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<PRE>[DOCID: f:s332is.txt]






107th CONGRESS
  1st Session
                                 S. 332

   To provide for a study of anesthesia services furnished under the 
  medicare program, and to expand arrangements under which certified 
        registered nurse anesthetists may furnish such services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 14, 2001

 Mr. DeWine (for himself and Mr. Reid) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
   To provide for a study of anesthesia services furnished under the 
  medicare program, and to expand arrangements under which certified 
        registered nurse anesthetists may furnish such services.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. STUDY AND REPORT ON ANESTHESIA SERVICES UNDER THE MEDICARE 
              PROGRAM; MODIFICATION OF REGULATIONS REGARDING 
              SUPERVISION OF CERTIFIED REGISTERED NURSE ANESTHETISTS.

    (a) Study.--
            (1) The Secretary of Health and Human Services shall 
        conduct a multistate comparative study of mortality and adverse 
        outcome rates of medicare patients by providers of anesthesia 
        services and by type of such providers. In conducting the 
        study, the Secretary shall develop comparative outcome data for 
        a representative sample of medicare patients based on the 
        complexity of the anesthesia services furnished to such 
        patients.
            (2) In conducting the study, the Secretary shall consult 
        with appropriate national professional organizations with 
        respect to the methodology, and shall use medicare operating 
        room reimbursement claims data verified by sampling actual 
        patient records.
    (b) Report.--Not later than January 1, 2006, the Secretary shall 
submit to Congress a report containing the results of the study 
conducted under subsection (a).
    (c) Promulgation of Revised Regulations.--
            (1) In general.--Pending the completion of the study under 
        subsection (a), the Secretary of Health and Human Services 
        shall revise any regulations establishing conditions of 
        participation under the medicare program for hospitals and 
        ambulatory surgical centers under title XVIII of the Social 
        Security Act relating to anesthesia services furnished under 
        such program to provide that nurse anesthetists may furnish 
        anesthesia services as follows:
                    (A) Under the medical direction of an immediately 
                available anesthesiologist.
                    (B) Under the supervision of an immediately 
                available physician.
                    (C) If not under subparagraph (A) or (B), then 
                under a written collaboration agreement with an 
                immediately available physician or physician group that 
                is--
                            (i) experienced in the administration of 
                        anesthesia; and
                            (ii) credentialed by the hospital or 
                        ambulatory surgical center to participate in 
                        such collaboration.
            (2) Definitions.--In this subsection:
                    (A) The term ``medical direction'' has the meaning 
                given that term in a regulation promulgated by the 
                Secretary pursuant to section 1887(a)(1)(A) of the 
                Social Security Act (42 U.S.C. 1395xx(a)(1)(A)).
                    (B) The term ``supervision'' means the medical 
                management of the anesthesia services furnished.
                    (C) The term ``collaboration'' means joint 
                management by a physician and a nurse anesthetist of 
                anesthesia services furnished pursuant to a jointly 
                developed written agreement that defines the respective 
                role of the collaborating parties, consistent with the 
                respective levels of their education, training, and 
                experience in furnishing such services.
                                 &lt;all&gt;

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