[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3396 Introduced in House (IH)]






108th CONGRESS
  1st Session
                                H. R. 3396

  To direct the Secretary of Health and Human Services to establish a 
    process under which a provider of services or other health care 
 provider under the Medicare Program may petition the Secretary for an 
   adjustment of the rate of payment made to that provider under the 
 Medicare Program based on a significant inequity between the rate of 
      payment applicable to that provider, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 29, 2003

 Mr. King of Iowa introduced the following bill; which was referred to 
 the Committee on Ways and Means, and in addition to the Committee on 
Energy and Commerce, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To direct the Secretary of Health and Human Services to establish a 
    process under which a provider of services or other health care 
 provider under the Medicare Program may petition the Secretary for an 
   adjustment of the rate of payment made to that provider under the 
 Medicare Program based on a significant inequity between the rate of 
      payment applicable to that provider, 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. SHORT TITLE.

    This Act may be cited as the ``Medicare Inequity Adjustment Act''.

SEC. 2. CORRECTION OF SIGNIFICANT MEDICARE PAYMENT INEQUITIES.

    (a) Findings.--Congress finds that inequities exist in medicare's 
legacy reimbursement formulas and in the evaluations of reports that 
promote and perpetuate disparate compensation rates for similar 
services.
    (b) Adjustment Authority.--
            (1) In general.--The Secretary of Health and Human Services 
        shall establish a process under which a provider of services or 
        other health care provider under the medicare program may 
        petition the Secretary for an adjustment of the rate of payment 
        made to that provider under the medicare program based on a 
        significant inequity between the rate of payment applicable to 
        that provider and the rate of payment applicable to similar 
        providers located in adjoining areas. Under such process the 
        provider shall have the right to compile records and present to 
        the Secretary empirical evidence of such inequities. The 
        Secretary shall make a determination on such a petition and 
        notify the provider of such determination.
            (2) Adjustment.--Based upon a petition under paragraph (1), 
        the Secretary, notwithstanding any other provision of law, 
        shall provide for such adjustment of payment rate as is 
        necessary to correct significant inequities.
            (3) Taking quality into account.--In providing an 
        adjustment under paragraph (2), the Secretary shall take into 
        account and provide for a higher payment adjustment, insofar as 
        reliable data are available, a provider that is a high quality, 
        cost-effective provider.
            (4) Judicial review.--Notwithstanding any other provision 
        of law, if a provider is dissatisfied with a determination 
        under paragraph (1), or the amount of any adjustment effected 
        under paragraph (2), the provider shall have the right to a 
        review of such determination in an action before an appropriate 
        district court of the United States and the court shall hear 
        such action de novo and shall not give deference to any 
        findings of fact or conclusions of law of the Secretary.
            (5) No budget neutrality or other adjustment for other 
        providers.--Nothing in this section shall be construed as 
        authorizing the Secretary to reduce medicare payment rates to 
        any providers as a result of a payment adjustment made to other 
        providers under this section.
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