,,ii  #aac? ,,congress  #a/ ,session    
,s4 #addd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,augu/ #a1 #bjac ,mr4  
,wyd5 7= himself & ,mr4 ,isakson7       
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
provide paym5t "u "p ,a ( ! ,m$ic>e     
,program on a reasonable co/ basis =    
ane/hesia s]vices furni%$ by an         
ane/hesiologi/ 9 c]ta9 rural hospitals 9
 ! same mann] z paym5ts are provid$ =   
ane/hesia s]vices furni%$ by            
ane/hesiologi/ assi/ants & c]tifi$      
regi/]$ nurse ane/heti/s 9 su*          
hospitals4  #a4 ,%ort title ,?is ,act   
may be cit$ z ! ,m$ic>e ,access to      
,rural ,ane/hesiology ,act ( #bjac4  #b4
 ,m$ic>e "p ,a paym5t = ane/hesiologi/  
s]vices 9 c]ta9 rural hospitals bas$ on 
,,crna pass-?r\gh rules  7a7 ,9 ,g5]al  
,section #ahad ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acie;f7 is am5d$ by
 add+ at ! end ! foll[+ new subsection3 

7m7 ,ane/hesiologi/ ,s]vices ,provid$ 9 
,c]ta9 ,rural ,hospitals  7#a7 ,not)/&+ 
any o!r provision ( ?is title1 cov]age &
 paym5t %all be provid$ "u ?is "p =     
physicians' s]vices t are ane/hesia     
s]vices furni%$ by a physician :o is an 
ane/hesiologi/ 9 a rural hospital       
describ$ 9 p>agraph 7#c7 9 ! same mann] 
z paym5t is made "u ! exception provid$ 
9 section #icbj7k7 ( ! ,omnibus ,budget 
,reconciliation ,act ( #aihf1 z am5d$ by
 section #facb ( ! ,omnibus ,budget     
,reconciliation ,act ( #aihi 7#db       
,u4,s4,c4 #aciek note7 7relat+ to paym5t
 on a reasonable co/1 pass-?r\gh basis71
 = c]tifi$ regi/]$ nurse ane/heti/      
s]vices furni%$ by a c]tifi$ regi/]$    
nurse ane/heti/ 9 a hospital describ$ 9 
su* section4  7#b7 ,no paym5t %all be   
made "u any o!r provision ( ?is title = 
physicians' s]vices = :i* paym5t is made
 "u ?is subsection4  7#c7 ,a rural      
hospital describ$ 9 ?is p>agraph is a   
hospital describ$ 9 section #icbj7k7 ( !
 ,omnibus ,budget ,reconciliation ,act (

 #aihf1 z s am5d$ 7#db ,u4,s4,c4 #aciek 
note71 except t--  7,a7 any ref]5ce 9   
su* section to a c]tifi$ regi/]$ nurse  
ane/heti/ or ane/heti/ is deem$ a       
ref]5ce to a physician :o is an         
ane/hesiologi/ or ane/hesiologi/1       
respectively2 &  7,b7 any ref]5ce to    
,janu>y #a1 #aihh or #aihg is deem$ a   
ref]5ce to su* date & ye> z ! ,secret>y 
%all specify4  4  7b7 ,effective ,date  
,! am5dm5t made by subsection 7a7 %all  
apply to s]vices furni%$ dur+ co/       
report+ p]iods beg9n+ on or aft] ! date 
( ! enactm5t ( ?is ,act4