To amend title XVIII of the Social Security Act to establish a uniform national medicare physician fee schedule.

May 22, 2003

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

To amend title XVIII of the Social Security Act to establish a uniform national medicare physician fee schedule.

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 Physician Payment Equity Act of 2003'.

SEC. 2. ESTABLISHMENT OF UNIFORM NATIONAL MEDICARE PHYSICIAN FEE SCHEDULE.

(a) IN GENERAL- 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 `(B) and (C)' and inserting `(B), (C), (D), and (E)' in the matter preceding clause (i);

(2) by redesignating subparagraph (D) as subparagraph (F); and

(3) by inserting after subparagraph (C) the following new subparagraph:

`(D) UNIFORM NATIONAL MEDICARE PHYSICIAN FEE SCHEDULE RATES- For purposes of payment for services furnished on or after January 1, 2007, the Secretary shall set each geographic index in subparagraphs (A) and (B) to 1.00 for any locality for which such a geographic index is not 1.00.'.

(b) TRANSITION FOR ELIMINATION OF GEOGRAPHIC FEE DIFFERENTIAL- Section 1848(e)(1) of the Social Security Act (42 U.S.C. 1395w-4(e)(1)), as amended by subsection (a), is amended by inserting after subparagraph (D) the following new subparagraph:

`(E) PHASE-OUT OF GEOGRAPHIC ADJUSTMENT INDICES-

`(i) THREE-YEAR FLOOR AT 1.0 ON GEOGRAPHIC PHYSICIAN WORK ADJUSTMENT INDEX- After calculating the geographic physician work indices in subparagraph (A)(iii), for purposes of payment for services furnished on or after January 1, 2004, and before January 1, 2007, the Secretary shall increase such physician work index to 1.00 for any locality for which such physician work index is less than 1.00.

`(ii) TWO-YEAR FLOOR AT 1.0 ON GEOGRAPHIC COST-OF-PRACTICE ADJUSTMENT INDEX- After calculating the geographic cost-of-practice indices in subparagraphs (A)(i) and (B), for purposes of payment for services furnished on or after January 1, 2005, and before January 1, 2007, the Secretary shall increase such cost-of-practice indices to 1.00 for any locality for which such cost-of-practice indices are less than 1.00.

`(iii) ONE-YEAR FLOOR AT 1.0 ON GEOGRAPHIC MALPRACTICE ADJUSTMENT INDEX- After calculating the geographic malpractice indices in subparagraph (A)(ii), for purposes of payment for services furnished during 2006, the Secretary shall increase such malpractice index to 1.00 for any locality for which such malpractice index is less than 1.00.'.

(c) EFFECTIVE DATE- The amendments made by this section shall apply to payments for items and services provided on and after January 1, 2004.

SEC. 3. GAO STUDY AND REPORT ON THE EFFECTS OF THE REVISIONS TO THE MEDICARE PHYSICIAN FEE SCHEDULE.

(a) STUDY- The Comptroller General of the United States shall conduct a study on the effects of the amendments made by section 2 on--

(1) the recruitment and retention of physicians;

(2) the access of medicare beneficiaries to physicians, medical tests, and medical therapies in each fee schedule area (as defined in section 1848(j)(2) of the Social Security Act (42 U.S.C. 1395w-4(j)(2)); and

(3) the use by medicare beneficiaries of items and services for which payment may be made under the medicare program in each such fee schedule area.

(b) REPORT- Not later than the date that is 5 years after the date of enactment of this Act, the Comptroller General shall submit to Congress a report on the study conducted under subsection (a) together with such recommendations as the Comptroller General determines to be appropriate.

END