Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2005

Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2005 - Amends title XIX (Medicaid) of the Social Security Act to eliminate the state option to include nurse practitioners, certified nurse-midwives, and physician assistants as primary care case managers. Specifies as primary care case managers any nurse practitioner, certified nurse-midwife, or physician assistant that provides primary care case management services under a primary care case management contract.

Revises the coverage of certain nurse practitioner services under the Medicaid fee-for-service program to remove the specification of certified pediatric nurse practitioner and certified family nurse practitioner in order to extend such coverage to services furnished by a nurse practitioner or clinical nurse specialist.

Includes nurse practitioners, clinical nurse specialists, physician assistants, certified nurse midwives, and certified registered nurse anesthetists in the mix of service providers which Medicaid managed care organizations are required to maintain.

[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2716 Introduced in House (IH)]






109th CONGRESS
  1st Session
                                H. R. 2716

  To amend title XIX of the Social Security Act to improve access to 
 advanced practice nurses and physician assistants under the Medicaid 
                                Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 26, 2005

 Mr. Olver (for himself, Mr. Boehlert, Mrs. Capps, Mr. LaTourette, Mr. 
    Towns, Mrs. Johnson of Connecticut, Mr. Waxman, Mrs. Kelly, Ms. 
   Herseth, Mr. English of Pennsylvania, Mr. Markey, and Mr. Platts) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend title XIX of the Social Security Act to improve access to 
 advanced practice nurses and physician assistants under the Medicaid 
                                Program.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicaid Advanced Practice Nurses 
and Physician Assistants Access Act of 2005''.

SEC. 2. IMPROVED ACCESS TO SERVICES OF ADVANCED PRACTICE NURSES AND 
              PHYSICIAN ASSISTANTS UNDER STATE MEDICAID PROGRAMS.

    (a) Primary Care Case Management.--Section 1905(t)(2) of the Social 
Security Act (42 U.S.C. 1396d(t)(2)) is amended by striking 
subparagraph (B) and inserting the following:
            ``(B) A nurse practitioner (as defined in section 
        1861(aa)(5)(A)).
            ``(C) A certified nurse-midwife (as defined in section 
        1861(gg)).
            ``(D) A physician assistant (as defined in section 
        1861(aa)(5)(A)).''.
    (b) Fee-for-Service Program.--Section 1905(a)(21) of such Act (42 
U.S.C. 1396d(a)(21)) is amended--
            (1) by inserting ``(A)'' after ``(21)'';
            (2) by striking ``services furnished by a certified 
        pediatric nurse practitioner or certified family nurse 
        practitioner (as defined by the Secretary) which the certified 
        pediatric nurse practitioner or certified family nurse 
        practitioner'' and inserting ``services furnished by a nurse 
        practitioner (as defined in section 1861(aa)(5)(A)) or by a 
        clinical nurse specialist (as defined in section 
        1861(aa)(5)(B)) which the nurse practitioner or clinical nurse 
        specialist'';
            (3) by striking ``the certified pediatric nurse 
        practitioner or certified family nurse practitioner'' and 
        inserting ``the nurse practitioner or clinical nurse 
        specialist''; and
            (4) by inserting before the semicolon at the end the 
        following: ``and (B) services furnished by a physician 
        assistant (as defined in section 1861(aa)(5)) with the 
        supervision of a physician which the physician assistant is 
        legally authorized to perform under State law''.
    (c) Including in Mix of Service Providers Under Medicaid Managed 
Care Organizations.--Section 1932(b)(5)(B) of such Act (42 U.S.C. 
1396u-2(b)(5)(B)) is amended by inserting ``, with such mix including 
nurse practitioners, clinical nurse specialists, physician assistants, 
certified nurse midwives, and certified registered nurse anesthetists 
(as defined in section 1861(bb)(2))'' after ``services''.
    (d) Effective Date.--The amendments made by this section shall 
apply to items and services furnished in calendar quarters beginning on 
or after 90 days after the date of the enactment of this Act, without 
regard to whether or not final regulations to carry out such amendments 
have been promulgated by such date.
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