[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6386 Introduced in House (IH)]







110th CONGRESS
  2d Session
                                H. R. 6386

 To amend title XVIII of the Social Security Act to extend and revise 
  incentive payments for physician scarcity areas under part B of the 
                           Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 26, 2008

  Mr. McCarthy of California introduced the following bill; which was 
 referred to the Committee on Energy and Commerce, and in addition to 
   the Committee on Ways and Means, 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 amend title XVIII of the Social Security Act to extend and revise 
  incentive payments for physician scarcity areas under part B of the 
                           Medicare Program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. EXTENSION AND REVISION OF MEDICARE INCENTIVE PAYMENTS FOR 
              PHYSICIAN SCARCITY AREAS.

    (a) 5-Year Extension.--Paragraph (1) of section 1833(u) of the 
Social Security Act (42 U.S.C. 1395l(u)) is amended by striking 
``2008'' and inserting ``2012''.
    (b) Change in Eligibility Criteria.--Such section is further 
amended--
            (1) in paragraph (1)(A)--
                    (A) by inserting ``or paragraph (8), as the case 
                may be'' after ``paragraph (4)''; and
                    (B) by inserting ``(or 2.5 percent in the cases 
                specified in paragraph (8))'' after ``5 percent'';
            (2) in each of clauses (i) and (ii) of paragraph (2)(C), by 
        inserting ``and paragraph (8)'' after ``in this paragraph'';
            (3) in paragraph (3), by striking ``The Secretary'' and 
        inserting ``For years before 2009, the Secretary'';
            (4) in paragraph (4)(A), by striking ``The Secretary'' and 
        inserting ``For years before 2009, the Secretary''; and
            (5) by adding at the end the following new paragraph:
            ``(8) New rules for scarcity areas.--
                    ``(A) In general.--Subject to subparagraph (B)(ii), 
                in applying paragraph (1) in the case of physicians' 
                services furnished on or after July 1, 2008--
                            ``(i) the term `primary care scarcity 
                        county' means a county (or equivalent area) 
                        which the Secretary identifies as having a 
                        primary care ratio (as determined under 
                        paragraph (2)(C)(i)) of less than 1 to 150;
                            ``(ii) the term `specialist care scarcity 
                        county' means a county (or equivalent area) 
                        which the Secretary identifies as having a 
                        specialist care ratio (as determined under 
                        paragraph (2)(C)(ii)) of less than 1 to 150;
                            ``(iii) for physicians' services furnished 
                        by a primary care physician in a primary care 
                        scarcity county (as defined in clause (i)) 
                        which the Secretary identifies under such 
                        clause as having a primary care ratio of more 
                        than 1 to 300, `2.5 percent' shall be 
                        substituted for `5 percent' in paragraph (1); 
                        and
                            ``(iv) for physicians' services furnished 
                        by a physician, who is not a primary care 
                        physician, in a specialist care scarcity county 
                        (as defined in clause (ii)) which the Secretary 
                        identifies under such clause as having a 
                        specialist care ratio of more than 1 to 300, 
                        `2.5 percent' shall be substituted for `5 
                        percent' in paragraph (1).
                The provisions of subparagraphs (B) through (D) of 
                paragraph (4) shall apply to identification of counties 
                under this subparagraph in the same manner as they 
                apply to the identification of counties under 
                subparagraph (A) of paragraph (4).
                    ``(B) Review of ratios.--
                            ``(i) Study.--The Secretary, in 
                        consultation with the Medicare Payment Advisory 
                        Commission and the Comptroller General of the 
                        United States, shall conduct a study to better 
                        determine whether the primary and specialist 
                        care ratios applied under subparagraph (A) are 
                        appropriate to provide the proper incentive 
                        payments for physician scarcity areas.
                            ``(ii) Authority to apply different 
                        ratios.--In the case of physicians' services 
                        furnished on or after such date (no earlier 
                        than January 1, 2012) as the Secretary may 
                        specify, if the Secretary determines based on 
                        the study conducted under clause (i) that other 
                        ratios should be substituted for the 1-to-300 
                        and 1-to-150 ratios specified in subparagraph 
                        (A), the Secretary may substitute such other 
                        ratios in applying such subparagraph.''.
                                 <all>