[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3170 Introduced in House (IH)]

103d CONGRESS
  1st Session
                                H. R. 3170

    To amend title XVIII of the Social Security Act to require the 
Secretary of Health and Human Services to consult with representatives 
   of physicians and to use the most recent available data in making 
 geographic adjustments to the payment rates for physicians' services 
     under part B of the medicare program, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 29, 1993

 Mr. Chapman introduced the following bill; which was referred jointly 
      to the Committees on Energy and Commerce and Ways and Means

_______________________________________________________________________

                                 A BILL


 
    To amend title XVIII of the Social Security Act to require the 
Secretary of Health and Human Services to consult with representatives 
   of physicians and to use the most recent available data in making 
 geographic adjustments to the payment rates for physicians' services 
     under part B of the medicare program, 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. MODIFICATIONS TO GEOGRAPHIC COST OF PRACTICE INDEX UNDER 
              MEDICARE PHYSICIAN FEE SCHEDULE.

    (a) Requiring Consultation With Representatives of Physicians in 
Reviewing Geographic Adjustment Factors.--Section 1848(e)(1)(C) of the 
Social Security Act (42 U.S.C. 1395w-4(e)(1)(C)) is amended by striking 
``shall review'' and inserting ``shall, in consultation with 
appropriate representatives of physicians, review''.
    (b) Use of Most Recent Data In Geographic Adjustment.--Section 
1848(e)(1) of such Act (42 U.S.C. 1395w-4(e)(1)) is amended by adding 
at the end the following new subparagraph:
                    ``(D) Use of recent data.--In establishing indices 
                and index values under this paragraph, the Secretary 
                shall use the most recent data available relating to 
                practice expenses, malpractice expenses, and physician 
                work effort in different fee schedule areas.''.
    (c) Deadline for Initial Review and Revision.--The Secretary of 
Health and Human Services shall first review and revise geographic 
adjustment factors under section 1848(e)(1)(C) of the Social Security 
Act by not later than January 1, 1995. Not later than April 1, 1994, 
the Secretary shall study and report to the Committee on Finance of the 
Senate and the Committee on Ways and Means and the Committee on Energy 
and Commerce of the House of Representatives on the construction of the 
geographic cost of practice index under section 1848(e)(1)(A)(i) of 
such Act.
    (d) Report on Review Process.--Not later than 1 year after the date 
of the enactment of this Act, the Secretary of Health and Human 
Services shall study and report to the Committee on Finance of the 
Senate and the Committee on Ways and Means and the Committee on Energy 
and Commerce of the House of Representatives on--
            (1) the data necessary to review and revise the indices 
        established under section 1848(e)(1)(A) of the Social Security 
        Act, including--
                    (A) the shares allocated to physicians' work 
                effort, practice expenses (other than malpractice 
                expenses), and malpractice expenses;
                    (B) the weights assigned to the input components of 
                such shares; and
                    (C) the index values assigned to such components;
            (2) any limitations on the availability of data necessary 
        to review and revise such indices at least every three years;
            (3) ways of addressing such limitations, with particular 
        attention to the development of alternative data sources for 
        input components for which current index values are based on 
        data collected less frequently than every three years; and
            (4) the costs of developing more accurate and timely data.
    (e) Development of Criteria for Use in Determining Payment 
Localities.--The Physician Payment Review Commission shall conduct a 
study to develop criteria that would be used to refine the fee schedule 
areas that are used within States, in applying geographic adjustment 
factors for computing payment amounts, under section 1848 of the Social 
Security Act. The Commission shall include a report on such study in 
its recommendations submitted to the Congress under section 1845(b) of 
such Act in 1994.

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