,i #aai? ,,congress #b;d ,session ,h4 ,r4 #ifdb ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,july #ac1 #bjbf,mr4 ,mool5a> introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,ways & ,means ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to provide paym5t "u "p ,a ( ! ,m$ic>e program on a reasonable co/ basis = ane/hesia s]vices furni%$ by an ane/hesiologi/ 9 c]ta9 rural hospitals & critical access hospitals4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,m$ic>e ,access to ,rural ,ane/hesiology ,act4 #b4 ,m$ic>e "p ,a paym5t = ane/hesiologi/ s]vices 9 c]ta9 rural hospitals & critical access hospitals 7a7 ,subsection 7d7 hospitals 7#a7 ,9 g5]al ,section #ahhf7;d77#e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7d77#e77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,n7 7i7 ,= co/ report+ p]iods beg9n+ on or aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ! ,m$ic>e ,access to ,rural ,ane/hesiology ,act1 9 ! case ( a subsection 7d7 hospital describ$ 9 clause 7ii71 paym5t to su* hospital = physicians' s]vices t are ane/hesia s]vices furni%$ by a physician :o is an ane/hesiologi/ 9 su* hospital %all be made on a reasonable co/ basis4 7ii7 7,i7 ,subject to subclause 7,,ii71 = purposes ( clause 7i71 a subsection 7d7 hospital describ$ 9 ?is clause is1 ) respect to a ye> 7beg9n+ ) #bjbf71 a subsection 7d7 hospital t is locat$ 9 a rural area 7z def9$ 9 p>agraph 7#b77;,d77 7b n includ+ any hospital t is treat$ z be+ locat$ 9 su* an area pursuant to p>agraph 7#h77;,e77 t e/abli%es1 at any "t be=e ! ye>1 to ! satisfaction ( ! ,secret>y1 t-- 7aa7 z ( ! date ( ! enactm5t ( ! ,m$ic>e ,access to ,rural ,ane/hesiology ,act1 ! hospital employ$ or contract$ ) a physician :o is an ane/hesiologi/ 7b n m ?an "o full-"t equival5t physician72 7bb7 9 #bjbf1 ! hospital _h a volume ( surgical proc$ures 7includ+ inpati5t & outpati5t proc$ures7 requir+ ane/hesia s]vices t did n exce$ #hjj 7or su* high] numb] z ! ,secret>y det]m9es to be appropriate72 & 7cc7 ea* physician :o is an ane/hesiologi/ employ$ by1 or "u contract )1 ! hospital has agre$ n to bill "u "p ,b = pr(essional s]vices furni%$ by ! ane/hesiologi/ at ! hospital4 7,,ii7 ,) respect to a ye> 7aft] #bjbg71 a hospital is n a subsection 7d7 hospital describ$ 9 ?is clause unless ! hospital e/abli%es1 be=e ! beg9n+ ( ! ye>1 t ! hospital has _h a volume ( surgical proc$ures 7includ+ inpati5t & outpati5t proc$ures7 requir+ ane/hesia s]vices 9 ! previ\s ye> t did n exce$ #hjj 7or su* high] numb] z ! ,secret>y det]m9es to be appropriate74 4 7#b7 ,treat$ z "p ( inpati5t hospital s]vices ,section #ahfa7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7b77 is am5d$-- 7,a7 9 p>agraph 7#f71 by /rik+ or at ! end2 7,b7 9 p>agraph 7#g71 by /rik+ ! p]iod at ! end & ins]t+ 2 or2 & 7,c7 by add+ at ! end ! foll[+ new p>agraph3 7#h7 a physician :o is an ane/hesiologi/ :]e ! hospital is a subsection 7d7 hospital describ$ 9 section #ahhf7;d77#e77,n77ii74 4 7#c7 ,exclud$ f op]at+ co/s ( inpati5t hospital s]vices ,section #ahhf7;a77#d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7a77#d77 is am5d$ 9 ! second s5t5ce by ins]t+ = co/ report+ p]iods beg9n+ on or aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ! ,m$ic>e ,access to ,rural ,ane/hesiology ,act1 co/s ( physicians' s]vices t are ane/hesia