[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 1135 Introduced in Senate (IS)]







108th CONGRESS
  1st Session
                                S. 1135

To amend title XVIII of the Social Security Act to establish a uniform 
               national medicare physician fee schedule.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 22, 2003

 Mr. Hatch (for himself, Mr. Jeffords, Mr. Grassley, 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 establish a uniform 
               national medicare physician fee schedule.

    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 Physician Payment Equity 
Act of 2003''.

SEC. 2. ESTABLISHMENT OF UNIFORM NATIONAL MEDICARE PHYSICIAN FEE 
              SCHEDULE.

    (a) In General.--Section 1848(e)(1) of the Social Security Act (42 
U.S.C. 1395w-4(e)(1)) is amended--
            (1) in subparagraph (A), by striking ``(B) and (C)'' and 
        inserting ``(B), (C), (D), and (E)'' in the matter preceding 
        clause (i);
            (2) by redesignating subparagraph (D) as subparagraph (F); 
        and
            (3) by inserting after subparagraph (C) the following new 
        subparagraph:
                    ``(D) Uniform national medicare physician fee 
                schedule rates.--For purposes of payment for services 
                furnished on or after January 1, 2007, the Secretary 
                shall set each geographic index in subparagraphs (A) 
                and (B) to 1.00 for any locality for which such a 
                geographic index is not 1.00.''.
    (b) Transition for Elimination of Geographic Fee Differential.--
Section 1848(e)(1) of the Social Security Act (42 U.S.C. 1395w-
4(e)(1)), as amended by subsection (a), is amended by inserting after 
subparagraph (D) the following new subparagraph:
                    ``(E) Phase-out of geographic adjustment indices.--
                            ``(i) Three-year floor at 1.0 on geographic 
                        physician work adjustment index.--After 
                        calculating the geographic physician work 
                        indices in subparagraph (A)(iii), for purposes 
                        of payment for services furnished on or after 
                        January 1, 2004, and before January 1, 2007, 
                        the Secretary shall increase such physician 
                        work index to 1.00 for any locality for which 
                        such physician work index is less than 1.00.
                            ``(ii) Two-year floor at 1.0 on geographic 
                        cost-of-practice adjustment index.--After 
                        calculating the geographic cost-of-practice 
                        indices in subparagraphs (A)(i) and (B), for 
                        purposes of payment for services furnished on 
                        or after January 1, 2005, and before January 1, 
                        2007, the Secretary shall increase such cost-
                        of-practice indices to 1.00 for any locality 
                        for which such cost-of-practice indices are 
                        less than 1.00.
                            ``(iii) One-year floor at 1.0 on geographic 
                        malpractice adjustment index.--After 
                        calculating the geographic malpractice indices 
                        in subparagraph (A)(ii), for purposes of 
                        payment for services furnished during 2006, the 
                        Secretary shall increase such malpractice index 
                        to 1.00 for any locality for which such 
                        malpractice index is less than 1.00.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to payments for items and services provided on and after January 
1, 2004.

SEC. 3. GAO STUDY AND REPORT ON THE EFFECTS OF THE REVISIONS TO THE 
              MEDICARE PHYSICIAN FEE SCHEDULE.

    (a) Study.--The Comptroller General of the United States shall 
conduct a study on the effects of the amendments made by section 2 on--
            (1) the recruitment and retention of physicians;
            (2) the access of medicare beneficiaries to physicians, 
        medical tests, and medical therapies in each fee schedule area 
        (as defined in section 1848(j)(2) of the Social Security Act 
        (42 U.S.C. 1395w-4(j)(2)); and
            (3) the use by medicare beneficiaries of items and services 
        for which payment may be made under the medicare program in 
        each such fee schedule area.
    (b) Report.--Not later than the date that is 5 years after the date 
of enactment of this Act, the Comptroller General shall submit to 
Congress a report on the study conducted under subsection (a) together 
with such recommendations as the Comptroller General determines to be 
appropriate.
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