,,ii  #aacth ,,congress  #ast ,session  
,s4 #addd  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,august #a1    
#bjac ,mr4 ,wyden 7for himself and ,mr4 
,isakson7 introduced the following bill2
 which was read twice and referred to   
the ,committee on ,finance  ,a ,,bill   
,to amend title ,,xviii of the ,social  
,security ,act to provide payment under 
part ,a of the ,medicare ,program on a  
reasonable cost basis for anesthesia    
services furnished by an                
anesthesiologist in certain rural       
hospitals in the same manner as payments
 are provided for anesthesia services   
furnished by anesthesiologist assistants
 and certified registered nurse         
anesthetists in such hospitals4  #a4    
,short title ,this ,act may be cited as 
the ,medicare ,access to ,rural         
,anesthesiology ,act of #bjac4  #b4     
,medicare part ,a payment for           
anesthesiologist services in certain    
rural hospitals based on ,,crna         
pass-through rules  7a7 ,in ,general    

,section #ahad of the ,social ,security 
,act 7#db ,u4,s4,c4 #acie;f7 is amended 
by adding at the end the following new  
subsection3  7m7 ,anesthesiologist      
,services ,provided in ,certain ,rural  
,hospitals  7#a7 ,notwithstanding any   
other provision of this title1 coverage 
and payment shall be provided under this
 part for physicians' services that are 
anesthesia services furnished by a      
physician who is an anesthesiologist in 
a rural hospital described in paragraph 
7#c7 in the same manner as payment is   
made under the exception provided in    
section #icbj7k7 of the ,omnibus ,budget
 ,reconciliation ,act of #aihf1 as      
amended by section #facb of the ,omnibus
 ,budget ,reconciliation ,act of #aihi  
7#db ,u4,s4,c4 #aciek note7 7relating to
 payment on a reasonable cost1          
pass-through basis71 for certified      
registered nurse anesthetist services   
furnished by a certified registered     
nurse anesthetist in a hospital         
described in such section4  7#b7 ,no    

payment shall be made under any other   
provision of this title for physicians' 
services for which payment is made under
 this subsection4  7#c7 ,a rural        
hospital described in this paragraph is 
a hospital described in section #icbj7k7
 of the ,omnibus ,budget ,reconciliation
 ,act of #aihf1 as so amended 7#db      
,u4,s4,c4 #aciek note71 except that--   
7,a7 any reference in such section to a 
certified registered nurse anesthetist  
or anesthetist is deemed a reference to 
a physician who is an anesthesiologist  
or anesthesiologist1 respectively2 and  
7,b7 any reference to ,january #a1 #aihh
 or #aihg is deemed a reference to such 
date and year as the ,secretary shall   
specify4  4  7b7 ,effective ,date ,the  
amendment made by subsection 7a7 shall  
apply to services furnished during cost 
reporting periods beginning on or after 
the date of the enactment of this ,act4