[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3674 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 3674

    To amend title XVIII of the Social Security Act to increase the 
    nonfacility practice expense relative value units for specified 
             services furnished under the Medicare program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 25, 2023

Mr. Bilirakis (for himself, Mr. Cardenas, Mr. Murphy, and Mr. Davis of 
  Illinois) 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 increase the 
    nonfacility practice expense relative value units for specified 
             services furnished under the Medicare program.

    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 ``Providing Relief and Stability for 
Medicare Patients Act of 2023''.

SEC. 2. INCREASING THE NONFACILITY PRACTICE EXPENSE RELATIVE VALUE 
              UNITS FOR SPECIFIED SERVICES FURNISHED UNDER THE MEDICARE 
              PROGRAM.

    (a) In General.--Section 1848(c)(2) of the Social Security Act (42 
U.S.C. 1395w-4(c)(2)) is amended by adding at the end the following 
subparagraph:
                    ``(P) Increase of nonfacility practice expense 
                relative value units for specified services.--
                            ``(i) In general.--The Secretary shall 
                        increase the nonfacility practice expense 
                        relative value units applied to a specified 
                        service (as defined in clause (ii)) furnished 
                        in--
                                    ``(I) 2024, by 10 percent of the 
                                number of nonfacility practice expense 
                                relative value units that would 
                                otherwise apply to such service 
                                furnished in such year without 
                                application of this clause; and
                                    ``(II) 2025, by 15 percent of the 
                                number of nonfacility practice expense 
                                relative value units that would 
                                otherwise apply to such service 
                                furnished in such year without 
                                application of this clause.
                            ``(ii) Specified service defined.--For 
                        purposes of this subparagraph, the term 
                        `specified service' means, with respect to a 
                        service furnished in a year, a service with a 
                        nonfacility practice expense relative value 
                        unit that was calculated for such year (without 
                        application of this subparagraph) based on 65 
                        percent or more of the service's direct 
                        practice expense cost being attributed to 
                        equipment and supply costs.
                            ``(iii) Funding.--There shall be 
                        transferred from the General Fund of the 
                        Treasury to the Federal Supplementary Medical 
                        Insurance Trust Fund under section 1841 such 
                        sums as the Secretary determines are necessary 
                        for purposes of increasing payment amounts 
                        pursuant to this subparagraph, to remain 
                        available until expended.''.
    (b) Nonapplication of Budget Neutrality.--Section 1848(c)(2)(B)(iv) 
of the Social Security Act (42 U.S.C. 1395w-4(c)(2)(B)(iv)) is 
amended--
            (1) in subclause (IV), by striking ``; and'' and inserting 
        a semicolon;
            (2) in subclause (V), by striking the period at the end and 
        inserting ``; and''; and
            (3) by adding at the end the following new subclause:
                                    ``(VI) subparagraph (P) shall not 
                                be taken into account in applying 
                                clause (ii)(II).''.
    (c) Report.--Not later than 1 year after the date of the enactment 
of this Act, the Comptroller General of the United States shall submit 
to Congress a report on the Medicare physician fee schedule and patient 
access, including--
            (1) an analysis of the number of health care providers 
        furnishing specified services (as defined in section 
        1848(c)(2)(P) of the Social Security Act, as added by 
        subsection (a)) in a nonfacility setting under the Medicare 
        program over the 20 year period ending on such date of 
        enactment, including a description of any changes in volume of 
        such services furnished under such program and the availability 
        of such services under such program and a description of wait-
        times, decreased hours, other factors that could impede a 
        patient's access to such services (such as increased cost 
        sharing);
            (2) an analysis of any change in the proportion of services 
        payable under such schedule furnished in nonfacility settings 
        compared to the proportion of such services furnished at other 
        sites of service over such period, including an analysis of the 
        impact of any such change on health system consolidation, 
        underserved and rural populations, quality of care of Medicare 
        beneficiaries, and increased cost to the Medicare program;
            (3) an analysis of whether significant annual changes in 
        provider reimbursement are a cause of any change described in 
        paragraph (2), disruptions in patient access to services, and 
        increased cost sharing; and
            (4) taking into account the analyses described in 
        paragraphs (1) through (3), recommendations for improving 
        Medicare patient access to specified services (as defined in 
        section 1848(c)(2)(P) of the Social Security Act, as added by 
        subsection (a)) and minimizing health system consolidation.
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