IMPROVEMENTS FOR MEDICARE ANESTHESIA TEACHING PROGRAMS.

SEC. 139. IMPROVEMENTS FOR MEDICARE ANESTHESIA TEACHING PROGRAMS.(a) Special Payment Rule for Teaching Anesthesiologists.—Section 1848(a) of the Social Security Act (42 U.S.C. 1395w–4(a)), as amended by section 132(b), is amended—(1) in paragraph (4)(A), by inserting “except as provided in paragraph (5),” after “anesthesia cases,”; and(2) by adding at the end the following new paragraph:“(6) Special rule for teaching anesthesiologists.—With respect to physicians’ services furnished on or after January 1, 2010, in the case of teaching anesthesiologists involved in the training of physician residents in a single anesthesia case or two concurrent anesthesia cases, the fee schedule amount to be applied shall be 100 percent of the fee schedule amount otherwise applicable under this section if the anesthesia services were personally performed by the teaching anesthesiologist alone and paragraph (4) shall not apply if—“(A) the teaching anesthesiologist is present during all critical or key portions of the anesthesia service or procedure involved; and“(B) the teaching anesthesiologist (or another anesthesiologist with whom the teaching anesthesiologist has entered into an arrangement) is immediately available to furnish anesthesia services during the entire procedure.”.(b) Treatment of Certified Registered Nurse Anesthetists.—With respect to items and services furnished on or after 122 STAT. 2542 January 1, 2010, the Secretary of Health and Human Services shall make appropriate adjustments to payments under the Medicare program under title XVIII of the Social Security Act for teaching certified registered nurse anesthetists to implement a policy with respect to teaching certified registered nurse anesthetists that—(1) is consistent with the adjustments made by the special rule for teaching anesthesiologists under section 1848(a)(6) of the Social Security Act, as added by subsection (a); and(2) maintains the existing payment differences between teaching anesthesiologists and teaching certified registered nurse anesthetists.