[Congressional Record Volume 149, Number 7 (Wednesday, January 15, 2003)]
[Senate]
[Page S856]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DAYTON:
  S. 171. A bill to amend the title XVIII of the Social Security Act to 
provide payment to medicare ambulance suppliers of the full costs of 
providing such services, and for other purposes; to the Committee on 
Finance.
  Mr. DAYTON. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 171

       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 Ambulance Payment 
     Reform Act of 2003''.

     SEC. 2. AMBULANCE PAYMENT RATES.

       (a) Payment Rates.--
       (1) In General.--Section 1834(l)(3) of the Social Security 
     Act (42 U.S.C. 1395m(l)(3)) is amended to read as follows:
       ``(3) Payment rates.--
       ``(A) In general.--Subject to any adjustment under 
     subparagraph (B) and paragraph (9) and the full payment of a 
     national mileage rate pursuant to paragraph (2)(E), in 
     establishing such fee schedule, the following rules shall 
     apply:
       ``(i) Payment rates in 2003.--

       ``(I) Ground ambulance services.--In the case of ground 
     ambulance services furnished under this part in 2003, the 
     Secretary shall set the payment rates under the fee schedule 
     for such services at a rate based on the average costs (as 
     determined by the Secretary on the basis of the most recent 
     and reliable information available) incurred by full cost 
     ambulance suppliers in providing nonemergency basic life 
     support ambulance services covered under this title, with 
     adjustments to the rates for other ground ambulance service 
     levels to be determined based on the rule established under 
     paragraph (1). For the purposes of the preceding sentence, 
     the term `full cost ambulance supplier' means a supplier for 
     which volunteers or other unpaid staff comprise less than 20 
     percent of the supplier's total staff and which receives less 
     than 20 percent of space and other capital assets free of 
     charge.
       ``(II) Other ambulance services.--In the case of ambulance 
     services not described in subclause (I) that are furnished 
     under this part in 2003, the Secretary shall set the payment 
     rates under the fee schedule for such services based on the 
     rule established under paragraph (1).

       ``(ii) Payment rates in subsequent years for all ambulance 
     services.--In the case of any ambulance service furnished 
     under this part in 2004 or any subsequent year, the Secretary 
     shall set the payment rates under the fee schedule for such 
     service at amounts equal to the payment rate under the fee 
     schedule for that service furnished during the previous year, 
     increased by the percentage increase in the Consumer Price 
     Index for all urban consumers (United States city average) 
     for the 12-month period ending with June of the previous 
     year.
       ``(B) Adjustment in rural rates.--For years beginning with 
     2004, the Secretary, after taking into consideration the 
     recommendations contained in the report submitted under 
     section 221(b)(3) the Medicare, Medicaid, and SCHIP Benefits 
     Improvements and Protection Act of 2000, shall adjust the fee 
     schedule payment rates that would otherwise apply under this 
     subsection for ambulance services provided in low density 
     rural areas based on the increased cost (if any) of providing 
     such services in such areas.''.
       (2) Conforming amendment.--Section 221(c) of the Medicare, 
     Medicaid, and SCHIP Benefits Improvement and Protection Act 
     of 2000 (114 Stat. 2763A-487), as enacted into law by section 
     1(a)(6) of Public Law 106-554, is repealed.
       (b) Use of Medical Conditions for Coding Ambulance 
     Services.--Section 1834(l)(7) of the Social Security Act (42 
     U.S.C. 1395m(l)(7)) is amended to read as follows:
       ``(7) Coding system.--
       ``(A) In general.--The Secretary shall, in accordance with 
     section 1173(c)(1)(B), establish a system or systems for the 
     coding of claims for ambulance services for which payment is 
     made under this subsection, including a code set specifying 
     the medical condition of the individual who is transported 
     and the level of service that is appropriate for the 
     transportation of an individual with that medical condition.
       ``(B) Medical conditions.--The code set established under 
     subparagraph (A) shall--
       ``(i) take into account the list of medical conditions 
     developed in the course of the negotiated rulemaking process 
     conducted under paragraph (1); and
       ``(ii) notwithstanding any other provision of law, be 
     adopted as a standard code set under section 1173(c).''.
                                 ______