,,ii #aaf? ,,congress #a/ ,session ,s4 #bhei ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,novemb] #ad1 #bjai,mr4 ,s*atz 7= himself & ,mr4 ,b>rasso7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to am5d ! ,public ,heal? ,s]vice ,act ) respect to ! designation ( g5]al surg]y %ortage areas1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,ensur+ ,access to ,g5]al ,surg]y ,act ( #bjai4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,accord+ to ! ,bureau ( ,heal? ,work=ce1 ! ,unit$ ,/ates faces a %ortage ( physicians4 7#b7 ,a #bjaf /udy entitl$ ,supply & ,dem& ( ,g5]al ,surgeons3 ,projections ,f #bjad-bjcj1 prep>$ by ! ,univ]sity ( ,nor? ,c>ol9a at ,*apel ,hill = ! ,am]ican ,college ( ,surgeons1 f\nd t ! supply ( g5]al surgeons w gr[ slightly by #bjcj b w n keep up ) ov]all gr[? 9 ! ,unit$ ,/ates population or dem& = surgical s]vices4 7#c7 ,a #bjai report releas$ by ! ,association ( ,am]ican ,m$ical ,colleges projects %ortages 9 all surgical specialties ( betwe5 #ad1cjj & #bc1djj surgeons by #bjcb4 7#d7 ,9 ord] to accurately prep>e = future physician work=ce dem&s1 compreh5sive1 imp>tial rese>* & high-quality data are ne$$ to in=m dynamic projections ( physician work=ce ne$s4 7#e7 ,a v>iety ( factors1 includ+ heal? outcomes1 utilization tr5ds1 gr[+ & ag+ populations1 & deliv]y sy/em *anges1 influ5ce work=ce ne$s & %\ld be consid]$ z "p ( flexible projections ( work=ce ne$s4 7#f7 ,giv5 ! p>ticul>ly acute ne$s 9 _m rural & o!r surgical work=ce %ortage areas1 additional ef=ts to assess ! adequacy ( ! curr5t g5]al surgeon work=ce are necess>y4 #c4 ,/udy on designation ( g5]al surgical heal? pr(essional %ortage areas ,"p ,d ( title ,,iii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b et seq47 is am5d$ by add+ at ! end ! foll[+3 ,,xiii ,g5]al ,surg]y ,%ortage ,areas #cdj;,j4 ,designation ( g5]al surg]y %ortage areas 7a7 ,g5]al surg]y %ortage area def9$ ,= purposes ( ?is section1 ! t]m g5]al surg]y %ortage area means1 ) respect to an urban1 suburban1 or rural area 9 ! ,unit$ ,/ates1 an area t has a population t is und]s]v$ by g5]al surgeons4 7b7 ,/udy & report 7#a7 ,/udy ,! ,secret>y1 act+ ?r\gh ! ,adm9i/rator ( ! ,heal? ,res\rces & ,s]vices ,adm9i/ration1 %all conduct a /udy on ! foll[+ matt]s relat+ to access by und]s]v$ populations to g5]al surgeons3 7,a7 ,:e!r curr5t %ortage designations1 su* z ! designation ( heal? pr(essional %ortage areas "u section #ccb1 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 "o bas$ on g5]al surgeons practic+ )9 hospital s]vice areas1 w\ld provide m accurate assessm5ts ( %ortages 9 ! availability ( local g5]al surgeons to meets ! ne$s ( ^? populations4 7,c7 ,pot5tial me?odologies = ! designation ( g5]al surg]y %ortage areas1 includ+ ! me?odology describ$ 9 p>agraph 7#b74 7#b7 ,me?odology = ! designation ( areas ,among ! me?odologies consid]$ "u p>agraph 7#a77;,c7 = ! designation ( g5]al surg]y %ortage areas1 ! ,secret>y %all analyze ! 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$ic>e pati5t orig9 data4 7,b7 ,id5tification ( surgeons ,id5tification ( all actively practic+ g5]al surgeons4 7,c7 ,surgeon to population ratios ,developm5t ( g5]al surgeon-to-population ratios = ea* surg]y s]vice area4 7,d7 ,?re%olds ,det]m9ation ( ?re%old g5]al surgeon-to-population ratios = ! numb] ( g5]al surgeons necess>y to treat a population = ea* ( ! foll[+ levels3 7i7 ,optimal supply ( g5]al surgeons4 7ii7 ,adequate supply ( g5]al surgeons4 7iii7 ,%ortage ( g5]al surgeons4 7iv7 ,critical %ortage ( g5]al surgeons4 7#c7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is subp>t1 ! ,secret>y %all submit to ,congress a report on ! /udy conduct$ "u ?is subsection4 7#d7 ,consultation ,9 conduct+ ! /udy "u p>agraph 7#a71 ! ,secret>y %all consult ) relevant /akehold]s1 includ+ m$ical societies1 organizations repres5t+ surgical facilities1 organizations ) exp]tise 9 g5]al surg]y1 & organizations repres5t+ pati5ts4 7#e7 ,publication ( data ,! ,secret>y %all p]iodically collect & publi% 9 ! ,f$]al ,regi/]-- 7,a7 data comp>+ ! availability & ne$ ( g5]al surg]y s]vices 9 urban1 suburban1 or rural areas 9 ! ,unit$ ,/ates2 & 7,b7 if ! ,secret>y designates "o or m g5]al surg]y %ortage areas "u subsection 7c71 a li/ ( ! areas s designat$4 7c7 ,designation ( g5]al surg]y %ortage areas 7#a7 ,me?odology develop$ ?r\gh regulation ,n lat] ?an #ab mon?s aft] ! date ( ! submission ( ! report "u subsection 7b77#c71 ! ,secret>y may e/abli%1 ?r\gh notice & comm5t rulemak+1 a me?odology = ! designation ( g5]al surg]y %ortage areas "u ?is section4 7#b7 ,requirem5ts ,if ! ,secret>y elects to develop me?odology "u p>agraph 7#a71 ! foll[+ %all apply3 7,a7 ,us+ ! me?odology e/abli%$ "u p>agraph 7#a7 & tak+ into consid]ation ! data ref]r$ to 9 subsection 7b77#e71 ! ,secret>y %all-- 7i7 designate g5]al surg]y %ortage areas 9 ! ,unit$ ,/ates2 7ii7 publi% a descriptive li/ ( ! areas2 & 7iii7 review annually1 &1 z necess>y1 revise su* designations4 7,b7 ,! ,secret>y %all foll[ simil> proc$ures ) respect to notice to appropriate p>ties1 opportunities = comm5t1 dissem9ation ( in=mation1 & reports to ,congress 9 designat+ g5]al surg]y %ortage areas "u ?is section z ^? t apply to ! designation ( heal? pr(essional %ortage areas "u section #ccb4 7,c7 ,9 designat+ g5]al surg]y %ortage areas "u ?is subsection1 ! ,secret>y %all consult ) relevant /akehold]s1 includ+ m$ical societies1 organizations repres5t+ surgical facilities1 organizations ) exp]tise 9 g5]al surg]y1 & organizations repres5t+ pati5ts4 4