s]vices furni%$ by a physician :o is an ane/hesiologi/ 9 a subsection 7d7 hospital describ$ 9 subsection 7d77#e77,n77ii71 be=e or co/s ) respect to adm9i/]+ blood clott+ factors4 7b7 ,critical access hospitals ,section #ahfa7mm7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7mm77 is am5d$-- 7#a7 9 p>agraph 7#b71 by add+ at ! end ! foll[+ new s5t5ce3 ,= co/ report+ p]iods beg9n+ on or aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ! ,m$ic>e ,access to ,rural ,ane/hesiology ,act1 su* t]m includes physicians' s]vices t are ane/hesia s]vices furni%$ by a physician :o is an ane/hesiologi/ 9 a critical access hospital describ$ 9 p>agraph 7#d742 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#d7 7,a7 ,subject to subp>agraph 7,b71 = purposes ( p>agraph 7#b71 a critical access hospital describ$ 9 ?is p>agraph is1 ) respect to a ye> 7beg9n+ ) #bjbg71 a critical access hospital t e/abli%es1 at any "t be=e ! ye>1 to ! satisfaction ( ! ,secret>y1 t-- 7i7 z ( ! date ( ! enactm5t ( ! ,m$ic>e ,access to ,rural ,ane/hesiology ,act1 ! critical access hospital employ$ or contract$ ) a physician :o is an ane/hesiologi/ 7b n m ?an "o full-"t equival5t physician72 7ii7 9 #bjbf1 ! critical access hospital _h a volume ( surgical proc$ures 7includ+ inpati5t & outpati5t proc$ures7 requir+ ane/hesia s]vices t did n exce$ #hjj 7or su* high] numb] z ! ,secret>y det]m9es to be appropriate72 & 7iii7 ea* physician :o is an ane/hesiologi/ employ$ by1 or "u contract )1 ! critical access hospital has agre$ n to bill "u "p ,b = pr(essional s]vices furni%$ by ! ane/hesiologi/ at ! critical access hospital4 7,b7 ,) respect to a ye> 7aft] #bjbg71 a critical access hospital is n a critical access hospital describ$ 9 ?is p>agraph unless ! critical access hospital e/abli%es1 be=e ! beg9n+ ( ! ye>1 t ! critical access hospital has _h a volume ( surgical proc$ures 7includ+ inpati5t & outpati5t proc$ures7 requir+ ane/hesia s]vices 9 ! previ\s ye> t did n exce$ #hjj 7or su* high] numb] z ! ,secret>y det]m9es to be appropriate74 4 7c7 ,exclud$ f m$ical & o!r heal? s]vices ,section #ahfa7s77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7s77#a77 is am5d$ by ins]t+ 7o!r ?an physicians' s]vices t are ane/hesia s]vices furni%$ dur+ a co/ report+ p]iod beg9n+ on or aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ! ,m$ic>e ,access to ,rural ,ane/hesiology ,act by a physician :o is an ane/hesiologi/ 9 a subsection 7d7 hospital describ$ 9 section #ahhf7;d77#e77,n77ii7 or a critical access hospital describ$ 9 section #ahfa7mm77#d77 be=e ! semicolon4 7d7 ,regulations ,! ,secret>y ( ,heal? & ,human ,s]vices %all revise ! regulations promulgat$ = purposes ( section #ahfb7;a77#ad7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciey7a77#ad77 su* t1 = co/ report+ p]iods beg9n+ on or aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ?is section1 su* regulations def9e ! t]m physicians' s]vices to exclude physicians' s]vices t are ane/hesia s]vices furni%$ by a physician :o is an ane/hesiologi/ 9-- 7#a7 a subsection 7d7 hospital describ$ 9 subp>agraph 7,n77ii7 ( section #ahhf7;d77#e7 ( su* ,act 7#db ,u4,s4,c4 #acieww7d77#e771 z add$ by subsection 7a72 or 7#b7 a critical access hospital describ$ 9 p>agraph 7#d7 ( section #ahfa7mm7 ( su* ,act 7#db ,u4,s4,c4 #aciex7mm771 z add$ by subsection 7b74