 4 Burden Reduction Act’’. 5 VerDate Sep 11 2014 18:44 Jun 19, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3730.IH H3730 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •HR 3730 IH SEC. 2. MODERNIZING PHYSICIAN, PHYSICIAN ASSISTANT, 1 AND NURSE PRACTITIONER UTILIZATION RE- 2 QUIREMENTS. 3 Section 1861(aa) of the Social Security Act (42 4 U.S.C. 1395x(aa)) is amended— 5 (1) in paragraph (2)(B), by striking ‘‘has an 6 arrangement’’ and all that follows through the first 7 semicolon and inserting ‘‘meets the requirements de- 8 scribed in paragraph (8);’’; and 9 (2) by adding at the end the following new 10 paragraph: 11 ‘‘(8) REQUIREMENTS FOR CERTAIN FACILITIES DE- 12 SCRIBED.—For purposes of paragraph (2)(B), with re- 13 spect to a facility which is not a physician-directed clinic, 14 the following requirements are described in this para- 15 graph: 16 ‘‘(A) ARRANGEMENT.—The facility has an ar- 17 rangement consistent with the provisions of State 18 and local law relative to the practice, performance, 19 and delivery of health services, with one or more 20 physician assistants (as defined in paragraph 21 (5)(A)) or one or more nurse practitioners (as de- 22 fined in such paragraph). 23 ‘‘(B) PRACTICE AND OVERSIGHT REQUIRE- 24 MENTS.—The delivery of health services under such 25 arrangement shall be in accordance with State law 26 VerDate Sep 11 2014 18:44 Jun 19, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3730.IH H3730 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •HR 3730 IH or the State regulatory mechanism governing the 1 practice of physician assistants or nurse practi- 2 tioners.’’. 3 SEC. 3. REMOVING OUTDATED LABORATORY REQUIRE- 4 MENTS. 5 Section 1861(aa)(2)(G) of the Social Security Act 6 (42 U.S.C. 1395x(aa)(2)(G)) is amended by striking ‘‘, 7 including clinical laboratory services’’ and all that follows 8 through ‘‘additional diagnostic services’’ and inserting the 9 following: ‘‘and has prompt access to clinical laboratory 10 services and additional diagnostic services’’. 11 SEC. 4. ALLOWING RURAL HEALTH CLINICS THE FLEXI- 12 BILITY TO CONTRACT WITH PHYSICIAN AS- 13 SISTANTS AND NURSE PRACTITIONERS. 14 Section 1861(aa) of the Social Security Act (42 15 U.S.C. 1395x(aa)), in the first sentence of the flush mat- 16 ter following paragraph (2), is amended by inserting ‘‘or 17 contracts with’’ after ‘‘(iii) employs’’. 18 SEC. 5. URBANIZED AREA FIX. 19 Section 1861(aa) of the Social Security Act (42 20 U.S.C. 1395x(aa)), in the first sentence of the flush mat- 21 ter following paragraph (2), is amended by striking ‘‘(i) 22 is located in an area that is not an urbanized area’’ and 23 inserting ‘‘(i) is located in an area that is not in an urban 24 area of 50,000 or more’’. 25 VerDate Sep 11 2014 18:44 Jun 19, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3730.IH H3730 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •HR 3730 IH SEC. 6. EXCEPTION TO BEHAVIORAL HEALTH LIMITATION. 1 Section 1861(aa) of the Social Security Act (42 2 U.S.C. 1395x(aa)), in the first sentence of the flush mat- 3 ter following paragraph (2), is amended by inserting the 4 following before the period: ‘‘, except in the case where 5 the facility is located in an area that is designated (under 6 section 332(a)(1)(A) of the Public Health Service Act) as 7 a mental health professional shortage area’’. 8 SEC. 7. EFFECTIVE DATE. 9 This Act and the amendments made by this Act shall 10 take effect on January 1, 2024, and shall apply to items 11 and services furnished on or after such date. 12 Æ VerDate Sep 11 2014 18:44 Jun 19, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\H3730.IH H3730 pbinns on DSKJLVW7X2PROD with $$_JOB