Home > 106th Congressional Bills > S. 882 (is) To strengthen provisions in the Energy Policy Act of 1992 and the Federal Nonnuclear Energy Research and Development Act of 1974 with respect to potential Climate Change. [Introduced in Senate] ...

S. 882 (is) To strengthen provisions in the Energy Policy Act of 1992 and the Federal Nonnuclear Energy Research and Development Act of 1974 with respect to potential Climate Change. [Introduced in Senate] ...


Google
 
Web GovRecords.org








108th CONGRESS
  1st Session
                                 S. 881

To amend title XVIII of the Social Security Act to establish a minimum 
   geographic cost-of-practice index value for physicians' services 
                 furnished under the medicare program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 10, 2003

 Mr. Bingaman (for himself, Mr. Cochran, Mrs. Lincoln, Mr. Hatch, Mr. 
Jeffords, Ms. Landrieu, and Mr. Dayton) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to establish a minimum 
   geographic cost-of-practice index value for physicians' 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; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Rural Equity 
Payment Index Reform Act of 2003''.
    (b) Findings.--Congress makes the following findings:
            (1) Variations in the physician work adjustment factors 
        under section 1848(e) of the Social Security Act (42 U.S.C. 
        1395w-4w(e)) result in a physician work payment inequity 
        between urban and rural localities under the medicare physician 
        fee schedule.
            (2) The amount the medicare program spends on its 
        beneficiaries varies substantially across the country, far more 
        than can be accounted for by differences in the cost of living 
        or differences in health status.
            (3) Since beneficiaries and others pay into the program on 
        the basis of income and wages and beneficiaries pay the same 
        premium for part B services, these payments result in 
        substantial cross-subsidies from people living in low payment 
        States with conservative practice styles or beneficiary 
        preferences to people living in higher payment States with 
        aggressive practice styles or beneficiary preferences.
            (4) Congress has been mindful of these variations when it 
        comes to capitation payments made to managed care plans under 
        the Medicare+Choice program and has put in place floors that 
        increase monthly payments by more than one-third in some of the 
        lowest payment counties over what would otherwise occur. But 
        this change addresses only a very small fraction of medicare 
        beneficiaries who are presently enrolled in Medicare+Choice 
        plans operating in low payment counties.
            (5) Unfortunately, Congress has only begun to address the 
        underlying problem of substantial geographic variations in fee-
        for-service spending under traditional medicare.
            (6) Improvements in rural hospital payment systems under 
        the medicare program help to reduce aggregate per capita 
        payment variation as rural hospitals are in large part located 
        in low payment counties.
            (7) Many rural communities have great difficulty attracting 
        and retaining physicians and other skilled health 
        professionals.
            (8) Targeted efforts to provide relief to rural doctors in 
        low payment localities would further reduce variation by 
        improving access to primary and tertiary services along with 
        more equitable payment.
            (9) Geographic adjustment factors in the medicare program's 
        resource-based relative value scale unfairly suppress fee-for-
        service payments to rural providers.
            (10) Actual costs are not presently being measured 
        accurately and payments do not reflect the costs of providing 
        care.
            (11) Unless something is done about medicare payment in 
        rural areas, as the baby boom cohort ages into medicare, the 
        financial demands on rural communities to subsidize care for 
        their aged and disabled medicare beneficiaries will progress 
        from difficult to impossible in another 10 years.
            (12) The impact on rural health care infrastructure will be 
        first felt in economically depressed rural areas where the 
        ability to shift costs is already limited.

SEC. 2. PHYSICIAN FEE SCHEDULE WAGE INDEX REVISION.

    Section 1848(e)(1) of the Social Security Act (42 U.S.C. 1395w-
4(e)(1)) is amended--
            (1) in subparagraph (A), by striking ``subparagraphs (B) 
        and (C)'' and inserting ``subparagraphs (B), (C), and (E)''; 
        and
            (2) by adding at the end the following new subparagraph:
                    ``(E) Floor for work geographic indices.--
                            ``(i) In general.--Notwithstanding the work 
                        geographic index otherwise calculated under 
                        subparagraph (A)(iii), in no case may the work 
                        geographic index applied for payment under this 
                        section be less than--
                                    ``(I) 0.976 for services furnished 
                                during 2004;
                                    ``(II) 0.987 for services furnished 
                                during 2005;
                                    ``(III) 0.995 for services 
                                furnished during 2006; and
                                    ``(IV) 1.000 for services furnished 
                                during 2007 and subsequent years.
                            ``(ii) Exemption from limitation on annual 
                        adjustments.--The increase in expenditures 
                        attributable to clause (i) shall not be taken 
                        into account in applying subsection 
                        (c)(2)(B)(ii)(II).''.
                                 <all>

Pages: 1

Other Popular 106th Congressional Bills Documents:

