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<bill bill-stage="Introduced-in-House" dms-id="H6778050455EB4DBBAE166359D02743AB" public-private="public" bill-type="olc"> 
<metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>109 HR 2356 IH: Preserving Patient Access to Physicians Act of 2005</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2005-05-12</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
<form> 
<distribution-code display="yes">I</distribution-code> 
<congress>109th CONGRESS</congress> <session>1st Session</session> 
<legis-num>H. R. 2356</legis-num> 
<current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber> 
<action> 
<action-date date="20050512">May 12, 2005</action-date> 
<action-desc><sponsor name-id="S000303">Mr. Shaw</sponsor> (for himself and <cosponsor name-id="C000141">Mr. Cardin</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name>, and in addition to the Committee on <committee-name committee-id="HWM00">Ways and Means</committee-name>, 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</action-desc> 
</action> 
<legis-type>A BILL</legis-type> 
<official-title>To amend title XVIII of the Social Security Act to reform the Medicare physician payment update system through repeal of the sustainable growth rate (SGR) payment update system.</official-title> 
</form> 
<legis-body id="HFD0ACB1ED5F24F518EF70159DDB33232" style="OLC"> 
<section section-type="section-one" id="H265CD12FA9984F4F915B2285AC55B148" display-inline="no-display-inline"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Preserving Patient Access to Physicians Act of 2005</short-title></quote>.</text></section> 
<section id="H28FB61C9E2DD4063BBFFDBD98E6965B"><enum>2.</enum><header>Reform of the medicare physician payment update system through elimination of the sustainable growth rate (SGR) payment update system</header> 
<subsection id="H4180C63DEC3C480DA597AAEF61BF99E"><enum>(a)</enum><header>In general</header><text>Section 1848(d) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4(d)</external-xref>) is amended by adding at the end the following new paragraphs:</text> 
<quoted-block act-name="Social Security Act" id="H82129B33671F41B993E1DB97410781B8"> 
<paragraph id="HA0D34734528D498B8246AAAF77D20035"><enum>(6)</enum><header>Update for 2006</header><text>The update to the single conversion factor established in paragraph (1)(C) for 2006 shall not be less than 2.7 percent.</text></paragraph> 
<paragraph id="HCFEB03C2A5794E74936441E6713EA022"><enum>(7)</enum><header>Update for years beginning with 2007</header> 
<subparagraph id="HEDA5E8FFF932496BADDD63A848333924"><enum>(A)</enum><header>In general</header><text>Unless otherwise provided by law, subject to the budget-neutrality factor determined by the Secretary under subsection (c)(2)(B)(ii), the update to the single conversion factor established in paragraph (1)(C) for a year beginning with 2007 is equal to the product of—</text> 
<clause id="H88F2C377F3C444C3B26370B7CE9B647E"><enum>(i)</enum><text>1 plus the Secretary’s estimate of the percentage change in the value of the input price index (as provided under subparagraph (B)(ii)) for the year (divided by 100); and</text></clause> 
<clause id="H9E8A0ED5252247EF9E720057BE777037"><enum>(ii)</enum><text>1 minus the Secretary’s estimate of the productivity adjustment factor under subparagraph (C) for the year.</text></clause></subparagraph> 
<subparagraph id="H786B602953604D1FB577E4AAB8AF08BF"><enum>(B)</enum><header>Input price index</header> 
<clause id="H3B4B08EE91D246369095265048A500BF"><enum>(i)</enum><header>Establishment</header><text>Taking into account the mix of goods and services included in computing the medicare economic index (referred to in the fourth sentence of section 1842(b)(3)), the Secretary shall establish an index that reflects the weighted-average input prices for physicians’ services for a year. Such index shall only account for input prices and not changes in costs that may result from other factors (such as productivity).</text></clause> 
<clause id="H23F8A6CB245745839C96FE4FCADEBAEB"><enum>(ii)</enum><header>Annual estimate of change in index</header><text>The Secretary shall estimate, before the beginning of each year (beginning with 2007) the change in the value of the input price index under clause (i) from the previous year to the year involved.</text></clause></subparagraph> 
<subparagraph id="H82BEFD2CC5E441EA8675DB1725E45832"><enum>(C)</enum><header>Productivity adjustment factor</header><text>The Secretary shall estimate, and cause to be published in the Federal Register not later than November 1 before the beginning of each year (beginning with 2007), a productivity adjustment factor that reflects the Secretary’s estimate of growth in multifactor productivity in the national economy, taking into account growth in productivity attributable to both labor and nonlabor factors. Such adjustment may be based on a multi-year moving average of productivity (based on data published by the Bureau of Labor Statistics).</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> 
<subsection id="HFD6F17C446CF4D34BC76CB31934FBE4C"><enum>(b)</enum><header>Conforming amendments</header><text>Section 1848 of the Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395w-4">42 U.S.C. 1395w–4</external-xref>) is amended—</text> 
<paragraph id="HBE2E8F9BCF3040FABB25EDD3D4549994"><enum>(1)</enum><text>in subsection (d)(1)(A), by striking “subparagraph (B))” and all that follows and inserting the following: “subparagraph (B))—</text> 
