,,ii  #aahth ,,congress  #ast ,session  
,s4 #bdei  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,july #be1     
#bjbc,mr4 ,carper 7for himself and ,mr4 
,barrasso7 introduced the following     
bill2 which was read twice and referred 
to the ,committee on ,finance  ,a ,,bill
  ,to amend title ,,xviii of the ,social
 ,security ,act to ensure appropriate   
supervision requirements for outpatient 
physical therapy and outpatient         
occupational therapy1 and for other     
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,enabling ,more of  
the ,physical and ,occupational         
,workforce to ,engage in ,rehabilitation
 ,act or the ,,empower ,act4  #b4       
,ensuring appropriate supervision       
requirements for outpatient physical    
therapy and outpatient occupational     
therapy  7a7 ,in general  7#a7 ,payment 
,section #ahcd7v77#a7 of the ,social    
,security ,act 7#db ,u4,s4,c4           
#aciem7v77#a77 is amended1 in the second
 sentence 7as amended by subsection     

7a771 by inserting 1 but in no case     
shall the ,secretary impose a           
supervision requirement on such services
 that is different than any such        
requirement under applicable ,state law 
before the period at the end4  7#b7     
,definition ,section #ahfa7p7 of the    
,social ,security ,act1 is amended1 in  
the first sentence of the flush matter  
following subparagraph 7#d77;,b71 by    
inserting 1 but in no case may those    
conditions impose a supervision         
requirement that is different than any  
such requirement under applicable ,state
 law after as the ,secretary may find   
necessary4  7#c7 ,effective date ,the   
amendments made this subsection shall   
take effect on ,july #a1 #bjbd4  7#d7   
,implementation ,notwithstanding any    
other provision of law1 the ,secretary  
may implement the provisions of1 and the
 amendments made by1 this subsection by 
program instruction or otherwise4  7b7  
,,gao study and report on access to     
therapy services in rural and           

underserved areas  7#a7 ,study ,the     
,comptroller ,general of the ,united    
,states 7in this section referred to as 
the ,comptroller ,general7 shall conduct
 a study on how the #ae percent payment 
differential under section #ahcd7v7 of  
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciem7v77 for services       
furnished by occupational therapy       
assistants and physical therapists      
assistants has impacted access to       
occupational therapy and physical       
therapy services in rural and medically 
underserved areas across all settings   
7#b7 ,report ,not later than ,december  
#ca1 #bjbe1 the ,comptroller ,general   
shall submit to ,congress a report on   
the study conducted under paragraph     
7#a71 together with recommendations for 
such legislation and administrative     
action as the ,comptroller ,general     
determines appropriate4