[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5270 Introduced in House (IH)]
111th CONGRESS
2d Session
H. R. 5270
To amend the Federal Employees' Compensation Act to cover services
provided to injured Federal workers by physician assistants and nurse
practitioners, and for other purposes.
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IN THE HOUSE OF REPRESENTATIVES
May 11, 2010
Mr. Hare (for himself, Mr. George Miller of California, and Mr. Souder)
introduced the following bill; which was referred to the Committee on
Education and Labor
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A BILL
To amend the Federal Employees' Compensation Act to cover services
provided to injured Federal workers by physician assistants and nurse
practitioners, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Improving Access to Workers'
Compensation for Injured Federal Workers Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Medical services and supplies provided by physician
assistants (PAs), nurse practitioners (NPs), clinical nurse
specialists (CNSs), certified nurse midwives (CNMs), and
certified registered nurse anesthetists (CRNAs), are not
included in the definition of ``medical, surgical, and hospital
services and supplies'' in the Federal Employees' Compensation
Act (5 U.S.C. 8101 et seq.). PAs, NPs, CNSs, CNMs, and CRNAs
are not included in the definition of ``physician'' in such
Act, and claims signed by PAs, NPs, CNSs, CNMs, and CRNAs have
been denied by the Office of Workers' Compensation Programs of
the Department of Labor.
(2) In some rural areas where many of these providers are
the only full-time providers of care, injured Federal workers
may have to travel more than 100 miles to receive care that is
reimbursable.
(3) In some cases, Federal workers have been advised to use
hospital emergency rooms for non-emergency care, rather than
receiving care after hours at local clinics where many of these
providers are the only health care professionals on site.
(4) PAs, NPs, CNSs, CRNAs, and CNMs are covered providers
within Medicare, Medicaid, Tri-Care, and most private insurance
plans.
(5) PAs, NPs, CRNAs, and CNMs are legally regulated in all
50 States, the District of Columbia, and Guam.
(6) All 50 States, the District of Columbia, and Guam
authorize physicians to delegate prescriptive privileges to the
PAs they supervise, authorize NPs to prescribe medications
under their own signature; 48 States, the District of Columbia,
American Samoa, and Guam provide prescriptive authority to
CNMs; and CRNAs have prescriptive authority in 28 states (and
the District of Columbia) and order and administer anesthesia
medication and provide anesthesia and interventional pain
management services in all 50 states and the District of
Columbia.
(7) PAs, NPs, and CRNAs work in virtually every area of
medicine and surgery and are also employed by the Federal
Government to provide medical care, including by the Department
of Veterans Affairs, the Department of Defense, and the Public
and Indian Health Services.
(8) CNSs have clinical nursing expertise in diagnosis and
provide direct care to prevent, remediate, or alleviate illness
and promote health. CNSs practice in hospitals, clinics,
nursing homes, and other community-based settings.
(9) CNMs provide vital care to pregnant Federal workers who
are injured on the job.
(10) CRNAs, the oldest of the advanced practice nurse
specialties, administer approximately 32 million anesthetics to
patients each year in the U.S., and in some States are the sole
providers of anesthetics in nearly 100 percent of rural
hospitals.
(11) CRNAs work in almost every setting in which anesthesia
is given, including operating rooms, dental offices, pain
clinics, ambulatory surgical settings, and provide
interventional pain management service.
(12) Amending the Federal Employees' Compensation Act to
recognize PAs, NPs, CRNAs, CNSs, and CNMs as covered providers
will bring this Act in line with the overwhelming majority of
State workers' compensation programs, which recognize each of
these providers as covered providers.
(13) The exclusion of PAs, NPs, CNSs, CNMs, and CRNAs from
the category of covered providers under the Federal Employees'
Compensation Act limits patients' access to medical care,
services, and supplies, disrupts continuity of care, and
creates unnecessary costs for the Office of Workers'
Compensation Programs.
SEC. 3. INCLUSION OF PHYSICIAN ASSISTANTS AND ADVANCED PRACTICE
REGISTERED NURSES IN FEDERAL EMPLOYEES' COMPENSATION ACT.
(a) Inclusion.--Section 8101 of title 5, United States Code, is
amended--
(1) in paragraph (3), by inserting ``other eligible
providers,'' after ``chiropractors,'';
(2) by striking ``and'' at the end of paragraphs (18) and
(19);
(3) by striking the period at the end of paragraph (20) and
inserting ``; and''; and
(4) by adding at the end the following:
``(21) `other eligible provider' means a physician
assistant, nurse practitioner, clinical nurse specialist,
certified nurse midwife, or certified registered nurse
anesthetist, within the scope of their practice as defined by
State law, or as credentialed by the Federal government.''.
(b) Conforming Amendments.--Chapter 81 of title 5, United States
Code, is amended--
(1) in section 8103(a)--
(A) in the matter preceding paragraph (1), by
inserting ``or other eligible provider'' after
``physician'';
(B) in paragraph (3), by inserting ``or other
eligible providers'' after ``physicians''; and
(C) in the matter following paragraph (3), by
inserting ``or other eligible provider'' after
``physician'';
(2) in section 8121(6), by inserting ``or other eligible
provider'' after ``physician''; and
(3) in section 8123(a)--
(A) in the second sentence, by inserting ``or other
eligible provider'' after ``physician''; and
(B) in the third sentence, by striking ``of the
employee'' and inserting ``or other eligible provider
of the employee''.
SEC. 4. EFFECTIVE DATE.
The amendments made by this section shall apply beginning on the
first day of the second Federal fiscal year quarter that begins on or
after the date of the enactment of this Act.
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