,i  #aacth ,,congress  #b;d ,session    
,h4 ,r4 #dffc  ,,in ,,the ,,house ,,of  
,,representatives  ,may #ae1 #bjad ,mrs4
 ,black 7for herself and ,ms4           
,schakowsky7 introduced the following   
bill2 which was referred to the         
,committee on ,ways and ,means  ,a      
,,bill  ,to amend title ,,xviii of the  
,social ,security ,act to permit certain
 nurse practitioners1 clinical nurse    
specialists1 physician assistants1 and  
certified nurse-midwives to provide     
certain certifications with respect to  
inpatient hospital services under the   
,medicare program4  #a4 ,short title    
,this ,act may be cited as the ,protect 
,patient ,access and ,promote ,hospital 
,efficiency ,act4  #b4 ,permitting      
certain nurse practitioners1 clinical   
nurse specialists1 physician assistants1
 and certified nurse-midwives to provide
 certain certifications with respect to 
inpatient hospital services under the   
,medicare program  7a7 ,in general      
,section #ahad7;a77#c7 of the ,social   

,security ,act 7#db ,u4,s4,c4           
#acie;f7a77#c77 is amended by inserting 
7or1 in the case of such inpatient      
hospital services ordered by a nurse    
practitioner1 clinical nurse specialist1
 physician assistant 7as such terms are 
defined in section #ahfa7;aa77#e771 or a
 certified nurse-midwife 7as such term  
is defined in section #ahfa7;gg77 who is
 privileged and credentialed at the     
hospital at which such services are to  
be furnished1 the nurse practitioner1   
clinical nurse specialist1 physician    
assistant1 or certified nurse-midwife7  
after a physician4  7b7 ,no effect on   
,state scope of practice law ,nothing in
 this section1 including the amendment  
made by this section1 shall be construed
 as1 or have the effect of1 changing any
 ,state scope of practice law for any   
health care professional4