; . (2) Nursing facility services supervision and clinical records Section 1919(b)(6)(A) of the Social Security Act ( 42 U.S.C. 1396r(b)(6)(A) ) is amended to read as follows: (A) require that the health care of every resident be provided under the supervision of a physician or nurse practitioner (or, at the option of a State, under the supervision of a clinical nurse specialist or physician assistant who is not an employee of the facility but who is working in collaboration with a physician); . 108. Improving access to Medicaid clinic services Section 1905(a)(9) of the Social Security Act ( 42 U.S.C. 1396d(a)(9) ) is amended by adding or nurse practitioner after physician in both places that it appears. II Removal of Barriers to Practice on Certified Registered Nurse Anesthetists 201. Clarifying that certified registered nurse anesthetists can be reimbursed by Medicare for evaluation and management services Section 1861(bb)(1) of the Social Security Act ( 42 U.S.C. 1395x(bb)(1) ) is amended by inserting , including pre-anesthesia evaluation and management services, after and related care . 202. Revision of conditions of payment relating to services ordered and referred by certified registered nurse anesthetists Not later than 3 months after the date of enactment of this Act, the Secretary of Health and Human Services shall revise section 410.69 of title 42, Code of Federal Regulations, to clarify that, for purposes of payment under part B of title XVIII of the Social Security Act— (1) certified registered nurse anesthetists are authorized to order, certify, and refer services to the extent allowed under the law of the State in which the services are furnished