1 S. 3181 (es) To establish the White House Commission on the National Moment of Remembrance, and for other purposes. [Engrossed in Senate] ...
2 H.R. 3217 (ih) To assist the efforts of farmers and cooperatives seeking to engage in value-added processing of agricultural goods. [Introduced in House] ...
3 H.R. 4579 (eh) To provide for the exchange of certain lands within the State of Utah. [Engrossed in House] ...
4 H.R. 911 (ih) To designate the Federal building located at 310 New Bern Avenue in Raleigh, North Carolina, as the ``Terry Sanford Federal Building''. [Introduced in House] ...
5 H.R. 3239 (ih) To require any organization that is established for the purpose of raising funds for the creation of a Presidential archival depository to disclose the sources and amounts of any funds raised. [Introduced in House] ...
6 H.R. 2607 (rfs) To promote the development of the commercial space transportation [Referred in Senate] ...
7 S. 283 (is) To amend the Internal Revenue Code of 1986 to provide a partial exclusion from gross income for dividends and interest received by individuals. [Introduced in Senate] ...
8 H.R. 4869 (ih) To amend the Clayton Act to protect American consumers from foreign drug price discrimination. [Introduced in House] ...
9 H.R. 5644 (ih) To amend title 5, United States Code, to move the legal public holiday known as Washington's Birthday to election day in Presidential election years. [Introduced in House] ...
10 H.Res. 678 (ath) Providing for the printing of a revised edition of the Rules and Manual of the House of Representatives for the One Hundred Seventh Congress. [Agreed to House] ...
11 H.R. 3657 (rh) To provide for the conveyance of a small parcel of public domain land in the San Bernardino National Forest in the State of California, and for other purposes. [Reported in House] ...
12 S. 453 (es) To designate the Federal building located at 709 West 9th Street in Juneau, Alaska, as the ``Hurff A. Saunders Federal Building''. [Engrossed in Senate] ...
13 S. 1854 (es) To reform the Hart-Scott-Rodino Antitrust Improvements Act of 1976. [Engrossed in Senate] ...
14 S. 101 (is) To promote trade in United States agricultural commodities, livestock, and value-added products, and to prepare for future bilateral and multilateral trade negotiations. [Introduced in Senate] ...
15 H.R. 4640 (ih) To make grants to States for carrying out DNA analyses for use in the [Introduced in House] ...
16 S. 872 (is) To impose certain limits on the receipt of out-of-State municipal solid waste, to authorize State and local controls over the flow of municipal solid waste, and for other purposes. [Introduced in Senate] ...
17 H.R. 1377 (enr) To designate the facility of the United States Postal Service located at 9308 South Chicago Avenue, Chicago, Illinois, as the ``John J. Buchanan Post Office Building''. [Enrolled bill] ...
18 S. 747 (is) To amend title 49, United States Code, to promote rail competition, and for other purposes. [Introduced in Senate] ...
19 H.R. 434 (eh) To authorize a new trade and investment policy for sub-Sahara Africa. [Engrossed in House] ...
20 H.R. 4921 (ih) To amend title 38, United States Code, to revise the eligibility criteria for presumption of service-connection of certain diseases and disabilities for veterans exposed to ionizing radiation during military service. [Introduced in House] %...
21 H.R. 1379 (enr) To amend the Omnibus Consolidated and Emergency Supplemental Appropriations Act, 1999, to make a technical correction relating to international narcotics control assistance. [Enrolled bill] ...
22 H.Con.Res. 333 (enr) [Enrolled bill] ...
23 H.R. 5621 (ih) To amend the Balanced Budget Act of 1997 to apply the Medicaid disproportionate share hospital payment transition rule to public hospitals in all States. [Introduced in House] ...
24 H.R. 3785 (ih) To suspend temporarily the duty on machines, and their parts, for use in the manufacture of digital versatile discs (DVDs). [Introduced in House] ...
25 H.R. 195 (ih) To apply the rates of duty effective after December 31, 1994, to certain water resistant wool trousers that were entered, or withdrawn from warehouse for consumption, after December 31, 1988, and before January 1, 1995. [Introduced in House]...
26 H.R. 4846 (eh) To establish the National Recording Registry in the Library of Congress to maintain and preserve sound recordings that are culturally, historically, or aesthetically significant, and for other purposes. [Engrossed in House] ...
27 H.J.Res. 27 (ih) Providing for the reappointment of Dr. Hanna H. Gray as a citizen regent of the Board of Regents of the Smithsonian Institution. [Introduced in House] ...
28 H.R. 5166 (ih) To amend titles XVIII and XIX of the Social Security Act to impose requirements with respect to staffing in nursing facilities receiving Medicare or Medicaid funding. [Introduced in House] ...
29 H.R. 1729 (rh) To designate the Federal facility located at 1301 Emmet Street in Charlottesville, Virginia, as the ``Pamela B. Gwin Hall''. [Reported in House] ...
30 H.R. 1749 (rh) To designate Wilson Creek in Avery and Caldwell Counties, North Carolina, as a component of the National Wild and Scenic Rivers System. [Reported in House] ...


Other Documents:

106th Congressional Bills Records and Documents

GovRecords.org presents information on various agencies of the United States Government. Even though all information is believed to be credible and accurate, no guarantees are made on the complete accuracy of our government records archive. Care should be taken to verify the information presented by responsible parties. Please see our reference page for congressional, presidential, and judicial branch contact information. GovRecords.org values visitor privacy. Please see the privacy page for more information.
House Rules:

104th House Rules
105th House Rules
106th House Rules

Congressional Bills:

104th Congressional Bills
105th Congressional Bills
106th Congressional Bills
107th Congressional Bills
108th Congressional Bills

Supreme Court Decisions

Supreme Court Decisions

Additional

1995 Privacy Act Documents
1997 Privacy Act Documents
1994 Unified Agenda
2004 Unified Agenda

Congressional Documents:

104th Congressional Documents
105th Congressional Documents
106th Congressional Documents
107th Congressional Documents
108th Congressional Documents

Congressional Directory:

105th Congressional Directory
106th Congressional Directory
107th Congressional Directory
108th Congressional Directory

Public Laws:

104th Congressional Public Laws
105th Congressional Public Laws
106th Congressional Public Laws
107th Congressional Public Laws
108th Congressional Public Laws

Presidential Records

1994 Presidential Documents
1995 Presidential Documents
1996 Presidential Documents
1997 Presidential Documents
1998 Presidential Documents
1999 Presidential Documents
2000 Presidential Documents
2001 Presidential Documents
2002 Presidential Documents
2003 Presidential Documents
2004 Presidential Documents

Home Executive Judicial Legislative Additional Reference About Privacy