text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Medicare Certified Registered Nurse 
  First Assistant Direct Reimbursement Act of 2001''.
  
  SEC. 2. MEDICARE COVERAGE OF SURGICAL FIRST ASSISTING SERVICES OF 
                CERTIFIED REGISTERED NURSE FIRST ASSISTANTS.
  
      (a) Services Covered.--Section 1861(s)(2) of the Social Security 
  Act (42 U.S.C. 1395x(s)(2)), as amended by sections 102(a) and 105(a) 
  of the Medicare, Medicaid, and SCHIP Benefits Improvement and 
  Protection Act of 2000, as enacted into law by section 1(a)(6) of 
  Public Law 106-554, is amended--
              (1) by striking ``and'' at the end of subparagraph (U);
              (2) by inserting ``and'' at the end of subparagraph (V); 
          and
              (3) by adding at the end the following new subparagraph:
              ``(W) surgical first assisting services (as defined in 
          subsection (ww)(1)) furnished by a certified registered nurse 
          first assistant (as defined in subsection (ww)(2));''.
      (b) Services Described.--Section 1861 of the Social Security Act 
  (42 U.S.C. 1395x) , as amended by sections 102(b) and 105(b) of the 
  Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act 
  of 2000, as enacted into law by section 1(a)(6) of Public Law 106-554, 
  is amended by adding at the end the following new subsection:
  
   ``Surgical First Assisting Services; Certified Registered Nurse First 
                                 Assistant
  
      ``(ww)(1) The term `surgical first assisting services' means 
  services consisting of first assisting a physician with surgery and 
  related preoperative, intraoperative, and postoperative care (as 
  determined by the Secretary) furnished by a certified registered nurse 
  first assistant (as defined in paragraph (2)) which the certified 
  registered nurse first assistant is legally authorized to perform by 
  the State in which the services are performed.
      ``(2) The term `certified registered nurse first assistant' means 
  an individual who--
              ``(A) is a registered nurse and is licensed to practice 
          nursing in the State in which the surgical first assisting 
          services are performed;
              ``(B) has completed a minimum of 2,000 hours of first 
          assisting a physician with surgery and related preoperative, 
          intraoperative, and postoperative care; and
              ``(C) is certified as a registered nurse first assistant by 
          an organization recognized by the Secretary.''.
      (c) Payment Amount.--Section 1833(a)(1) of the Social Security Act 
  (42 U.S.C. 1395l(a)(1)), as amended by sections 105(c) and 223(c) of 
  the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection 
  Act of 2000, as enacted into law by section 1(a)(6) of Public Law 106-
  554, is amended--
              (1) by striking ``and'' before ``(U)''; and
              (2) by inserting before the semicolon at the end the 
          following: ``, and (V) with respect to surgical first assisting 
          services (as defined in section 1861(ww)(1)) furnished by a 
          certified registered nurse first assistant (as defined in 
          section 1861(ww)(2)), the amount paid shall be 80 percent of 
          the lesser of the actual charge for the services or 85 percent 
          of the amount determined under the fee schedule established 
          under section 1848(b) for the same services if furnished by a 
          physician''.
      (d) Payments to Employers.--
              (1) In general.--Section 1833(r) of the Social Security Act 
          (42 U.S.C. 1395l(r)) is amended--
                      (A) in paragraph (1), by inserting ``or section 
                  1861(s)(2)(W) (relating to surgical first assisting 
                  services)'' after ``clinical nurse specialist 
                  services)''; and
                      (B) in paragraph (2), by striking 
                  ``1861(s)(2)(K)(ii)'' and inserting ``1861(s)(2)(K)(ii) 
                  or 1861(s)(2)(W)''.
              (2) Application of mandatory assignment rules.--Section 
          1842(b)(18)(C)(i) of such Act (42 U.S.C. 1395u(b)(18)(C)(i)) is 
          amended by striking ``physician assistant, nurse practitioner, 
          clinical nurse specialist'' and inserting ``physician 
          assistant, nurse practitioner, clinical nurse specialist, or 
          certified registered nurse first assistant''.
              (3) Exclusion from bundled payments for covered skilled 
          nursing facility services.--Section 1888(e)(2)(A)(ii) of such 
          Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by inserting 
          ``surgical first assisting services of a certified registered 
          nurse first assistant,'' after ``services of a certified 
          registered nurse anesthetist,''.
      (e) Reduction in Payments To Avoid Duplicate Payment.--
  Notwithstanding any other provision of law, the Secretary of Health and 
  Human Services may reduce the amount of payments otherwise made to 
  hospitals under title XVIII of the Social Security Act (42 U.S.C. 1395 
  et seq.) to eliminate estimated duplicate payments for historical or 
  current costs attributable to surgical first assisting services 
  furnished by certified registered nurse first assistants as described 
  in section 1861(ww) of such Act (as added by subsection (a)).
      (f) Effective Date.--The amendments made by this section shall 
  apply to services furnished on or after the date of the enactment of 
  this Act.
  
  SEC. 3. STUDY OF PAYMENT RATES.
  
      Not later than 180 days after the date of the enactment of this 
  Act, the Secretary of Health and Human Services shall submit to 
  Congress a report containing recommendations for adjustments to the 
  payment amounts established under part B of title XVIII of the Social 
  Security Act for surgical first assisting services furnished by 
  certified registered nurse first assistants (as described in section 
  1861(ww) of such Act (as added by section 1(a)) to ensure that the 
  payment amounts reflect the approximate costs of furnishing such 
  services, taking into account the costs of compensation, overhead, and 
  supervision attributable to certified registered nurse first 
  assistants.
target: Medicare Certified Registered Nurse First Assistant Direct Reimbursement Act of 2001 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of surgical first assisting services furnished by certified registered nurse first assistants.
feat_title: To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for surgical first assisting services of certified registered nurse first assistants.