,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #dhgh  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #be1 #bjbc ,mrs4
 ,lesko 7= h]self & ,ms4 ,ku/]7         
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xviii ( !     
,social ,security ,act to ensure        
appropriate sup]vision requirem5ts =    
outpati5t physical !rapy & outpati5t    
occupational !rapy4  #a4 ,%ort title    
,?is ,act may be cit$ z ! ,enabl+ ,m ( !
 ,physical & ,occupational ,work=ce to  
,engage 9 ,rehabilitation ,act or !     
,,emp[] ,act4  #b4 ,ensur+ appropriate  
sup]vision requirem5ts = outpati5t      
physical !rapy & outpati5t occupational 
!rapy  7a7 ,9 g5]al  7#a7 ,paym5t       
,section #ahcd7v77#a7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           

#aciem7v77#a77 is am5d$ 9 ! second      
s5t5ce by ins]t+ 1 b 9 no case %all !   
,secret>y impose a sup]vision requirem5t
 on su* s]vices t is diff]5t ?an any su*
 requirem5t "u applicable ,/ate law be=e
 ! p]iod at ! end4  7#b7 ,def9ition     
,section #ahfa7p7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciex7p77 is am5d$ 
9 ! fir/ s5t5ce ( ! flu% left text      
foll[+ p>agraph 7#d77;,b7 by ins]t+ 1 b 
9 no case may ^? conditions impose a    
sup]vision requirem5t t is diff]5t ?an  
any su* requirem5t "u applicable ,/ate  
law aft] z ! ,secret>y may f9d necess>y4
  7#c7 ,effective date ,! am5dm5ts made 
by ?is subsection %all take effect on   
,janu>y #a1 #bjbd4  7b7 ,implem5tation  
,not)/&+ any o!r provision ( law1 !     
,secret>y may implem5t ! provisions (1 &
 ! am5dm5ts made by1 ?is section by     
program in/ruction or o!rwise4  #c4     
,,gao /udy on access to !rapy s]vices 9 
rural & und]s]v$ areas ,n lat] ?an      
,decemb] #ca1 #bjbd1 ! ,comptroll]      
,g5]al ( ! ,unit$ ,/ates %all conduct an

 analysis ( h[ ! ,m$ic>e "p ,b #ae p]c5t
 paym5t diff]5tial = s]vices provid$ by 
occupational !rapy assi/ants & physical 
!rapy assi/ants has impact$ access to   
occupational !rapy & physical !rapy     
s]vices 9 rural & m$ically und]s]v$     
areas1 across all ,m$ic>e "p ,b sett+s4