110 HR 6386 IH: To amend title XVIII of the Social Security Act to extend U.S. House of Representatives 2008-06-26 text/xml EN 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.

I 110th CONGRESS 2d Session H. R. 6386 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.

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. .