RURAL HEALTH CLINIC SERVICES - CONFERENCE REPORT - Medicare Amendments

Sep 21, 2026

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Conference report accompanying H.R. 8422 addresses amendments to the Social Security Act to provide payment for rural health clinic services. It includes Medicare amendments revising sections 1832 and 1833, adding definitions and coverage rules for “rural health clinic services,” and establishing requirements for facilities, services, supervision, clinical records, hospital referral arrangements, and policy governance. The Secretary of Health, Education, and Welfare must study copayment feasibility and report to Congress within one year.

LanguageEnglish

CategoryResearch & Report

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Pages14

Reading Time35 min

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CONFERENCE REPORT

MEDICARE AMENDMENTS

Rural Health Clinic Services

ouuu人 I # RURAL HEALTH CLINIC SERVICES NoVEMBER 1,1977.—Ordered to be printed Mr.ULLMAN,from the committee of conference,submitted the following # CONFERENCE REPORT [To accompany H.R.8422] The committee of conference on the disagreeing votes_of the twoHouses on the amendment of the Senate to the bill(H.R.8422)toamend titles XVIII and XIX of the Social Security Act to providepayment for rural health clinic services,and for other purposes,having met,after full and free conference,have agreed to recommendand do recommend to their respective Houses as follows: That the House recede from its disagreement to the amendment ofthe Senate and agree to the same with an amendment as follows: In lieu of the matter proposed to be inserted by the Senate amend-ment insert the following: ## MEDICARE AMENDMENTS SECTION1.(a)Section 1832(a)of the Social Security Act is amended— (1)by striking out "paragraph(2)(B)"in paragraph(1)andinserting in lieu thereof"subparagraphs(B)and (D)of paragraph (2)”;and (2)by striking out the period at the end of paragraph(2)(C)andinserting in lieu thereof“;and”and by adding the following newsubparagraph at the end of paragraph(2): (D)rural health clinic services.” (b)Section 1833(a)of such Act is amended— (1)by striking out"and"at the end of paragraph(1); (2)by inserting"(except those services described in subparagraph(D)of section 1832(a)(2)”in paragraph(2)after“1832(a)(2)”; (3)by striking out the period at the end of paragraph(2)andinserting in lieu thereof“,and”;and :(4)by inserting the following new paragraph after paragraph(2):“(3)in the case of services described in section 1832(a)(2)(D),80 percent of costs which are reasonable and related to the cost offurnishing such services or on such other tests of reasonableness asthe Secretary may prescribe in regulations,including those authorizedunder section 1861(v)(1)(A)." 29-0060 2 (c)The Secretary of Health,Education,and Welfare(hereinafter inthis Act referred to as the‘Secretary")shall conduct a study of the feasi-bility and desirability of imposing a copayment for each zisit to a ruralhealth clinic for rural health clinic services under part B of title XVIIIof the Social Security Act,instead of the deductible and coinsuranceamounts otherwise required under section 1833 of such Act with respectto the provision of such services.The Secretary shall report to the appro-priate committees of Congress,not later than one year after the date ofenactment of this Act,on such study and on any recommendations he mayhave for changes in the provisions of part B of title XVIll of the SocialSecurity Act to refect thefndings of such study. (d)Šection 1861 of such Act is amended by adding at the end thereofthe following new subsection: "Rural Health Clinic Services "(aa)(1)The term ‘rural health clinic services'means— "(A)physicians'services and such services and supplies as arecovered under section 1861(s)(2)(A)if furnished as an incident to aphysician's professional service, "(B)such services furnished by a physician assistant or by anurse practitioner and such services and supplies furnished as anincident to his service as would otherwise be covered if furnished by aphysician or as an incident to a physician's service,and "(C)in the case of a rural health clinic located in an area inwhich there exists a shortage of home health agencies,part-time orintermittent nursing care and related medical supplies(other thandrugs and biologicals)furnished by a registered professional nurseor licensed practical nurse to a homebound individual under awritten plan of treatment(i)established and periodically reviewed bya physician described in paragraph(2)(B),or(ii)established by anurse practitioner or physician assistant and periodically reviewedand approved by a physician described in paragraph(2)(B), when furnished to an individual as an outpatient of a rural health clinic.“(2)The term rural health clinic'means a facility which— “(A

FAQs

What is the purpose of this conference report for H.R. 8422?

It recommends House agreement to amend Senate provisions to provide payment for rural health clinic services and related purposes under the Social Security Act.

Which Social Security Act sections are amended to implement the rural health clinic payment changes?

The report amends sections 1832(a) and 1833(a), and adds new definitions and related requirements through an amendment to section 1861.

What study is required from the Secretary and what is the reporting deadline?

The Secretary must study feasibility and desirability of imposing a copayment per visit to a rural health clinic, and report to the appropriate congressional committees within one year after enactment, including any recommendations for Part B changes.

Sep 21, 2026

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