,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #bccj  ,,in ,,the ,,house ,,of  
,,representatives  ,june #ab1 #bjac ,mr4
 ,bilirakis 7for himself1 ,mr4          
,butterfield1 ,mrs4 ,capps1 ,mr4        
,guthrie1 ,mr4 ,michaud1 ,mr4           
,mc,kinley1 ,mr4 ,gerlach1 ,mr4         
,huizenga of ,michigan1 and ,mr4        
,meehan7 introduced the following bill2 
which was referred to the ,committee on 
,energy and ,commerce1 and in addition  
to the ,committee on ,ways and ,means1  
for a period to be subsequently         
determined by the ,speaker1 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 provide comprehensive 
audiology services to ,medicare         
beneficiaries1 and for other purposes4  
#a4 ,short title ,this ,act may be cited
 as the ,medicare ,audiology ,services  
,enhancement ,act of #bjac4  #b4        
,comprehensive audiology services for   

,medicare beneficiaries  7a7 ,in general
 ,section #ahfa of the ,social ,security
 ,act 7#db ,u4,s4,c4 #aciex7 is         
amended--  7#a7 in subsection 7s77#b7-- 
7,a7 in subparagraph 7,,ee71 by striking
 and at the end2  7,b7 in subparagraph  
7,,ff71 by adding and at the end2 and   
7,c7 by adding at the end the following 
new subparagraph3  7,,gg7 audiology     
services 7as defined in subsection      
7ll77#c772  2 and  7#b7 by amending     
paragraph 7#c7 of subsection 7ll7 to    
read as follows3  7#c7 ,the term        
audiology services means only the       
following services furnished by a       
qualified audiologist as the audiologist
 is legally authorized to perform under 
,state law 7or the ,state regulatory    
mechanism provided by ,state law71      
pursuant to an order or referral by a   
physician1 as would otherwise be covered
 if furnished by a physician3  7,a7     
,hearing and balance assessment         
services4  7,b7 ,auditory treatment     
services1 including auditory processing 

and auditory rehabilitation treatment4  
7,c7 ,vestibular treatment services4    
7,d7 ,intraoperative neurophysiologic   
monitoring services4  4  7b7 ,payment   
under part ,b under physician fee       
schedule for comprehensive audiology    
services ,section #ahdh7;j77#c7 of the  
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7;j77#c77 is amended by        
inserting 7#b77;,,gg71 before 7#c714    
7c7 ,audiology services performed in    
hospitals excluded from inpatient       
hospital services ,section #ahfa7;b77#d7
 of the ,social ,security ,act 7#db     
,u4,s4,c4 #aciex7b77#d77 is amended by  
striking and services of a certified    
registered nurse anesthetist and        
inserting services of a certified       
registered nurse anesthetist1 and       
inter-operative neurophysiological      
monitoring provided by a physician or   
qualified audiologist 7as defined in    
subsection 7ll77#d77;,b774  7d7         
,requirements of service ,section       
#ahce7;a77#b7 of the ,social ,security  

,act 7#db ,u4,s4,c4 #acien7a77#b77 is   
amended--  7#a7 in subparagraph 7,b71 by
 striking and 7,d7 and inserting 7,d71  
and 7,,gg72  7#b7 by striking and at the
 end of subparagraph 7,e72  7#c7 by     
striking the period at the end of       
subparagraph 7,f7 and inserting 2 and2  
and  7#d7 by inserting after            
subparagraph 7,f7 the following new     
subparagraph3  7,g7 in the case of      
outpatient audiology services1 7i7 such 
services are or were required because   
the individual needed the specialized   
services of a physician or qualified    
audiologist to furnish such audiology   
services1 7ii7 a plan of care for       
furnishing such services has been       
established by the physician or         
qualified audiologist and is submitted  
to and periodically reviewed by the     
referring or ordering physician1 and    
7iii7 such services are or were         
furnished while the individual is or was
 under the care of a physician4  4  7e7 
,audiology services included as         

designated health services for purposes 
of limitation on certain physician      
referrals ,section #ahgg7;h77#f7 of the 
,social ,security ,act 7#db ,u4,s4,c4   
#acienn7h77#f77 is amended by adding at 
the end the following new subparagraph3 
7,m7 ,audiology services 7as defined in 
section #ahfa7ll77#c774  4  7f7         
,participation in ,medicare ,nothing in 
this section shall be construed to      
require a qualified audiologist 7as     
defined in section #ahfa7ll77#d77;,b7 of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #aciex7ll77#d77;,b777 to      
participate in the ,medicare program    
under title ,,xviii of the ,social      
,security ,act 7#db ,u4,s4,c4 #acie et  
seq474  7g7 ,effective date ,the        
amendments made by this section shall   
apply to services furnished on or after 
,january #a1 #bjad4