Page:United States Statutes at Large Volume 100 Part 3.djvu/226

 100 STAT. 2034

PUBLIC LAW 99-509—OCT. 21, 1986

at?.^ ered as incurred expenses for purposes of subsections (a) and (b).". fc) CERTIFICATION STANDARD.—(1) Section 1835(a)(2)(C) of such Act S* (42 U.S.C. 1395n(a)(2)(C)) is amended— (A) by inserting "or outpatient occupational therapy services" I >» after "outpatient physical therapy services", . luif (B) in clause (i), by inserting "or occupational therapy services, respectively," after "physical therapy services", and (C) in clause (ii), by inserting "or qualified occupational therapist, respectively," after "qualified physical therapist". (2) The second sentence of section 1835(a) of such Act and section . 1866(e) of such Act (42 U.S.C. 1395n(a), 1395cc(e)) are each amended— (A) by inserting "(or meets the requirements of such section through the operation of section 1861(g))" after "1861(p)(4)(A)" i),i, and after "1861(p)(4)(B)", and 1; ^ (B) by inserting "or (through the operation of section 1861(g)) -«<;j J with respect to the furnishing of outpatient occupational therapy services" after "(as therein defined)", (d) DEFINITION AND INCLUSION WITH OTHER PART B SERVICES.—(1)

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42 USC 1395k note.

OUTPATIENT OCCUPATIONAL THERAPY SERVICES

"(g) The term 'outpatient occupational therapy services' has the meaning given the term 'outpatient physical therapy services' in subsection (p), except that 'occupational' shall be substituted for 'physical' each place it appears therein.". (2) Section 1861(s)(2)(D) of such Act (42 U.S.C. 1395x(s)(2)(D)) is amended by inserting "and outpatient occupational therapy services" after "outpatient physical therapy services". (3) Section 1861(v)(5)(A) of such Act (42 U.S.C. 1395x(v)(5)(A)) is amended by inserting "(including through the operation of section 1861(g))" after "section 1861(p)". (e) EFFECTIVE DATE.—The amendments made by this section shall apply to expenses incurred for outpatient occupational therapy services furnished on or after July 1, 1987. SEC. 9338. SERVICES OF A PHYSICIAN ASSISTANT.

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(a) SERVICES COVERED.—Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)), as amended by section 9335(c)(1) of this subtitle, is amended— (1) by striking "and" at the end of subparagraph (I), (2) by adding "and" at the end of subparagraph (J), and (3^ by adding at the end the following new subparagraph: »aj '*(K)(i) services which would be physicians' services if furnished by a physician (as defined in subsection (r)(l)) and which n^ are performed by a physician assistant (as defined in subsection (aa)(3)) under the supervision of a physician (as so defined) in a s^mya hospital, skilled nursing facility, or intermediate care facility (as defined in section 1905(c)) or as an assistant at surgery and 42 USC 1396d. which the physician assistant is legally authorized to perform by the State in which the services are performed, and "(ii) such services and supplies furnished as an incident to such services as would be covered under subparagraph (A) if furnished as an incident to a physician's professional service;".

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