,i #aafth ,,congress #ast ,session ,h4 ,r4 #ahda ,,in ,,the ,,house ,,of ,,representatives ,march #ba1 #bjai,mr4 ,bera 7for himself1 ,mr4 ,bucshon1 ,mr4 ,peters1 and ,mr4 ,mullin7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,public ,health ,service ,act with respect to the designation of general surgery shortage areas1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,ensuring ,access to ,general ,surgery ,act of #bjai4 #b4 ,findings ,congress finds the following3 7#a7 ,according to the ,bureau of ,health ,workforce1 the ,united ,states faces a shortage of physicians4 7#b7 ,a #bjaf study entitled ,supply and ,demand of ,general ,surgeons3 ,projections ,from #bjad-bjcj1 prepared by the ,university of ,north ,carolina at ,chapel ,hill for the ,american ,college of ,surgeons1 found that the supply of general surgeons will grow slightly by #bjcj but will not keep up with overall growth in the ,united ,states population or demand for surgical services4 7#c7 ,a #bjah report released by the ,american ,association of ,medical ,colleges projects shortages in all surgical specialties of between #bj1gjj and #cj1ejj surgeons by #bjcj4 7#d7 ,in order to accurately prepare for future physician workforce demands1 comprehensive1 impartial research and high quality data are needed to inform dynamic projections of physician workforce needs4 7#e7 ,a variety of factors1 including health outcomes1 utilization trends1 growing and aging populations1 and delivery system changes1 influence workforce needs and should be considered as part of flexible projections of workforce needs4 7#f7 ,given the particularly acute needs in many rural and other surgical workforce shortage areas1 additional efforts to assess the adequacy of the current general surgeon workforce are necessary4 #c4 ,study on designation of general surgery shortage areas ,part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b et seq47 is amended by adding at the end the following3 ,,xiii ,general ,surgery ,shortage ,areas #cdj;,j4 ,designation of general surgery shortage areas 7a7 ,general surgery shortage area defined ,for purposes of this section1 the term general surgery shortage area means1 with respect to an urban1 suburban or rural area in the ,united ,states1 an area that has a population that is underserved by general surgeons4 7b7 ,study and report 7#a7 ,study ,the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall conduct a study on the following matters relating to access by underserved populations to general surgeons3 7,a7 ,whether current shortage designations1 such as the designation of health professional shortage areas under section #ccb1 results in accurate assessments of the adequacy of local general surgeons to address the needs of underserved populations in urban1 suburban1 or rural areas4 7,b7 ,whether another measure of access to general surgeons by underserved populations1 such as one based on general surgeons practicing within hospital service areas1 would provide more accurate assessments of shortages in the availability of local general surgeons to meets the needs of those populations4 7,c7 ,potential methodologies for the designation of general surgery shortage areas1 including the methodology described in paragraph 7#b74 7#b7 ,methodology for the designation of areas ,among the methodologies considered under paragraph 7#a77;,c7 for the designation of general surgery shortage areas1 the ,secretary shall analyze the effectiveness and accuracy of the following methodology3 7,a7 ,development of surgery service areas ,development of surgery service areas through the identification of hospitals with surgery services and the identification of populations by zip code areas using ,medicare patient origin data4 7,b7 ,identification of surgeons ,identification of all actively practicing general surgeons4 7,c7 ,surgeon to population ratios ,development of general surgeon-to-population ratios for each surgery service area4 7,d7 ,thresholds ,determination of threshold general surgeon-to-population ratios for the number of general surgeons necessary to treat a population for each of the following levels3 7i7 ,optimal supply of general surgeons4 7ii7 ,adequate supply of general surgeons4 7iii7 ,shortage of general surgeons4 7iv7 ,critical shortage of general surgeons4 7#c7 ,report ,not later than one year after the date of the enactment of this subpart1 the ,secretary shall submit to ,congress a report on the study conducted under this subsection4 7#d7 ,consultation ,in conducting the study under paragraph 7#a71 the ,secretary shall consult with relevant stakeholders1 including medical societies1 organizations representing surgical facilities1 organizations with expertise in general surgery1 and organizations representing patients4 7#e7 ,publication of data ,the ,secretary shall periodically collect and publish in the ,federal ,register-- 7,a7 data comparing the availability and need of general surgery services in urban1 suburban or rural areas in the ,united ,states2 and 7,b7 if the ,secretary designates one or more general surgery shortage areas under subsection 7c71 a list of the areas so designated4 7c7 ,designation of general surgery shortage areas 7#a7 ,methodology developed through regulation ,not later than #ab months after the date of the submission of the report under subsection 7b77#c71 the ,secretary may establish1 through notice and comment rulemaking1 a methodology for the designation of general surgery shortage areas under this section4 7#b7 ,requirements ,if the ,secretary elects to develop methodology under paragraph 7#a71 the following shall apply3 7,a7 ,using the methodology established under paragraph 7#a7 and taking into consideration the data referred to in subsection 7b77#e71 the ,secretary shall-- 7i7 designate general surgery shortage areas in the ,united ,states2 7ii7 publish a descriptive list of the areas2 and 7iii7 review annually1 and1 as necessary1 revise such designations4 7,b7 ,the ,secretary shall follow similar procedures with respect to notice to appropriate parties1 opportunities for comment1 dissemination of information1 and reports to ,congress in designating general surgery shortage areas under this section as those that apply to the designation of health professional shortage areas under section #ccb4 7,c7 ,in designating general surgery shortage areas under this subsection1 the ,secretary shall consult with relevant stakeholders1 including medical societies1 organizations representing surgical facilities1 organizations with expertise in general surgery1 and organizations representing patients4 4