<quoted-block id="HA0BA8A111EF046B0A0BA07421BE266E5"> 
<clause id="H85446ED6D68C4928B17BF3B9B2F1AB8"><enum>(i)</enum><text>for years before 2001, adjusted by the update (established under paragraph (3)) for the year involved;</text></clause> 
<clause id="HC36F79D8A91640E1A26821000011CE77"><enum>(ii)</enum><text>for 2001, 2002, and 2003, multiplied by the update (established under paragraph (4)) for the year involved;</text></clause> 
<clause id="H0413D4A69C5D4EE4AF08E8C099D32F74"><enum>(iii)</enum><text>for 2004 and 2005, multiplied by the update (established under paragraph (5)) for that year;</text></clause> 
<clause id="HA9AFA14533BA4EB5B78FFF4DB55BC0A"><enum>(iv)</enum><text>for 2006, multiplied by the update (established under paragraph (6)) for that year; and</text></clause> 
<clause id="HC6E0A349AAB04CC3BFD29465EFD3648E"><enum>(v)</enum><text>for 2007 and each subsequent year, multiplied by the update (established under paragraph (7)) for the year involved.</text></clause><after-quoted-block>;</after-quoted-block></quoted-block></paragraph> 
<paragraph id="H43F112781C624171AB75F8516076E466"><enum>(2)</enum><text>by striking clause (i) of subsection (d)(1)(E) and inserting the following:</text> 
<quoted-block id="HD3398889F78E45A5BC88AE3F85DC57CB"> 
<clause id="H7E6F05480B94446F9FDC78877015EBC8"><enum>(i)</enum><text>cause to have published in the Federal Register not later than November 1—</text> 
<subclause id="H909EE106604B4D270050D03364907C49"><enum>(I)</enum><text>of 2000 and each subsequent year, the conversion factor which will apply to physicians’ services for the succeeding year;</text></subclause> 
<subclause id="H63921D4D147B42DBB6EF15E0FE773214"><enum>(II)</enum><text>of 2000, 2001, and 2002, the update determined under paragraph (4) for such succeeding year and the allowed expenditures under such paragraph for the succeeding year;</text></subclause> 
<subclause id="H9DE05D6DBB634B839F485EE76677E1F6"><enum>(III)</enum><text>of 2003 and 2004, the update determined under paragraph (5) for 2004 and 2005;</text></subclause> 
<subclause id="HB501F9B8A26D4649B9DCBD9B43E7DB95"><enum>(IV)</enum><text>of 2005, the update determined under paragraph (6) for 2006; and</text></subclause> 
<subclause id="H816A747E31544ACDBD5B8E3616FCBD9C"><enum>(V)</enum><text>of 2006 and each subsequent year, the update determined under paragraph (7) for the succeeding year; and</text></subclause></clause><after-quoted-block>;</after-quoted-block></quoted-block></paragraph> 
<paragraph id="H4FD6159E3CD84222958879FF3CC25317"><enum>(3)</enum><text>in subsection (d)(1)(E)(ii), by inserting <quote>(for years before 2006)</quote> after <quote>the sustainable growth rate</quote>;</text></paragraph> 
<paragraph id="H61B0AA551C434C2B822DD17B2828616E"><enum>(4)</enum><text>in subsection (d)(4)—</text> 
<subparagraph id="H10828E19FA764483912699D2C37CF02"><enum>(A)</enum><text>in the heading, by striking <quote><header-in-text level="subsection" style="OLC">years beginning with 2001</header-in-text></quote> and inserting <quote><header-in-text level="subsection" style="OLC">2001, 2002, and 2003</header-in-text></quote> ;</text></subparagraph> 
<subparagraph id="H28BB64BC358F4410A5D4AA59D3A6264E"><enum>(B)</enum><text>in subparagraph (A), in the matter preceding clause (i), by striking <quote>for a year beginning with 2001</quote> and inserting <quote>for 2001, 2002, and 2003</quote>;</text></subparagraph> 
<subparagraph id="HCEBC20A2AC9648D3AFDEEDA73204DB00"><enum>(C)</enum><text>in subparagraph (C)(iii), by striking “<header-in-text>Years beginning with 2000</header-in-text>.—The allowed expenditures for a year (beginning with 2000)” and inserting “<header-in-text level="subparagraph" style="OLC">2000, 2001, and 2002.—</header-in-text>The allowed expenditures for each of years 2000, 2001, and 2002”; and</text></subparagraph> 
<subparagraph id="H54D03C823823476F833B135066DF32F4"><enum>(D)</enum><text>in subparagraph (E), by striking “<header-in-text>beginning with 2001</header-in-text>” and “for a year beginning with 2001” and inserting <quote><header-in-text level="subparagraph" style="OLC">2001, 2002, and 2003</header-in-text></quote> and “for 2001, 2002, and 2003”, respectively; and</text></subparagraph> </paragraph> 
<paragraph id="H42B614A3BBC245A88EE4DDDC8936F12"><enum>(5)</enum><text>in subsection (f)—</text> 
<subparagraph id="H493F4448D50B4F548ED7981AA54FC72"><enum>(A)</enum><text>in paragraph (1)(B), by striking <quote>November 1 of each succeeding year</quote> and inserting <quote>November 1 of each year before 2005</quote>;</text> </subparagraph> 
<subparagraph id="H6DAF38DFA41841E1AC5508916DAB884B"><enum>(B)</enum><text>in paragraph (2), by inserting <quote>and ending with 2003</quote> after <quote>beginning with 2000</quote>;</text></subparagraph> 
<subparagraph id="H84432A47667143CA804E11076383B400"><enum>(C)</enum><text>in paragraph (3), by striking <quote>for a year beginning with 2001</quote> and inserting <quote>for 2001, 2002, and 2003</quote>; and</text></subparagraph> 
<subparagraph id="H9FE6B489D88C43F09D688064ACBF7F24"><enum>(D)</enum><text>in paragraph (3)(C), by striking <quote><header-in-text level="subparagraph" style="OLC">for 2003 and succeeding years</header-in-text></quote> and inserting <quote><header-in-text level="subparagraph" style="OLC">for 2003</header-in-text></quote> and by striking <quote>a year after 2002</quote> and inserting <quote>2003</quote>.</text></subparagraph> </paragraph></subsection> </section> 
</legis-body> 
</bill> 


