,,ii  #aah? ,,congress  #a/ ,session    
,s4 #bdei  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #be1 #bjbc,mr4   
,c>p] 7= himself & ,mr4 ,b>rasso7       
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
ensure appropriate sup]vision           
requirem5ts = outpati5t physical !rapy &
 outpati5t occupational !rapy1 & = o!r  
purposes4  #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$1 
9 ! second s5t5ce 7z am5d$ by subsection
 7a771 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 
,act1 is am5d$1 9 ! fir/ s5t5ce ( ! flu%
 matt] foll[+ subp>agraph 7#d77;,b71 by 
ins]t+ 1 b 9 no case may ^? conditions  
impose a sup]vision requirem5t t is     
diff]5t ?an any su* requirem5t "u       
applicable ,/ate law aft] z ! ,secret>y 
may f9d necess>y4  7#c7 ,effective date 
,! am5dm5ts made ?is subsection %all    
take effect on ,july #a1 #bjbd4  7#d7   
,implem5tation ,not)/&+ any o!r         
provision ( law1 ! ,secret>y may        
implem5t ! provisions (1 & ! am5dm5ts   
made by1 ?is subsection by program      
in/ruction or o!rwise4  7b7 ,,gao /udy &
 report on access to !rapy s]vices 9    
rural & und]s]v$ areas  7#a7 ,/udy ,!   
,comptroll] ,g5]al ( ! ,unit$ ,/ates 79 
?is section ref]r$ to z ! ,comptroll]   
,g5]al7 %all conduct a /udy on h[ ! #ae 
p]c5t paym5t diff]5tial "u section      
#ahcd7v7 ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #aciem7v77 = s]vices furni%$ 

by occupational !rapy assi/ants &       
physical !rapi/s assi/ants has impact$  
access to occupational !rapy & physical 
!rapy s]vices 9 rural & m$ically        
und]s]v$ areas across all sett+s  7#b7  
,report ,n lat] ?an ,decemb] #ca1 #bjbe1
 ! ,comptroll] ,g5]al %all submit to    
,congress a report on ! /udy conduct$ "u
 p>agraph 7#a71 toge!r ) recomm5dations 
= su* legislation & adm9i/rative action 
z ! ,comptroll] ,g5]al det]m9es         
appropriate4