[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 1098 Introduced in Senate (IS)]







108th CONGRESS
  1st Session
                                S. 1098

  To amend title XVIII of the Social Security Act to update the renal 
                        dialysis composite rate.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 21, 2003

Mr. Conrad (for himself, Mr. Santorum, Mrs. Lincoln, and Mr. Bingaman) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To amend title XVIII of the Social Security Act to update the renal 
                        dialysis composite rate.

    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 Renal Dialysis Payment 
Fairness Act of 2003''.

SEC. 2. UPDATE IN RENAL DIALYSIS COMPOSITE RATE.

    (a) In General.--The last sentence of section 1881(b)(7) of the 
Social Security Act (42 U.S.C. 1395rr(b)(7)) is amended--
            (1) by striking ``and'' before ``for such services'';
            (2) by inserting ``and before January 1, 2004,'' after 
        ``January 1, 2001,''; and
            (3) by inserting before the period at the end the 
        following: ``, and for such services furnished during each 
        subsequent year (beginning with 2004), by the ESRD market 
        basket percentage increase (as defined in paragraph (12)(A) and 
        including any additional factors that may increase costs 
        described in paragraph (12)(B)) above such composite rate 
        payment amounts for such services furnished on December 31 of 
        the previous year''.
    (b) ESRD Market Basket Percentage Increase Defined.--Section 
1881(b) of the Social Security Act (42 U.S.C. 1395rr(b)) is amended by 
adding at the end the following new paragraph:
    ``(12)(A) For purposes of this title, the term `ESRD market basket 
percentage increase' means, with respect to a calendar year, the 
percentage (estimated by the Secretary before the beginning of such 
year) by which--
            ``(i) the cost of the mix of goods and services included in 
        the provision of dialysis services (including the costs 
        described in subparagraph (D)) that is determined based on an 
        index of appropriately weighted indicators of changes in wages 
        and prices which are representative of the mix of goods and 
        services included in such dialysis services for the calendar 
        year; exceeds
            ``(ii) the cost of such mix of goods and services for the 
        preceding calendar year.
    ``(B) In addition to determining the percentage update under 
subparagraph (A), the Secretary shall also take into account any 
increase in the costs of furnishing the mix of goods and services 
described in such subparagraph resulting from--
            ``(i) the adoption of scientific and technological 
        innovations used to provide dialysis services;
            ``(ii) changes in the manner or method of delivering 
        dialysis services;
            ``(iii) productivity improvements in the provision of 
        dialysis services; and
            ``(iv) any other relevant factor.
    ``(C) The Secretary shall periodically review and update (as 
necessary) the items and services included in the mix of goods and 
services used to determine the percentage under subparagraph (A).
    ``(D) The costs described in this subparagraph include--
            ``(i) labor, including direct patient care costs and 
        administrative labor costs, vacation and holiday pay, payroll 
        taxes, and employee benefits;
            ``(ii) other direct costs, including drugs, supplies, and 
        laboratory fees;
            ``(iii) overhead, including medical director fees, 
        temporary services, general and administrative costs, interest 
        expenses, and bad debt;
            ``(iv) capital, including rent, real estate taxes, 
        depreciation, utilities, repairs, and maintenance; and
            ``(v) such other allowable costs as the Secretary may 
        specify.''.

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