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Title II — Removal of Barriers to Practice on Certified Registered Nurse Anesthetists

H.R. 2713 · 118th Congress · Apr 19, 2023 · Lineage

II Removal of Barriers to Practice on Certified Registered Nurse Anesthetists

Sec. 201 Clarifying that certified registered nurse anesthetists can be reimbursed by Medicare for evaluation and management services

Section 1861(bb)(1) of the Social Security Act (42 U.S.C. 1395x(bb)(1)) is amended by inserting “, including pre-anesthesia evaluation and management services,” after “and related care”.

Sec. 202 Revision of conditions of payment relating to services ordered and referred by certified registered nurse anesthetists

Not later than 3 months after the date of enactment of this Act, the Secretary of Health and Human Services shall revise section 410.69 of title 42, Code of Federal Regulations, to clarify that, for purposes of payment under part B of title XVIII of the Social Security Act—
(1)
certified registered nurse anesthetists are authorized to order, certify, and refer services to the extent allowed under the law of the State in which the services are furnished; and
(2)
payment shall be made under such part for such services so ordered, certified, or referred by certified registered nurse anesthetists.

Sec. 203 Special payment rule for teaching student registered nurse anesthetists

Section 1848(a)(6) of the Social Security Act (42 U.S.C. 1395w–4(a)(6)) is amended in the matter preceding subparagraph (A), by inserting “or student registered nurse anesthetists” after “physician residents”.

Sec. 204 Removing unnecessary and costly supervision of certified registered nurse anesthetists

Section 1861(bb)(2) of the Social Security Act (42 U.S.C. 1395x(bb)(2)) is amended—
(1)
in the second sentence, by inserting “, but may not require that certified registered nurse anesthetists provide services under the supervision of a physician” after “certification of nurse anesthetists”; and
(2)
in the third sentence, by inserting “under the supervision of an anesthesiologist” after “an anesthesiologist assistant”.

Sec. 205 CRNA services as a Medicaid-required benefit

(a)
In general— Section 1905(a)(5) of the Social Security Act (42 U.S.C. 1396d(a)(5)) is amended—
(1)
by striking “and (B)” and inserting “(B)”; and
(2)
by inserting before the semicolon at the end the following: “, and (C) services furnished by a certified registered nurse anesthetist (as defined in section 1861(bb)(2)), which such certified registered nurse anesthetist is authorized to perform under State law (or the State regulatory mechanism as provided by State law)”.
(b)
Payment— Section 1902(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended—
(1)
in paragraph (86), by striking “and” at the end;
(2)
in paragraph (87), by striking the period and inserting “; and”; and
(3)
by inserting after paragraph (87) the following new paragraph:

“(88) provide for payment for the services of a certified registered nurse anesthetist (as defined in section 1861(bb)(1)) in amounts no lower than the amounts, using the same methodology, used for payment for amounts under section 1833(a)(1)(H).”