,,ii  #aad? ,,congress  #b;d ,session   
,s4 #caff  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #ab1 #bjaf,mr4   
,grassley 7= himself & ,mr4 ,s*atz7     
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to direct ! ,secret>y (     
,heal? & ,human ,s]vices to conduct a   
/udy on ! designation ( surgical heal?  
pr(essional %ortage areas4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,ensur+ 
,access to ,g5]al ,surg]y ,act ( #bjaf4 
#b4 ,f9d+s ,congress f9ds ! foll[+3     
7#a7 ,accord+ to ! ,bureau ( ,heal?     
,work=ce1 ! ,unit$ ,/ates faces a       
%ortage ( physicians4  7#b7 ,9 ord] to  
accurately prep>e = future physician    
work=ce dem&s1 compreh5sive1 imp>tial   
rese>* & high quality data is ne$$ to   
in=m dynamic projections ( physician    
work=ce ne$s4  7#c7 ,a v>iety ( factors1
 includ+ heal? outcomes1 utilization    
tr5ds1 gr[+ & ag+ populations1 & deliv]y
 sy/em *anges1 influ5ce work=ce ne$s &  

%\ld be consid]$ z "p ( flexible        
projections ( work=ce ne$s4  7#d7 ,giv5 
! p>ticul>ly acute ne$s = surgeons 9 _m 
rural areas1 additional ef=ts to assess 
adequacy ( ! curr5t surgeon work=ce are 
necess>y4  #c4 ,/udy on designation (   
surgical heal? pr(essional %ortage areas
  7a7 ,/udy ,! ,secret>y ( ,heal? &     
,human ,s]vices 79 ?is section ref]r$ to
 z ! ,secret>y7 %all conduct a /udy on !
 foll[+ matt]s relat+ to access by      
und]s]v$ populations to g5]al surgeons3 
7#a7 ,:e!r ! designation ( heal?        
pr(essional %ortage areas "u section    
#ccb ( ! ,public ,heal? ,s]vice ,act    
7#db ,u4,s4,c4 #bed;e7 results 9        
accurate assessm5ts ( ! adequacy ( local
 g5]al surgeons to address ! ne$s (     
und]s]v$ populations 9 urban1 suburban1 
or rural areas4  7#b7 ,:e!r ano!r       
measure ( access to g5]al surgeons by   
und]s]v$ populations1 su* z hospital    
s]vice areas1 w\ld provide m accurate   
assessm5ts ( %ortages 9 ! availability (
 local g5]al surgeons to meets ! ne$s ( 

^? populations4  7#c7 ,! appropriat5ess 
( e/abli%+ ! designation "u su* section 
#ccb ( surgical heal? pr(essional       
%ortage areas 7z def9$ 9 subsection     
7b774  7b7 ,surgical heal? pr(essional  
%ortage area def9$ ,= purposes ( ?is    
section1 ! t]m surgical heal?           
pr(essional %ortage area means1 )       
respect to an urban1 suburban or rural  
area 9 ! ,unit$ ,/ates1 an area ) a     
population t is und]s]v$ by g5]al       
surgeons4  7c7 ,designation ( surgical  
heal? pr(essional %ortage area 7,,%psa7 
7#a7 ,9 g5]al ,9 c>ry+ out ! /udy "u ?is
 section1 ! ,secret>y %all consid]      
pot5tial me?odologies = ! designation ( 
surgical heal? pr(essional %ortage      
areas1 includ+--  7,a7 ! crit]ia "u :i* 
areas are designat$ z heal? pr(essional 
%ortage areas "u section #ccb ( !       
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bed;e72 &  7,b7 ! me?odology 
describ$ 9 p>agraph 7#b74  7#b7         
,me?odology = ! designation ( a ,,%psa  
,among ! me?odologies consid]$ "u       

p>agraph 7#a71 ! ,secret>y %all analyze 
! pot5tial effectiv5ess & accuracy ( !  
foll[+ me?odology3  7,a7 ,developm5t (  
surg]y s]vice areas ,developm5t ( surg]y
 s]vice areas ?r\gh ! id5tification (   
hospitals ) surg]y s]vices & !          
id5tification ( populations by zip code 
areas us+ ,m$ic>e pati5t orig9 data4    
7,b7 ,id5tification ( surgeons          
,id5tification ( all actively practic+  
g5]al surgeons4  7,c7 ,surgeon to       
population ratios ,developm5t ( g5]al   
surgeon-to-population ratios = ea*      
surg]y s]vice area4  7,d7 ,?re%olds     
,det]m9ation ( ?re%old g5]al            
surgeon-to-population ratios = ! numb] (
 g5]al surgeons necess>y to treat a     
population = ea* ( ! foll[+ levels3  7i7
 ,optimal supply ( g5]al surgeons4  7ii7
 ,adequate supply ( g5]al surgeons4     
7iii7 ,%ortage ( g5]al surgeons4  7iv7  
,critical %ortage ( g5]al surgeons4  7d7
 ,consultation ,9 conduct+ ! /udy "u ?is
 section1 ! ,secret>y %all consult )    
relevant /akehold]s ) appropriate       

exp]tise1 includ+ repres5tatives (      
organizations repres5t+ surgeons &      
pati5ts4  7e7 ,report ,n lat] ?an "o ye>
 aft] ! date ( ! enactm5t ( ?is ,act1 ! 
,secret>y %all submit to ,congress a    
report on ! /udy conduct$ "u ?is        
section1 includ+ su* recomm5dations =   
legislation or adm9i/rative action z !  
,secret>y det]m9es appropriate4